Showing posts with label PCT injury. Show all posts
Showing posts with label PCT injury. Show all posts

Sunday, July 3, 2016

Broken Leg Anniversary

Celebrating two years since my stress fracture with a solo backpacking trip up Broken Leg Mountain in the Swan Range of northwestern Montana.
This is as high as I climbed.  Because it’s OK to turn around and not risk injury to reach the summit.
The stress fracture turned out to be a turning point in my life, shaping my PCT experience and my time beyond.  It is something that I think about everyday.
No longer following any footprints that came before.  Must make my own way forward.
Still wearing the same hiking shoe style and microspikes that I was when I got the stress fracture.  Sometimes I wonder how much has changed in two years.  Certainly not my gear.  But how about the things that matter?
Because of those heartbreaking ten weeks that it took to heal from my injury in 2014, I learned I couldn’t continue to have hiking be my sole source of happiness.  Happiness couldn’t be dependent on anything external.  Instead I found that joy that bubbles up from inside.
The sweet scent of wildflowers.
Something also clicked inside me after the stress fracture that made me want to find out what it means to give back.  At the time, the pain and disappointment were consuming and overwhelming.  Thankfully, I was surrounded by supportive friends that made all the difference.  I joined AmeriCorps in 2015 and signed up for another term this year.  Serving in AmeriCorps doesn't even begin to repay the generosity that had been shown to me, but it's a start.  And it shows me how I want to be in the world. From that desire to give back, I ended up finding my new passion that I hope can turn into the what-I-do-with-my-life.
When I look out into the distance to twinkling of small town lights, it makes me wonder about my place within the larger community.  From my hammock hung beside wildflower meadow, overlooking sunset sky.  What am I doing out here by myself?  What am I doing with this one precious but seeminly brief life I have?
Entering the world of parks, I also had to let go of the labels that I thought defined me and were so important in my old world— Dr., scientist, evolutionary biologist.  My old identity shattered when I left the ivory tower.  Disarmed may be the best descriptor.  I started fresh, humbled.  I could no longer wrap protective layers of labels around myself.  It turned out to be a good way of being.
Wrapped in my hoodie, surrounded by down, within the hammock.  And yet, there is not much at all between me and the world here.  Wind gusts in.  The ticks find their way in.  I feel part of it all here.
I used to think that life was about finding that one singular thing that you were good at, and then pursuing that one thing to an extraordinary degree of specialization until expertise was achieved.  Now I see that a rich life can take on multiple trajectories.  A rich life involves growth.  Growth can happen quickly by starting fresh.  Switching from one track to another involves so much letting go (as painful as that can be for those that like to cling and resist change.)
Glaciers left those lines in the rock.  Glaciers carved that valley.  Sometimes, it helps to sit still and think about all the things that used to be here, but are gone now- the layers of rocks that got scraped away, the miles and miles of glaciers that moved through here.  And how smooth and beautiful that which remains is.  (Does the smooth rock miss the glaciers?  Does it miss being hidden beneith other layers of rock?)
Changing light of sunset.
Two years later, I can celebrate the anniversary of my stress fracture by appreciating the changes that came as a result.  Now life outside long trails has never seemed brighter.

Date hiked: May 30-31, 2016
Trail hiked: Echo Broken Leg Trail #544 in Flathead National Forest

Tuesday, January 13, 2015

How to have a successful hike

It’s not about planning.  It’s not about food.  It’s not about gear.  Sorry.  Those of you who are planning a thru hike of the PCT might want to click on those links if you want to be directed to blog posts that I’ve already written about tangible things to do to prepare for your hike.  In contrast, this other stuff is not so easy, especially for someone who, like me, organizes everything with spreadsheets and to-do lists.  But it is valuable to examine what it means to have a successful hike.  My hope is that some things I’ve learned could help you.

What I thought before:
I used to buy into the myth that a successful hike on the PCT meant hiking all the way from Mexico to Canada in a single year.   I really should have known better.  I am aware that not everyone thinks this way.  Some people still take HYOH to heart, but this is rare.  Being immersed in backpacking culture, it was hard to not believe that messages around me that said:

    - Faster meant better.
    - Keep going no matter what.
    - Thru hikers were superior to section hikers.

I idolized thru hikers.  I wanted to be like the strong women whose trail journals I’d read.  I saw how thru hikers proclaimed their daily mileages- success quantified in a way I could understand and measure myself against.  I wanted to be successful just like them.
I wanted to be just like this badass PCT hiker- strong & confident.  Wait... who is that? Looks kinda familiar...
What actually happened on my PCT hike was this:
I got a stress fracture that forced me to step back from my hike.  That stress fracture was a powerful teacher.  When I finally got back on the trail after my foot healed, I had lost a lot of strength in my foot and I could no longer physically do the number of miles I had been.  That meant I couldn’t complete the PCT in one year.  According to what I though before, I was an “unsuccessful thru hiker.”  I could have just given up and tried again for a “real thru” the following year.  Instead I changed my mindset.  Hiking the PCT wasn’t a sports event.  It was not a race where I could DNF.  I was freed from measuring the worth of my hike by the number of miles that I accomplished.

The first 2 miles back on the PCT after my stress fracture were full of so much joy and wonder, that I knew that the miles weren’t what mattered to me.  But what did matter?  I struggled with finding something to replace the satisfaction I used to feel for doing miles and to redefine what I was doing out there.  My second day back on the trail, I wrote:

"If I took a good photo, would that make my hike more meaningful?  What about if I saw a cool flower?  Learned some new skill?  Swam more?  Stopped at more vistas?  Or had some insightful realization?  Those things are so much harder to measure and put a finger on than miles per day displayed with pride at the top of a blog post.  Do badass hikers take the time to sit and watch every moment of a sunrise or sunset?  How will I tell if I’m really having a meaningful experience out here?" -from my blog on 8/25/2014
I captured this sunrise in a photo AND got to go for a swim in that lake.  Is that enough to make my day meaningful?

Look I found a flower.  Is this photo good enough?  Do I need to find one without brown spots on the petals?  Would that be better?
That was the crux of the problem- to find meaning in my hike.  I couldn’t just copy what everyone else was doing.  Success was something that couldn't be quantified.  I was forced to re-prioritize my hike on my own terms.  I had to find happiness and joy from within.  I discovered (as my friend SlowBro puts is), that “the journey is the reward.”

This turned out to be a pretty profound way to live.  It meant I was out there to live each moment fully.  It meant I was in it for the experience, not to achieve anything.
Does that mean I can just sit here and watch the sunset?  I don't have to make more miles tonight?
What about these clouds?  Is it enough to simply watch them float by?
I think I'm catching on: time to go for a swim and then wiggle my toes in the soft grass.
In all seriousness, coming to this realization was not easy.  Success is something that is so important in our culture.  We are taught at a young age how important it is to get good grades, to win, and to achieve.  It turns out there are actually two definitions of success: (1) achieving high social status and (2) achieving one's goals.  It helps to examine each of these in turn. 

The first definition of success: status
In terms of achieving high social status, I’ve lived my life being goal-oriented and seeking validation of my accomplishments by others.  I wanted to show that I wasn’t just a slacker who was out there goofing off.  I was a serious hiker.
Working diligently on becoming a serious hiker.
But of course you probably already can see where this is going.  To find meaning in my hike, I had to realize that I was backpacking the PCT for me, not to prove anything to anyone else.  I had to learn to ignore these comments about “unsuccessful” thru hikes and dismantle the notion in my own mind of a backpacking hierarchy with thru hikers superior to section hikers. 

The second definition of success: achieving goals
The second definition of success is achieving one's goals.  I listed a few goals in this pre-hike blog post.  When I was writing my list before my hike, my wise friend said, "Write out those goals, but then take them and burn them.  Let them go."  I had no idea what she meant because I thought goals needed to be achieved.  But now I get what she was trying to tell me.  Goals may be limiting if they prevent us from seeing beyond them, or seeing exactly what is in front of us.  I learned not just to let go of my goals, but a few times, I even learned to live without goals.

One thing about goals is you can outgrow them.  Sometimes the goals you have at the start of the hike just aren’t important anymore.  I know other hikers who got off the trail, people who hiked over 900 miles on the PCT, when they came to realize the trail was not serving their needs anymore.  They had made important self-discoveries, learned valuable lessons already, and outgrown their need to be on the trail.

I also had goals that I clung to that turned out to be harmful.  One of my unwritten goals was to be a strong, bad-ass hiker.  I remembering thinking before I started that I would crawl my way to Canada if I was ever injured.  That being strong meant hiking through the pain.  The danger of thinking that was that I hiked on my stress fracture for 100 miles, through the snow and rocks of the Sierra, because I didn’t want to quit.  Sure, I proved I could deal with physical pain.  But I was taking the maximum dose of ibuprofen and still feeling like a knife was stabbing through my foot with every step.  So following through on that goal was causing incredible damage to my body and not allowing me to have any sort of meaningful or valuable hike.  I needed to let go of that goal.
This is me in the Sierra saying, "I'm going to keep icing my injured foot with snow and then I will hobble all the way to Canada.  Because I'm a tough thru hiker! GRRR!"
Another one of the goals that I wrote about before my hike was avoiding injury.  By that account, I failed.  I know people think that injuries are avoidable because I thought that myself when I started.  I am a planner so I like to believe that I have some control and can always plan my way through anything, but that’s just not true.  I found on the PCT that some things just happen.  Once I let go of my goal and the disappointment I felt, then I could see how much I had learned from my injury.
What?!?!  Isn't the answer to everything careful planning and calculations?
What it looked like for me to have a successful hike
What does it look like to have a meaningful hike?  It is completely up to you- that’s the beauty, that’s what’s also difficult to figure out.  250 miles after getting back to the trail after the stress fracture, I wrote:

“I’m completely free of the self-imposed constraints of a thru hike.  I don’t feel at all guilty of not doing a certain amount of miles every day.  Which means I can swim in as many lakes as I want, spend time taking photos, hike as much or as little as I want, and it’s all OK.  In the end, I know I won’t have the accomplishment of a thru hike, but now I think that is something that I don’t need right now.  I used to think that if I were a thru hiker it would mean that I had achieved success in hiking.  Now I aim for a colorful sunrise, for making a connection with a fellow hiker, for being observant.  I define my own priorities and sometimes I even throw out any goals and I just am.  Each day that I am on the trail, I win.”   -blog post from 9/19/2014
It was great to rest, and it was also great when my foot finally got strong enough that I could hike as many miles as I wanted.  I hiked 26 miles to get to this view so I could wake up and have a good sunrise for my birthday the next morning.  I call this a "win!"
I got to talk to inspirational hikers like this couple who were setting out to hike the Sierra High Route. Win!
I marveled at the wonder and beauty around me each day. Another example of living in the moment.  Win!
I saw a bobcat.  And a mountain lion.  Plus bears.  And some frogs.  Not that I set out with any intention to see any of this wildlife, but it was amazing to see all nontheless.  Win!
 It's not that I didn't plan anymore.  Just that I met each day with an open heart.
So… How do you have a successful hike?
If I could go back and give myself some pre-hike advice, it sure wouldn’t be to train harder or to plan more.  Instead, I would say:

   - Quit striving for (someone else's definition of) success. 
   - Be authentically yourself and accept yourself for who you are.  

   - The journey is the reward.

Here are some suggestions for avoiding the mental traps I fell into:

(1) Don’t believe the nonsense that thru hikers are superior to a section hikers.  The beauty of backpacking is that there are so many wonderful ways of doing it.  Respect the record-setters and thru hikers because they really are incredible.  But also celebrate the section hiker that tackles the trail over the course of her lifetime.  Seek out and talk to the weekenders that may explore parts of the trail that run through their backyards over the entire season.  If you are lucky, you may also find a few of those wonderful hikers that set off on their own routes off-the-beaten path.  Remember- the important thing is to get out on the trail.

(2)  Define your own hike.  If you want to do an end to end hike, then go for it by all means.  But realize that there are other paths.  Flip-flops, chunk hikes, section hikes, routes, multiple trails, continuous or not.  Get creative!  It’s all arbitrary anyway.

(3) Redefine your goals as you go and acknowledge that sometimes goals change over the course of your hike.  Burn your list of goals.  Allow yourself to grow and learn.  Be curious about everything.   Discover what brings you joy.
And if all else fails, then get up early and watch another sunrise.
Further reading

The Hoofist- Great hikes I have never done (and don’t care about)

PMags- Hike My Hike- Damn it!

Semi-Rad- The Hierarchy of Camping

Halfway to Anywhere- The Thru-hiker Superiority Complex 

Zen Habits- The best goal is no goal

The Minimalist- Moving beyond goals

Monday, September 1, 2014

Day 141: Into Carson Pass

Day 141: 8/27/14
1074 to 1078
Miles hiked: 4

I lingered in camp for an extra hour as I watched the sunrise.  It wasn’t hard to remember to slow down with this view from camp.  
Alpineglow.
I wondered if everything (anything?) I’ve learned from my injury will sink in permanently.  Will I still go swimming and rambling around camp once my foot gets strong?  I certainly will have the time, now that I am free of the time constraints of a thru hike.   
Enjoying the rambling switchbacks.
When I got to Carson Pass, I had a few hours before Steph picked me up.  I chatted with the wonderful docents at the interpretive center, poured over the wildflower guidebooks, and went on a side trail to visit another lake.  I loved the opportunity to meander.  
Another lake, another swim. 
Overall, I was delighted with how this first test trip on the PCT had gone.  The lower muscles in my legs and all the muscles in my feet were tired from being weak from the CAM boot, but there was no sign of re-injury.  I know having a few days to rest after this trip is going to be good for my foot though.  And I get to start making plans for continuing to hike the PCT into the fall.  

Special thanks to Steph for taking me to the trailheads and for all the support and for making my "comeback" possible!!!  YOU ARE AWESOME!!!

Saturday, August 30, 2014

Day 139: The problem of fewer miles

Day 139: 8/25/14
1052 to 1062
Miles hiked: 10

By 2 PM on my second day back on the PCT, I was already having a mini-meltdown.  I’d completed 10 miles, my pre-determined limit for the day to be easy on my foot after the stress fracture.  What was I gonna do in the 6 hours still left before dark?  I am so conditioned to keep hiking as long as there is daylight.   I felt the pull of the trail with every cell in my body.  But I realized I needed to rest my foot.  I was not gonna re-injure my foot.  NO WAY was I risking that.
Totally frustrated with my 2 PM finish time.
So I set up camp.  Thank goodness it started raining and continued raining until the night.  That made it much easier to be still in my hammock while I tried to think of ways to slow down and figure out how to manage my new my low mileage goals.  I tried to think about everything I’d learned about stillness and meditating while I’d been off the trail, but that was in the Redwoods and back in a house or a town.  It is so much harder practicing on the PCT. 
The soothing sound of rain on my tarp.
I reflected on the course of my day.  I thought I had been going as slow as I could possibly manage.  I took a break every hour to take off my shoes and massage the feet.  I was really trying hard but it was tough sitting very long. I wasn’t in the least bit tired.  My muscles ached to go go go go.  They had only just started to warm up, and there we were stopping again.  Such an endorphin junkie.  I thought I’d done the right thing by diligently going to the gym for hours every day, going swimming, keeping up my cardio and doing weight training.  But I now I almost wished I didn't have such a huge imbalance between the strength of my legs and lungs, and the weakness of my feet.  Now my legs were getting a taste of the trail and I was having a heck of a time trying to convince them to stop chasing more miles.
What was wrong with me for not wanting to spend more time here for a rest break?
Adapting to shorter miles and to being still was a more difficult mental challenge than I’d anticipated.  I needed to figure out techniques that would allow me to feel as engaged and connected to the outdoors as I do when I am moving down the trail.  Advanced-backpacking warrior-ninja-level  technique. 

While I was hiking, I had also tried to slow down my hiking pace as another way to adapt.  The downhills were OK, but I kept forgetting to take it easy on the uphills.  My darn legs would get all excited whenever I’d start to climb.  Back in the groove like nothing happened, totally forgetting the poor feet.  The feet weren’t complaining or anything, but I could tell they were weak and I didn’t know what they could handle yet.   Anyway, I knew I couldn’t go on hiking like this.  I knew it was a bigger problem- that of my mindset.
Uphills make me want to fly up up up and away.
Mental shifts are the hardest.  In my old mindset doing 20-25 miles each day was a given.  Wake up, hike all day, go to bed.  More miles accomplished equaled greater success.  No wonder it felt so difficult to stop hiking so early in the day!  It wasn’t just about how to fill the time.  It was how to feel like I was out there doing something that I could be proud of.  I needed to redefine my notions of what I was out there for.

If I took a good photo, would that make my hike more meaningful?  What about if I saw a cool flower?  Learned some new skill?  Swam more?  Stopped at more vistas?  Or had some insightful realization?  Those things are so much harder to measure and put a finger on than miles per day displayed with pride at the top of a blog post.  Do badass hikers take the time to sit and watch every moment of a sunrise or sunset?   How will you all know I’m not just a slacker goofing off in the woods?   How will I tell if I’m really having a meaningful experience out here?
Paintbrush.
After fighting so hard to get healed from my injury, what am I going to do now that I'm back out here?

Friday, August 29, 2014

Day 138: Back on the PCT!

Day 138: 8/24/14
1050 to 1052
Miles hiked: 2 (Possibly the best 2 miles ever!)
(Note: “Day” refers to days since starting the PCT back in April.  I got off the trail on day 64 at Tuolumne Meadows, PCT mile 940.  I took 74 “zero” days to heal from the stress fracture.  Those days off the trail were still part of my journey.)

Starting out for my first backpacking trip on the PCT in 10 weeks since the stress fracture, I was filled with uncertainty.  I half expected my foot to completely fail again.  I feared reinjury, more setbacks.  Could I trust my foot again?  I didn’t know.

The past weeks since getting out of the CAM boot, I had been carefully building up strength on incrementally longer dayhikes with my pack (up to 7 miles) and giving my foot extra time to heal by cross training every other day.  Now I was setting out for a 28 mile backpacking trip that I planned to do over the course of three nights- more than I’d done since the injury but I hoped it wasn’t too much of a stretch.  I tried not to think about how before my injury, I could do 28 miles in a single day.  Jim (PITA) had recommended this section as an easy place to start back, and Renee (Pathfinder) had taken extensive notes for me when she passed through about the terrain.  Still, I made backup plans with Steph in case something happened to my foot and I didn’t think I could make it. 
Steph drops me off at Ebbetts Pass.
Stepping onto the PCT in the late-afternoon from Ebbetts Pass filled with nervousness, I realized there was nothing I could do but hike.  I pushed aside the endless stream of thoughts, all the second-guessings.  I took a deep breath.  And I simply hiked. 
What rocks!  What trees!  What sky!
Hiking those first two miles to the first night’s camp was like no other hike I’d done.  I was fully engaged, in the moment.  All thoughts were irrelevant.  I was hiking.  HIKING!  All my senses were awake.   Listening to the birds calling.  Tasting the wind.  Pausing to pick gooseberries, to examine every flower, to touch the bright green moss.  Feeling sun on skin and earth on feet.  Every scent on the air tickled my nose.  I was so quiet I crept up on a coyote down the slope.  What wildness, what beauty!

I was hiking like it was the last hike I would ever do.  Like I wanted to stretch those miles out and make them last forever.  As if I had to savor every single moment wholeheartedly.  To appreciate the sweetness of being able to hike.   It could be all that I’d ever get.   
Feet doing a happy dance.
I sat and watched the sunset over Upper Kinney Lake.  Quiet.  Content.  For an entire two hours.  If those are the only two miles I get, that's OK.  It was worth those weeks of healing.  Worth it for everything that happened- for what I learned, for the redwoods, for time with Steph, for the visit with my parents, for who I have become.

Then, I curled up sung in my hammock.  Overwhelmed with happiness to be back home on the PCT.
Yay I made it!  I love this life of mine!

Friday, August 22, 2014

Foot injury- Depressive spirals

The PCT has a way of bringing you face to face with your demons.  You know, those things you’ve spend your whole life trying to escape, trying not to face.  It’s one of the best and most difficult things about long-distance hiking, and about the journey that has continued for me as I’ve been off the trail healing for the past few month from a stress fracture.

A week out of the CAM boot, I was still trying to tell if my foot was fully healed.  In the parking lot at Donner Pass, walking towards the PCT trailhead about to go on another short dayhike to test my foot, I felt a shooting pain in my foot at the stress fracture site.  Fuck!  What was happening?  Was the bone not healed?  Did I reinjure it?  It was clear and intense pain.    
This pain was off the charts. -from Hyperbole and a Half
As I hobbled back to the car, that pain let loose something inside of me.  Sorrow I didn’t know I still carried exploded.  It was as if all the inner peace I’d been feeling had evaporated, and all that was left inside me was emptiness and despair:

I was a failure.  The one thing I loved the most, I was an utter failure at.   I was mad that my friends were still on the trail and I wasn't.  I was pissed off that I still couldn't find something to blame for the stress fracture.  The entire universe was unfair and I hated everyone and everything.  I was fed up at myself for waiting around months thinking I would get back on the trail.  Why couldn't I give up and find something else to do?  My life was meaningless. 

I sat in the car for a while while the sky opened up and the rain fell hard.

I was mad at myself for being so narrowly focused that I had nothing else in my life besides hiking the PCT.   Here was the awful demon I had to face:  I didn’t have another single goal to focus my life on after the PCT.  The PCT was everything.  Hiking was everything.  My life was unbalanced and limited.  It felt like I had lost interest in everything in my pursuit of the PCT, neglected my career, pushed aside other interests like trapeze, botany, books, movies, and other areas like family, relationships, community.  Now I had nothing.
Ripples on the pond.
I'd had a plan to camp at the trailhead at the PCT after the hike.  But I was too upset.  For the past 8 weeks I'd been longing for the trail, homesick for it because the trail felt like home.  But feeling that pain, the trail didn't feel like home anymore.  Nowhere felt like home.  I was totally adrift.

The next few days sucked.  I had to stay off my foot again as I waited for my appointment with the physical therapist.  No more walking.  My foot kept feeling tight.  I became convinced that the random twinges in my foot meant it was all over.  That I wasn’t getting back on the PCT.  That maybe I would never hike again.  I could feel my heart fracturing too.  My big dream that I’d been working towards for the past 5 years- hiking the PCT- that dream was over.  This injury that I thought I was slowly recovering from, this huge major hurdle that I thought I was making headway on, because of this setback, it was showing me that I had nothing.  No purpose, no passion, no home.  That I was nothing.  I wasn’t a hiker.  I would never make it to Canada.  I started looking at one way flights out of California.  I wanted to run away from everything and be far away from the PCT.

****
How many mental pits of despair was I gonna fall into and then have to drag myself out of on this frickin’ journey?  A journey that was suppose to be traveled on the PCT but which now taking me WAY beyond that.

I swam more circles around in the pond and looked at the sky.   There were clouds high up.  Birds.  I felt the cool resistance of the water against my skin.  I had never done much swimming before the stress fracture, but as I did circles, day after day, I noticed I was get stronger.  I thought that maybe I was even sort of starting to like swimming.
Ah clouds.
I went to yoga.  The people in my class were friendly and I liked chatting with them before class.  I started to loosen up and feel flexible.  I breathed, stretched, balanced.  I was doing poses I’d never done before.

Then, because I am a planner even when I don’t feel like I have anything in life I want to plan, I started to make lists.  I began with a list of everything I’ve always wanted to do that I could still do if my foot never healed: kayaking, biking, travel, climbing.  I listed classes I’d wanted to take but never had enough time: master naturalist, LNT master educator, wilderness first responder, native plant certificates.  I read job postings that sounded exciting and meaningful.  Things that were different but still used my skills.  Things that I wanted to learn to do.  Steph encouraged me to work on my resume.  Now, ‘After the PCT’ is not a big black hole of nothingness.  I wasn’t just a hiker after all, there was so much more to my life.  The world is my home, not just the PCT or any trail for that matter.  Wherever I go, that can be home if I want.  I’d just lost sight.
Seeing the possibility of balance.
Then, because I am an eternal optimist at heart even in my most darkest moments, I allowed that someday I might hike again, and if so, I looked at all the trails I wanted to do besides the PCT.  I dug out an old lists of winter hikes I’d started to plan: the Florida Trail, the Benton Mackaye Trail, the Pinhoti Trail.   I even got out my big spreadsheet I’ve been keeping over the years of all the long trails I wanted to do and the best seasons to do each section of them in.  I started it back when I wanted to section hike each long trail piece by piece and do each section according to best season for wildflowers and fall leaf peak.  I realized the PCT wasn’t the end.  It never was.

***

Oh yeah, about the pain in my foot.

When I talked to my hiking mentor, she told me that thing I felt in my foot might be a "pop" that can be the foot readjusting after being immobile for so long.  So it all clicked- this has been part of the (very long) healing process.

This was confirmed by the physical therapists- he did not think I needed to go back into the boot or that I had re-injured my foot.  He recommended I rest a few more days, and then try hiking again.  When I got back on the trail for a short dayhike, an amazing thing happened- I didn't feel any pain.  On the next few dayhikes, the twinges and nerves were gone.  It still feels weak, there is a loss in flexibility, and there is muscle-soreness after only a few miles, but I also felt some of this in my non-injured foot.

Basically, that "pop" I felt that sent me into a depressive spiral was really something that just needed to happen to set everything back in place again.  Phew!!! I feel like I’m on the slow road back to recovery once again.
Resting the feet on a dayhike.

Friday, August 8, 2014

Foot injury- Out of the boot

I’m finally out of the boot (i.e. “walking boot”), and have taken my first tentative steps on local trails.  These past 6 days mark the start of a transition period- testing out the foot to see if the stress fracture has healed completely.  Happy to say so far, no alarming pain, but I'm still not ready for backpacking.
First dayhike.  Western States Trail near Auburn, CA.
I had a tough time figuring out when to stop staying off my foot completely.  I spent an extra week wearing the boot over what the doctors suggested.  I decided I wanted to wait two weeks after it stopped hurting at all, 7 weeks total since getting off the PCT.   It helped that I went and visited my parents in Wisconsin.  It was easy to relax there.  Mom took me shoe shopping pretty much every day- I had a heck of a time finding new "sturdy and supportive" hiking shoes like the doctors recommended.  Now I’m back at Steph’s house near Auburn, CA, taking it one day at a time.

Day 1
The first day without the boot, my foot felt strange, stiff, and unfamiliar.  Like it wasn’t really my foot.  I tried not to panic when I feel the twinges of tightness and nerves.   With every tentative step, I keep expected the sharp stabs of pain to return that would indicate the healing isn’t done.  But they never did. 

I decided I didn’t want to hike that first day.  Instead, I went kayaking and paddled my heart out.  Oh the pent up energy!
Kayaking on Loon Lake in CA.
Walking on the shore of the lake to set up camp, I laced my feet into my new supportive hiking shoes.  The shoes felt oppressively stiff.  I couldn’t feel the ground.  I was wobbly and off-balance.  Oh how I missed my zero-drop, comfortable trail runners.  Even more I missed feeling agile and strong.

At the end of the day, the darkness of doubt flooded over me.  I was fearful those twinges were really the bone whispering that it wasn’t done healing.  I poked and rubbed the bone and tried to feel what was going on in there under the skin.   Was this the so-called phantom pain, or normal tingliness due to the callus and calcium buildup at the site of the injury?  Is the foot ready to start easing into hiking or does it want more rest?  I got frustrated because I don't know.  I hated that I don't know for sure.  I should know, right?

Day 2
Day two without the boot I was too afraid to take a hike.  My foot felt so strange just from walking around the house.  My foot reminded me of a plant that withered due to lack of rain.  All skinny, shriveled, translucent.  A tiny fragile creature.   Where had my muscular, weathered and calloused, boulder-hopping, mountain climbing feet gone?  How could I have been the strongest than I'd ever been my whole life, hiking 940 miles on the PCT, and then just 7 weeks later, be so weak and uncomfortable.
Was it really only two months ago that I was skipping across boulders in the Sierra?
It felt like I was inhabiting an unfamiliar body.  Doubt flooded my heart.  What was I still doing dreaming of the PCT?  Maybe I should give up, find something else to do.  I felt so lost.  Tears streamed down my face.  Then I got three emails from three awesome friends asking "how are you doing and how is your foot?"  How did they all know to check on me?  My mom told me on the phone that my uncle experienced the same tightness when he took off his boot.  And then Still Waters talked me through my fears.

I resolved to go for a hike the next day.  I was grateful that Arizona offered to walk with me.

Day 3
On my first 3-mile dayhike, I slowly ambled along a flat section of the Western States Trail above the American River.  I felt like I was learning to walk all over again.  I kept waiting for the stabs of pain to return, but they never did.  I thought about how lucky I am to have ended up here, so close to this awesome place, and I thought about of all the trail runners who compete in the 100-mile endurance run along this famous trail.  In contrast to those incredible athletes who'd journeyed on this trail before me, 3 miles shouldn’t be a big deal.  But those 3 miles were (mentally) exhausting, and took all the bravery I could muster.  When I made it back to the trailhead, I was incredibly relieved. 

Day 4
Another day of rest.  I walked less than half an hour on the way to go swimming in the pond.   I didn't want to overdo it.  I massaged my foot and iced it.  The stiffness was a little better.  My optimism renewed.

Day 5
For the second dayhike, I walked 4.8 miles and lost/gained 1200 feet in elevation.  No sharp pain, but my balance was off.  I felt like I was a baby learning to walk.  The tamest stream crossings had me stepping gingerly, testing each rock.  Side trails beckoned with the sounds of waterfalls, but I dared not go down, not trusting my feet on the steep paths.  Where is the line between being careful and being fearful?
Carefully checking the stability of each step on a tiny stream crossing.
I went for a new personal record for slowest hike ever.  I picked blackberries until my hands were sticky with purple juice.  At the turnaround spot, I swam in the refreshingly cool water of the American River.  I remembered to savor every moment and to be appreciative of where I'm at right now.
Going for a swim in the American River.  Smiles not miles.
In the evening, my foot felt random tingling twitches and the muscle felt a little sore.  I rested, iced it, and massaged it, feeling glad I didn’t hike any further.

Day 6
Third dayhike.  6.2 miles.  I was more in the moment and more in my body.  I still kept listening for a sharp stab of pain that would tell me the stress fracture hasn't healed.  But all I got were twinges and stiffness.  The twinges have me concerned but my other, non-injured foot is stiff and twingy too.  I can't be certain if it’s the new shoes or from not walking for 7 weeks or if the stress fracture hasn't healed completely.  I wonder if I'm being overly sensitive or a hypochondriac or if I'm in denial of an actual problem.  I can't tell yet so I poke at my foot and ice it and do google searches for "phantom pain stress fracture."
Stopping for a rest break to ice by foot with my frozen water bottle.
I understand now why thru hikers don’t return to the trail after a stress fracture.  Recovery requires so much patience.  I wonder why I can't give up on the idea of returning to the PCT this year.  Why I can't go do something else for a while.  It would probably be different if I had a home or a job to go back to.  But the PCT is all I can think about.
A broken wing isn't stopping this butterfly.

Monday, July 28, 2014

Stress fractures: A guide for backpackers

I have been off the Pacific Crest Trail for the past 6 weeks healing from a stress fracture in my foot.  I still have a week left before I can slowly return to walking and to backpacking.

I didn't know anything about stress fractures before it happened to me, so I want to inform other hikers and backpackers about them.  It is important to be able to identify a stress fracture and distinguish it from an injury you can hike on so that you don’t cause more damage and you can heal faster. 

I've compiled the information that has helped me to understand the causes of stress fractures and the most helpful guidelines I've followed for physical and mental healing.  Some of it is from articles or websites (see references below), but most was advice given by my friends and the backpacking community and from my sports medicine doctor and physical therapist.
I got my stress fracture in the Sierra. Photo by Arizona.
Story of my stress fracture
The individual circumstances around a stress fracture and which bone is affected contribute to variability in the severity of the injury and duration of healing.  I felt the injury all of the sudden on Muir Pass in the Sierra at mile 840 of the PCT, postholing in snow.  I felt a stabbing pain at the top of my foot that didn’t go away even with a maximum dose of ibuprofen.  The pain only lessened when I was going uphill or when I rested.  While backpacking, I had to concentrate on every step to avoid the shooting pain that felt like a stake was being driven through my foot.  Because I changed my gait (i.e. hobbled) to avoid putting more pressure on the ball of my foot, I got several bad blisters.  I didn’t recognize this as a stress fracture and instead I kept backpacking for another 100 miles through the snow and rocks of the Sierra.  It wasn’t getting better on the trail so I got off the trail at Tuolumne Meadows (mile 940).  My injury wasn't diagnosed as a stress fracture of the metatarsus for another four weeks.

What are stress fractures?
Stress fractures are microcracks in the bone and are often considered overuse injuries.  Bones get broken down during activity and are constantly being rebuilt.  When there is too little rest they can’t rebuild fast enough and are weakened.   Fatigue contributes when the muscles get tired so do not lessen the shock on the bone due to repeated impacts. 

What causes stress fractures?
Stress fractures are caused by a variety of factors including increases in distance, weight, speed, or internal factors like inadequate nutrition or hormone irregularities.  I believe mine was due to a combination of factors acting together including the sudden increase in pack weight (bear canister, microspikes), altered stride due to walking in snow, increase in pace (due to wanting to get up the passes quickly before postholing conditions worsened), and my change in shoe size (up 1/2 size) at Kennedy Meadows (mile 700)  that led to my feet slipping around in my shoes.
Changing to a larger shoe size in Lone Pine/ Kennedy Meadows- big mistake!
Important things to know about stress fractures
-Diagnosis of stress fractures is tricky.  The tiny cracks of a stress fracture do not show up on x-rays right after they occur.  Only when they start healing can they be seen on an x-ray.  The first doctor I went to took an x-ray, didn’t see anything, and then didn’t diagnosis the stress fracture.  Then my insurance company spent 2 weeks delaying the MRI which could have shown it.  Finally I went to a doctor that deals with athletes and got a second opinion and diagnosis.

-Stress fractures are surprisingly common among runners and backpackers.  When I started asking around, I learned that some of my fellow backpackers have recovered from this type of injury.  Hearing their personal stories has been incredibly helpful in coping with the pain and frustration of being off trail.

-Rest is required to heal a stress fracture.  This is not an injury that you can hike through.  If you keep hiking you could break it completely or it could cause other injuries and delay healing for months or even years.  I had never heard of stress fracture and was in denial of the severity of the injury.  If I’d gotten off sooner, it would have healed faster and I’d likely already be back on the trail right now.
Healing in the redwoods and wearing the boot.
Physical healing 
There are several things you can do to promote the physical healing of the bone.  Obviously, follow the advice you get from your medical doctor.  These are the steps I've taken:

-I rested my foot.  It was extremely difficult to go from being on my feet for 12-14 hours a day to the level of rest required to heal the stress fracture.  On the trail, rest meant sitting for 15 minutes every few hours.  After the injury, rest involved staying off the foot 23-24 hours a day and wearing a “walking boot.”  The boot took pressure of the injury to speed up healing.  I avoided walking even in the boot as much as possible.

-Pain meant the stress fracture was getting irritated.  This prevents healing.  I DID NOT do any activity or intensity level that caused pain.  I struggled with this mentally since I always used to increase my activity until I felt pain and therefore had exercised enough.  I used to enjoy post-exercise soreness.  Now I am really careful not to do any activity that hurts.  And if I do overdo it, I take the next day off and avoid that activity.

-I followed my physical therapist's suggestions about other forms of activity to keep up my strength and cardio that avoided direct pressure on the foot.  I lifted weights, spent hours on a stationary recumbent bike, used an arm bike, and swam with my feet immobilized (using a pull buoy between my knees).  Keeping up my cardio and getting my daily endorphins was key to maintaining my sanity and hopefully will allow me to transition more easily back to the trail.
Sweating at the gym.
-Ice often.  I iced in the morning, mid-day, evening, before working out, after working out, and lots of times in between.

-Physical therapy may help treatment.  Be sure to find a hands-on PT who has experience working with athletes.  I had ultrasound and joint mobilizations.  It calmed me to talk to the PT about the healing process and to get encouragement from them that I was doing the steps I needed to take to heal.

-Consider stopping taking anti-inflammatories (ibuprofen) which may interfere with bone healing.  I followed the guidelines given by my PT.

-I ate really well and completely shifted my diet compared to what I’d been eating on the trail.  Veggies, fruits, dairy, lean meats, and a high variety of fresh foods really made me feel better.
High variety of food does NOT mean different flavors of ramen.
Mentally healing
Being off the trail and dealing with an injury that forced me to be sedentary have been the most difficult things I've faced on my journey.  It was agonizing to be away from the trail.  I wasn't mentally prepared for leaving my friends or the awesome life I'd found on the PCT.  I felt like a failure.  I had to mentally prepare for the possibility that I might not make it to Canada this year.  It took a lot of work to view the injury as an opportunity rather than a huge setback.  This is what I have done to avoid falling into depression and to mentally heal:

-I had to accept that I couldn't run back to the trail and needed to be off trail for a long time while I healed.  6-8 weeks seems like forever to a long-distance backpacker.  I needed to change my mindset to take a long-term view.

-Accept that nothing is going to feel as good as backpacking.  I missed being outdoors and being separated from the trail community.  I didn’t have a plan for where to go or what to do with myself.  To cope, I used the opportunity to find other things- I’d never swam for fun or thought that I might enjoy meditating among the redwoods.  I found joy in connecting with the trail community in other ways.  I also connected with people beyond the trail using the same openness and curiosity that made connections happen so easily on the trail.

-Realize that you are not alone.  Do not keep the injury or your frustration to yourself.  Sharing your story is a powerful part of healing and will keep you connected to the backpacking community.  A stress fracture (or any injury) does not make you weak.  How you cope and what you learn from the experience shows your strength.

-Learn to be patient.  Diffusing the pent up energy I had and being still was agonizingly difficult.  I wanted to throw the f**king boot down a cliff.  I had to confront the anger and hurt.  To heal, I needed to shift mentally from “how do I get back to trail quickly” to “how do I heal completely and avoid re-injury in the future.”  I had to make peace with stillness.

-Maintain a positive mental outlook.  I was constantly assessing what activities and mental practices made me feel stress and what gave me peace.  Meeting friends on the trail was uplifting.  But being further from the trail most of the time made it easier to stay still.  But I also thought about my foot and bones healing, and visualized myself back out on the trail. 
Visiting Renee/ Pathfinder at Barker Pass.  We hadn't seen each other since Wrightwood.
-Redefine your notions of success.  I was devastated when I mistakenly thought getting injured meant my hike was unsuccessful.  I had to repeat to myself that “the journey is the reward” and I had to expand my notions about what the journey meant.  It isn’t just about getting to Canada, or even just about hiking.  It is way bigger than that.  It is about life, both on trail and off trail, and it is about recognizing the many aspect of that make a journey.

When I first set out on the PCT, my first long-distance hike that I'd been dreaming about and preparing for years, I knew it would change me.  I never expected that I would get an injury that would take me off trail.  I never would have imagined how being off trail has allowed me to learn so many lessons.  In many ways, I believe that this injury has facilitated the self-growth that I was seeking when I set out on the PCT.  Many of the lessons are still too raw to write about, but I am continuing to heal, and am learning to enjoy and appreciate this part of my journey.

Resources

Description of Stress Fractures by the American Academy of Orthopedic Surgeons
Runner's Guide to Stress Fractures in Runner's Connect

Shona Stephenson’s inspiring story of about returning to ultrarunning after a stress fracture.
Jen's story of depression after her stress fracture and about returning to running too soon.
DocSpice's stress fracture in the Whites that hasn’t healed completely in 6 months.

New Nomads on post-trail depression
Post-Thru-Hike- What was your Re-entry Experience Like? in Backpacking Light
How to cope with 5 stages of Injury Grief- from Active
Recovering from Post-AT thru-hiker depression- from Appalachian Trials

Acknowledgements

Huge thanks to Anna Huthmaker, Jan M., JJ, Farwalker, and Amanda for talking to be about their stress fractures or other injuries, and helping me stay sane.  Some of the best advice for healing was from Stacy Boone of Step Outdoors- thank you!  I'm grateful to Steph and Trish, and to Still Waters, for our conversations about the mental aspects of healing.  My PCT friends have been incredibly encouraging with emails and texts- thank you Pathfinder, Rewind, SlowBro, and MeToo.  Finally, I am thankful for having an incredible hiking partner in Arizona- especially for keeping up my spirits those last 100 miles hiking with the stress fracture (I have never laughed so much!), for connecting me with Steph and a home in which to heal, and for taking time off the trail to be there with me.