Wednesday, February 20, 2008

Increased Happiness for Trekkers

It occurs to me that a couple of my experiences in the Himalayas could be of benefit to a handful of people who might actually plug the proper keywords into a search engine. So here's today's meager contribution to world happiness:

I've had Achilles tendonitis for a number of years. Not a huge worst it forces me to hobble, and to refrain from high-impact sports for fear of exacerbating the problem. Most of the time it goes unnoticed. When considering a jaunt into the Himalayas last year, the Achilles was my biggest worry. You don't want the tendonitis to flare up when you're a week's trek away from any transportation.

I'm happy to report that the Achilles was a total non-factor in two weeks of fairly intense trekking. I even wonder if the trekking was somehow therapeutic...a year after the trek, the tendonitis seems less problematic than ever. Some non-medical advice based on one guy's experience: don't let a mild case of Achilles tendonitis inhibit a Himalayan adventure.


About 15 years ago I busted up my knee in a motorcycle accident. The PCL and ACL ligaments were severed, and the MCL torn. Surgery ensued. A year later, I was back in the Himalayas. Favoring my weak knee, I quickly incurred a fairly nasty case of "trekker's knee" in the strong knee. Worse than the pain was the frustration and humiliation of having to hobble through this amazing region. After three weeks in this state, I stumbled into a clinic located just a day's trek from Everest itself. The doctor, a Westerner, supplied me with ibuprofen for the inflamed joint.

I want to report that the result of taking this commonplace, over-the-counter drug was downright miraculous: within 30 minutes, I was walking normally, with only a dull reminder of the pain that had been stifling me for weeks. World-happiness-enhancing advice #2: bring plenty of ibuprofen along for any extended trek. Even if you're fairly confident in the ability of your knees to endure a pounding, you'll probably run into other folks who have a clear case of trekker's knee.

I can recall one case where I offered up the drug to some gimpy dude who had wrapped a t-shirt around his bum knee. Perhaps my enthusiasm for the miracle-inducing powers of ibuprofen was too intense, though, since he shunned me like a smack dealer ("I don't do that"), and hobbled away to another two weeks of pained trekking.

Of course, avoiding trekker's knee would be preferable to dependance on any drug, no matter how innocuous. The obvious advice would be to enter the trek with well-prepared knees. Less obvious is the following: take it easy on the downward slopes, particularly on the early stages of the trek. There's no need to rapidly bound from stone to stone, incurring repeated impacts to the joints, even if gravity seems to be on your side. If you have a history of weakness/injury in one knee, try to be mindful of whether you're favoring the stronger leg or not.

In terms of preparation, there are a lot of suggestions on the web. My own wisdom, for what it's worth, is to mimic trekking as closely as possible. If your preparation is restricted to the fitness club, don't assume that the stairclimber approximates the real thing. You'll be taking big steps in the mountains, stressing your gluteus maximus far more than you do on the stairclimber. You'll probably find that the cycling machines, set with high resistance and a low seat, do a much better job of stressing your glutes.

Your knees will take a pounding in the mountains. Question is, will a pre-pounding help "innoculate" them from various maladies (e.g. trekker's knee), or are you better off sticking with low-impact routines in the fitness club? I'm not sure about the medical literature, but there does seem to be anecdotal evidence that a pre-pounding might be worthwhile. In that case, don't avoid the treadmill. You want to give your knees repeated jolts, something they won't get on the stairclimber or cycling machines. The problem there, or course, is that you could injure your joints. With that in mind, you could begin to lay off the really heavy impact routines as your flight to Kathmandu draws nearer.