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Chapter 9

+ TROUBLESHOOTING INJURY, DISEASE, AND FIRST-AID

As a 22-year-old who had managed to go through life without a broken bone, I started my first big thru-hike with a level of hubris and naïveté that injury could never happen to me. One thousand miles in, I found myself with a peculiar problem: It was painful to walk. Sometimes it seemed like my feet actually felt more comfortable if I hobbled along with no shoes at all. I would hike 100 yards barefoot only to find new pain from pine needle pricks and sharp rocks.

The problem persisted on my next thru-hike of the PCT. In Ashland, Oregon, I finally saw a doctor about my issue. He told me I had plantar fasciitis—a common ailment among thru-hikers. He suggested new shoes, new insoles, and a series of exercises. I am so fortunate that the pain cleared and that in subsequent hikes I found tricks that helped me avoid further pain (mainly, switching out my shoes every 300–400 miles and using zero-drop shoes). But the lesson stuck: On the trail, physical injury and illness can happen to anyone.

Peruse this list and make sure you know the signs, symptoms, and on-trail fixes for these common hiker ailments. And even if you never get an injury on the trail, chances are your friends and people you meet along the way may need your help and advice.

PHYSICAL PROBLEMS

If you think you can do a thru-hike without getting blisters, cuts, bruises, or scapes, you’re wrong. Every hiker falls now and then, and minor boo-boos are almost unavoidable. Below are some simple issues you’re likely to encounter during your hike and the problems that are most specific to thru-hikers. Consider taking a Wilderness First Aid class of some kind if you’re planning to do lots of adventuring in your life. Check your local gear stores, as many offer classes or will know where to find a provider.

BLISTERS

Ah, the dreaded blister. How can such a small thing cause such big problems? If you’re hiking for months, odds are you’ll have to deal with a few blisters here and there. Before your trip, purchase shoes that fit you well, where you can’t feel any of the sides rubbing against your feet—including your toes. Most shoe stores have an incline board where you can determine whether your toes will hit the end of the shoe when you are going downhill. Remember that your feet will likely swell after hiking on them all day, so it’s often better to size up. I prefer breathable (aka not waterproof) shoes for most three-season hiking because they cause less foot sweat—moisture is a major contributor to getting blisters. I also look for lightweight shoes that will cause less rubbing on my feet. Test your shoes out on hikes. Breaking them in can only help. Cut your toenails short before your hike and when you resupply in town.

While hiking, listen to your feet. As soon as you notice a hot spot (any sort of rubbing), stop, take off your shoes, clean the spot, and dry it. Depending on your gait, shoe fit, and body chemistry, some blister methods may work better than others. At night, I will clean the blister and pop it with a sterile safety pin, let it dry as I sleep, and cover with Leukotape (a sports tape without stretch that has some major stickiness from a zinc oxide adhesive). Some hikers will treat clean, dry hot spots with tincture of benzoin, derived from a Styrax genus of plants. It can help Leukotape (or moleskin or any blister care item) stick to you better. It can also work alone as a second skin on hot spots to prevent them from developing into blisters. Leukotape is easy to find online but can be hard to find in stores. Tincture of benzoin can be found in drug stores in small bottles or in thru-hiker friendly single-use capsules.

Even the most careful and prepared hiker can slip in a creek, stumble on a rock, or get scraped up on a blowdown tree.

During breaks, take your shoes and socks off and let your feet dry out. Remove any grime from between your toes. Use a sock with a tight knit weave that can keep trail dirt out. Gaiters are another great defense against trail grime. Make sure they are lightweight, though, as bulky gaiters can sometimes heat your feet up, causing more foot sweat and moisture.

At night, dry your feet out and wear clean (or at least dry) socks to bed. Wash your socks out with water (no soap) to get rid of any dirt that could increase friction and rubbing—the cause of blisters. Alternatively, use a clean pair of socks each day.

CHAFING

Chafing is a result of salt rubbing against your skin. Sometimes it starts as “packne” (“acne” created by your pack) and turns into chafe. It can happen to any active person, but is most likely to happen to thru-hikers because of the length of time they are doing their activity and lack of access to showers. Chafing can lead to scarring (I have some on my neck from a hike four years ago). Chafing can be so painful that it makes people quit the trail for good. Some places hikers chafe include:

Along the seams in your clothes, especially your bottoms.

Between your upper thighs.

Where your pack rubs along your shoulders and lats.

Between your butt cheeks (yes, really).

On your low back (from your pack).

Under arms, lats, and armpits from your pack. This often happens from wearing tank tops or no shirt during backpacking. Your pack can get so saturated by sweat that even if it fits perfectly, chafing happens.

Prevention is the best medicine: If you feel your skin starting to get irritated, stop and deal with it right away by applying a lubricant of some kind. Here are some chafing tips from the hikers featured in this book (I won’t mention names to protect the innocent):

During the day, use a lubricant like Body Glide, 2Toms SportShield, or Bag Balm. I clean up with water, a wet wipe, and then hand sanitizer. I powder at night with Gold Bond, as long as there are no open wounds. At night I clean up with water, a wet wipe, and then hand sanitizer. Then Gold Bond it. The Gold Bond is a great preventive measure as it stops sweat at night. It’s useful as a preventive measure or for very minor chafing.

Bicycle spandex is the only thing that stops chafe for me. I wear knee-length. The spandex is miserable in the heat and everything gets crunched up, but it’s worth it because I don’t get chafing.

At night, I get nude in my sleeping bag to keep the chafe I already have from scabbing over or callousing, and so all the potential areas for chafe dry up. I like to put my soft, clean, cotton town clothes on my chafe at night. That prevents me from being so sweaty or getting dirt into the chafe at night.

For open wounds when you should have stopped and taken care of it, but didn’t, use Vagisil Anti-Itch cream (conveniently sold in 1-ounce containers). It helps with fungal and bacterial infections, and the Vaseline base helps against rubbing. Others have had success with a triple antibiotic ointment instead.

Avoid getting pee or sweat on your chafe. The high salt content makes the chafe burn.

If you notice chafe, stop and clean up with a wet wipe immediately. The alcohol in hand sanitizer dries stuff fast. Add a thin layer of Vagisil. Keep low-back chafe very clean, as it could get infected easily because your pack is dirty. My thighs are very sensitive to seams. They chafe and scar, so I often wear my baselayer inside out.

INJURIES

There’s a distinctive movement thru-hikers make after waking up in the morning. Instead of walking normally, hikers teeter from foot to foot, gingerly loosening their muscles in a walk-like motion commonly called “hiker hobble.” Watching hikers move after their muscles stiffen up may be good for laughs, but it also shows that soreness is a very common occurrence for long-distance walkers. After walking all day, back to back days, feeling sore is normal.

Those of us who played sports in high school or college may remember our coach’s advice—that we need to push hard through the pain. But how can a hiker tell the difference between when they are feeling sore and when they are truly injured? What is the difference? Two experts offer their two cents on how to tell the difference between soreness and injury.

The first step to diagnosing pain is mentally retracing your steps, says NOLS Wilderness Medicine Institute instructor Chris Brauneis. If you can think back through the past day or so and point to a time when you tripped on uneven terrain, rolled your ankle, or slipped in a boulder field, odds are you’ve tweaked something and are looking at an injury. If you know what caused the pain, you can often track whether or not it is an injury.

Brauneis also associates pinpoint pains with injury rather than soreness. If you can describe the pain and pinpoint it to a very specific spot (as compared to hurting all over), it may be a sign that something is injured.

In the case of the hiker hobble described above, after some movement and warm-up, many hikers find their soreness goes away. James Fisher, an Arizona-based personal trainer of adventure athletes, says if you wake up with debilitating stiffness but feel your pain diminishes as you warm up, you’re probably just sore.

Is there swelling?

“You can tear muscle, and if that’s the case you’ll usually get swelling. That’s a really good indication that something is wrong,” says Fisher. If your skin looks like it’s bubbling up or feels hot to the touch, you’ve probably hurt yourself beyond the standard collection of overuse micro-tears. Usability of the muscle after a tear depends entirely on how bad it is.

What if it’s an injury?

Telling the difference between soreness and injury is just the first step. Injuries can be further divided into two categories: muscular and skeletal. The distinction is critical. According to Fisher, muscle tends to strengthen about ten times faster than tendons and ligaments, which attach to bones and therefore fall into the skeletal category. Slow-to-repair skeletal injuries are a far greater cause for concern than damaged muscle.

HOW TO TELL MUSCULAR FROM SKELETAL PAIN

If you can increase the pain by pressing the spot with your hand, it’s probably muscular. If it’s a deep pain that probing can’t reach, it’s more likely to be within a joint or bone. This is a good rule of thumb if you have a slow-growing pain and suspect an overuse injury like a stress fracture. “Those are the tricky ones,” says Brauneis.

Often the only way to diagnose a stress fracture is with an X-ray, though Brauneis still relies on the usability test—examining a patient’s range of motion and ability to bear weight—to determine how bad things are. If your leg is in unbearable pain or buckling under you, it’s time to see a doctor. If not, carry on but keep an eye on it. Get it checked out if it worsens.

New and interesting noises can also be a bad sign. Two bone ends grinding against one another will make a sound called crepitus, and a tendon swollen in its sheath can squeak during movement. If your pain comes with its own orchestra, it’s time to back off for a few days and go see a doctor if rest doesn’t fix the problem.

DOES AN INJURY MEAN IT’S TIME TO GO HOME?

Injury doesn’t always mean you have to pack up and go home. “If you determine the injury is still usable, you can still treat it in the field,” says Brauneis. Again, the NOLS WMI team generally employs the usability test. If you can distribute your pack weight among your companions and keep going at a slow pace, it’s possible that the injury will start to heal without taking time off—but be considerate about how that will affect your companions. Brauneis says he’s had patients carry on with a sprained ankle, going slow, soaking in icy streams, and improving without having to stop altogether.

“Another thing we rely on is the fun factor,” Brauneis says. “Even though a person might not have a broken bone, what’s their experience going to be?” If forging ahead means misery, it might be worth getting off the trail and resting a few days.

Fisher emphasizes prevention and preparation—for both injury and soreness—to keep you on your feet.

“You’re going to be sore the first week of your thru-hike. You have to plan for that and be flexible on your mileage,” he says. Maintaining a conversational pace and avoiding lactic acid buildup can also fend off soreness. Fisher recommends extra rest on big downhill days—the eccentric contraction of your muscles fighting against gravity is more likely to make you sore than the concentric contraction of going uphill.

“Don’t bite off more than you can chew mileage-wise, elevation-wise, or pack weight-wise.” Fisher says he’s fixed more of his clients’ problems than he can count by cutting unnecessary pack weight. Backpackers should also stretch regularly; tight muscles, especially the hip flexors, can lead to lower back problems. Talk with your doctor about taking medications to reduce everyday aches and pains.

It’s hard to train for 20-mile days, and “training on the trail” needs to be treated as such: rest and recuperation are part of the process. The best way to stay on the trail is to avoid the soreness versus injury dilemma in the first place. Underestimate your abilities and take it easy. A slow start is worth it to avoid a premature end.

If you get sick on the trail, you may need to take an on-trail zero day to recover—even when conditions are less than ideal.

TOP DISEASES THRU-HIKERS SHOULD KNOW ABOUT

Of course thru-hikers, like regular people, can come down with all sorts of bugs, but here are the ones that are the most common for hikers or for which hikers are at an especially high risk.

NOROVIRUS

Noroviruses (stomach bug) can cause people to have gastroenteritis, an inflammation of the stomach and the intestines. This illness often begins suddenly and lasts about one to two days. Common symptoms include vomiting, diarrhea, and some stomach cramping. Less common symptoms include low-grade fever, chills, headache, muscle aches, nausea, and tiredness. This is of special concern for AT hikers. An unofficial poll of recent thru-hikers indicates fully half of AT hikers get norovirus, aka “food poisoning” or “the stomach flu.” The following information is adapted from the Appalachian Trail Conservancy (ATC).

Noroviruses are found in the stool or vomit of infected people and on infected surfaces that have been touched by ill people. Outbreaks are more likely in areas with multiple people in small spaces, like shelters and hostels. Norovirus can stay on surfaces and objects and still infect people after days or weeks. It can be spread by:

Eating food or drinking liquids that are contaminated with norovirus (untreated water sources can be contaminated).

Touching contaminated surfaces and then touching your mouth, nose, or eyes.

Not washing hands after using the bathroom and before eating or preparing food.

Prevent getting and spreading norovirus (stomach bug) through good hygiene practices. Wash your hands with soap and water often, especially after using the bathroom and before handling food or eating. Alcohol-based hand sanitizers are not as effective against norovirus, but may be used if soap and water are not available. Wash with biodegradable soap at least 200 feet (80 steps) from a water source. Boil water (rolling boil for at least 1 minute) or use chemical disinfectant (iodine, chlorine, or chlorine dioxide). Most filters do not remove viruses, but can be used effectively in combination with chemical disinfection against a broad range of pathogens. Bury human waste 8 inches deep in soil and at least 200 feet away from natural water if a privy is not available. Avoid sharing water bottles, eating utensils, and other personal items. Avoid shaking hands with other thru-hikers. Consider avoiding shelters and washing up after signing trail registers.

If you find yourself with the norovirus, first drink plenty of fluids and wash your hands often. Avoid contamination of common areas (e.g., shelters); consider camping or staying off the trail, if possible.

Limit contact with others and avoid preparing food and drinks for others for two to three days after recovery. Seek medical treatment, especially if you become dehydrated or illness lasts more than a few days (norovirus usually lasts one to two days). Report the date and location of any cases or outbreaks of vomiting and diarrhea on the AT or at places used by AT hikers (e.g., hostels) to the local health department and ATC at stomachbug@appalachiantrail.org. Your prompt report will help stop potential outbreaks.

When hikers drink the green and brown chunks found in cattle troughs, they can’t help but wonder why they feel sick afterwards.

GIARDIA

Giardia might be the most famous—or should I say, infamous—of hiking diseases. Giardiasis is a diarrheal disease caused by the microscopic parasite Giardia. A parasite is an organism that feeds off another to survive. Once a person or animal (e.g., cats, dogs, cattle, deer, and beavers) has been infected, the Giardia parasite lives in the intestines and is passed in feces (poop). Once outside the body, Giardia can sometimes survive for weeks or months. Giardia can be found within every region of the United States and around the world. Symptoms include diarrhea, gas or flatulence (often with a sulfur-like odor), greasy stool that can float, stomach or abdominal cramps, upset stomach or nausea, and dehydration. It usually takes one to three weeks for symptoms to appear after being infected with giardia.

The disease can be spread by swallowing Giardia picked up from surfaces that contain feces (poop) from an infected person or animal. It can also be spread by:

Drinking water or using ice made from water sources where Giardia may live (for example, untreated or improperly treated water from lakes, streams, or wells).

Swallowing water while swimming or playing in water where Giardia may live, especially in lakes, rivers, springs, ponds, and streams.

Eating uncooked food that contains Giardia organisms.

Having contact with someone who is ill with giardiasis.

Traveling to countries where giardiasis is common.

The best way to prevent giardia is to treat your water and make sure to clean your hands before eating. There’s a lot of controversy over how much giardia really is present in the backcountry; a 2003 BACKPACKER study found very little, and many believe the risk is overblown. Then again, the effort of filtering is pretty minor, and giardia is very unpleasant. Plus, thru-hikers are at a relatively high risk of catching the bug, because they are out for so long and in areas that can be pretty popular or well-trodden (like the AT). My take: Why risk it?

Since giardia is spread by having contact with those who are ill with (or carrying) giardiasis, be careful in the ways you interact with other hikers. Avoid sharing food with other thru-hikers, especially if they are ill. If you do share food, place it in the other person’s hand—don’t let them put their hand in your foodbag. Don’t share utensils. You never know whether another person cleans up properly after pooping. As I’ve been saying for years, never shake a thru-hiker’s hand.

If you think you’ve contracted giardia, see a doctor. He’ll ask you to submit a stool sample, and will give you prescribed medicine if you do have the disease.

LYME DISEASE

An unofficial poll says about one-third of all AT hikers get Lyme disease, but it’s also prevalent on other trails. Research is still being done to understand Lyme disease, but the consequences can be dire. It is worth knowing the warning signs and symptoms before you hike. According to the Centers for Disease Control (CDC), Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks (aka deer ticks). If caught early, it’s treated by antibiotics, but catching it is the tricky part. Typical symptoms include fever, headache, fatigue, achy joints and a characteristic bulls-eye-shaped skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. For more on Lyme, visit cdc.gov/lyme.

Watch for the standard bullseye that comes with Lyme disease.

The way to prevent Lyme disease is to prevent tick bites. There are two ways to do that: repellent and vigilance. Here’s what the CDC recommends:

Use repellents that contain 20 to 30 percent DEET on exposed skin and clothing for protection that lasts up to several hours. Always follow product instructions.

Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks, and tents with products containing 0.5 percent permethrin. It remains protective through several washings. Pretreated clothing is available and may provide longer-lasting protection.

Wear pants and long sleeves—even if it’s warm. Better hot than sick!

Tuck your shirt into your pants. Tuck your pants into your socks.

Wear light colors to see ticks on your clothes more easily.

Consider a hat with a flap behind the neck in serious tick country.

It’s also important to find and remove ticks. That’s trickier for a hiker in the field for days at a time than for day hikers, but here’s some advice from my friend Justin “Trauma” Lichter on the subject. I recommend reading his whole post about Lyme disease frequency on the AT at his website www.justinlichter.com.

Do daily body checks. If you are thru-hiking, get in the routine of doing body checks every evening before you go to sleep and quick scans at breaks. Make sure to check warm areas, like armpits, head, behind your knees, and groin. Often you can find ticks crawling on you before they bite you.

Check yourself when you are in town. Even most gas stations have bathrooms with mirrors that can help you check those hard-to-see spots.

If you find the tick and remove it within about 24 hours, you’re very unlikely to contract Lyme. If the tick has been in you for more than 48 hours and has Lyme, the chances of the tick transmitting Lyme to you are much higher. The incubation period for Lyme can be as long as a month after an infected bite. If you know you were bitten, keep an eye out for the bulls-eye rash or any flu-like symptoms, even without a rash.

Next, you need to know how to remove the tick. Here’s the proven way:

Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.

Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouthparts to break off and remain in the skin. If this happens, remove the mouthparts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.

After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.

If you think you have Lyme, get off the trail and go to a doctor immediately, ideally one with experience around Lyme, which is a bit of a tricky disease. There are blood tests to diagnose it, but they aren’t always reliable. If you do have Lyme but catch it early, antibiotics should clear it up.

Even if you don’t think you have Lyme, if you are hiking the AT or have removed many ticks from your body over your thru-hike, it is worth getting yourself tested for Lyme after you finish your hike. Budget some extra cash for this test, as it can be expensive. Although the tests are not always reliable, I did this after my first AT hike and ended up taking a round of antibiotics.

ROCKY MOUNTAIN SPOTTED FEVER

This is another tick-borne illness. In general it’s pretty rare (way less common than Lyme disease), but due to the fact that it can kill you if not treated quickly, it is worth knowing about. It is most prevalent in North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri. However, at least one CDT hiker has contracted it. According to the CDC, Rocky Mountain Spotted Fever (RMSF) is a tick-borne disease caused by the bacterium Rickettsia rickettsii. Typical symptoms include fever, headache, abdominal pain, vomiting, and muscle pain. A rash may also develop, but is often absent in the first few days, and in some patients never develops. To prevent the disease, follow all the same tick precautions mentioned in the previous section on Lyme.

RMSF is a serious disease that can kill you if not treated quickly. Symptoms vary widely, but if you have a fever, headache, nausea, vomiting, and muscle pain, with or without a spotted rash, get to a doctor as fast as possible. RMSF is treated with the antibiotic doxycycline.

WHAT TO DO ABOUT DISEASES ON THE TRAIL

Before you go, it’s worth talking to your doctor about your trip and discussing the possible diseases that are known to exist on specific trails. She or he will help you determine whether carrying prophylactic drugs is worth it for you, including antibiotics and painkillers in case of emergency.

While on the trail, use soap and/or hand sanitizer after pooping in the woods or shaking other hikers’ hands. Be careful when interacting with other hikers. Don’t share food with your hand or reach into bags of trail mix or other foods with your hand. Check yourself for ticks every night and ask others (if available) to check places you cannot see. Wear long sleeves and light-colored clothes.

If you notice something not feeling right on the trail, get off the trail and take a few rest days to see an urgent-care doctor. You can find them in trail towns, and most guidebooks will list clinics along with other town services. In extreme cases, some people go home to rest. Request a test for the disease you think you may have. If you are away from the trail (e.g., hiking the AT, but went back home to the West Coast to rest up), you may need to explain to your doctor the prevalence of the disease in the region where you were hiking. This is especially true for tick-borne diseases. Be consistent about taking any drugs issued to you, and do as much research as you can about your ailment. It may save your hike, if not the quality of the rest of your life.

When you finish hiking, reserve part of your budget for getting tested for diseases afterward, especially Lyme disease. The tests for this can cost up to $500, but if you have symptoms, you want to make sure you can afford to get the test.

NAVIGATION

I could write a whole book just on the navigation on long distance trails, but here are a few pieces of hard won advice that apply to any trail. Even if you have a GPS or phone app that aids with navigation (more information on this is available in the trail specific data), always carry a map and compass. Your phone can get wet or its battery could die. Plus, checking your map and finding where you are on it forces you to identify and appreciate the natural features around you. If you aren’t sure how to use a map and compass, many local outdoor clubs and stores offer classes.

Even with obvious trail, using a map can prevent you from taking the wrong trail at an intersection.
Even well-marked trails can sometimes be confusing (Appalachian Trail, 2008).

Experienced hikers frequently check their map and track where they are on it—especially at intersections.

The AT is usually well-marked with white blazes (6-inch paint marks on trees). The PCT is sometimes marked at intersections, as is the Colorado Trail. However, snow can obscure even obvious paths. Trails can become overgrown quickly, and after a storm, blown down trees may obscure the path. Signs may be removed, stolen, or damaged and can’t be counted on. This is why carrying a map and compass is important.

Some long trails require cross country sections. Other times, it may appear as if a cross country route may be a more direct route than taking the trail. Cross country routes typically take hikers twice as long as trail to cover the same distance.

Forest fires, landslides, and other natural disasters frequently close trails. In the American West, wildfires seem to close parts of the PCT and CDT each year. It’ll be up to you to figure out detours to reconnect to where the trail is open (some organizations post re-route suggestions on their websites).

CONQUERING MENTAL CHALLENGES AND STAYING MOTIVATED

A huge part of the challenge of finishing a thru-hike is the mental game. There were times during many of my first few thru-hikes when I thought about quitting. About ninety days into my first thru-hike of the Appalachian Trail, I found that much of the initial excitement of the trip was gone. Hiking during the hot and humid days was uncomfortable. The scenery from the relatively small mountains of the mid-Atlantic was not inspiring me. I wasn’t ready to quit yet, but I wrote home asking for encouragement.

My dad—usually a relatively taciturn person—wrote me an inspiring story of a long-distance bike trip he had taken as a teenager. A friend with whom I had gone on several day-hiking trips sent me a nice note and a pack of chocolate-covered espresso beans. Now, almost ten years later, I am so grateful that I identified the problem early and reached out to others for help. I wouldn’t be the person or hiker I am today if I had quit the AT. Here are my best lessons about the signs and triggers of quitting, and how to nip problems in the bud.

SIGNS AND TRIGGERS OF QUITTING

Just like we learn history to avoid falling down the same rabbit holes that our predecessors did, I hope you can learn how to persevere from those who have quit hiking. Some of the warning signs identified here are practical (like running out of money) and some of them are symptoms of fatigue (like not eating dinner). Read and remember this list—it will help you keep better track of where you are on the hiking motivation spectrum. These are major red flags that quitting may be in your future:

  Low bank account. Hopefully, your budget (see chapter 1) will keep you on track, but running low on money is a major reason people quit. Always check your bank balance when you are in town and force yourself to stick to a town budget (I limit myself to $100 per town stop). If you know you are bad with money, have a back-up plan, and make sure your spouse or family knows about any potential additional costs on your hike well in advance.

  Not eating dinner. Eat, especially your dinner. Food fuels not only your body but also your brain, and arguably, your morale. It helps you make smarter decisions and helps your body recover. If you ever feel too tired to eat, force yourself to eat. When I’m on the trail, the number one way I know if someone is about to quit is by watching them not eat dinner. If you don’t eat dinner, your chances of quitting go up significantly.

  Body hurting. Check for the symptoms of Lyme disease and, if necessary, get to a doctor immediately. Otherwise, take a good 30 minutes and stretch out your body; in fact, make sure that stretching is part of your routine. Take a zero day or three in town, if necessary. Hikers have been able to save their hike by seeing physical therapists, massage therapists, or traditional doctors, or by taking yoga classes mid-hike.

  Feeling bored. Thru-hiking can be repetitive, especially if the scenery isn’t changing. In “normal” life, we are used to being bombarded with constant stimuli. On the trail, we are not.

HOW TO AVOID A DOWNWARD SPIRAL

On a long hike, success is all about making smart small decisions. One of my hiking mentors, Glen van Peski, once said that with hiking (as compared to many other outdoor sports) we are given more chances to screw up, but we still can’t keep doing it repeatedly before truly bad things happen. If you do one thing wrong, it’s okay. Two things wrong, and you’ll be very uncomfortable. But if you do three things wrong, chances are someone will get hurt. Here’s a list of small things you can do to up your chances of staying safe.

First, identify problems early and don’t be afraid to change. Is your gear giving you some pain? Adjust your straps if your pack is bothering you (many experienced hikers fiddle with their straps every few hours to give their back and shoulder a different sensation). Consider getting a different piece of gear next time you are in town. Getting new gear may be pricey, but if it can stop you from quitting, it could be worth it. Are you tired all the time? Reduce your miles. Maybe your body hurts or you’re finding you don’t have enough time on the trail to fish and see wildlife. This is your trip, so spend it doing what you love. Pushing too hard leads to burnout. Flexibility on trail is the key to happiness. Follow your bliss.

Second, be hygienic. Always use hand sanitizer or water and biodegradable soap after pooping, using privies, or shaking other hikers’ hands. When sharing food, pour it into your hand or others’ hands; don’t reach into your food or let others’ dirty hands get into your food bag. To eat your own food, use a spoon instead of your hands, even for funny things like broken chips. For solid food, better to give another person food from your dirty utensil than to have their hands or utensil in your food. These measures may seem extreme, but help prevents the spread of disease—a major reason people get off the trail.

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Tips to Avoid Boredom

Talk and walk with other hikers. Even if it is just for a few hours and you have to hike at a different pace than your own, this is sure to brighten your day. I have met some of the most interesting people this way—a snake handler, a possum hunter, and people from all around the world. The trail is a safe space where you can meet people from all walks of life.

Jam out. Put mp3s of your favorite music, podcasts, or audiobooks on your phone. Some hikers even carry a radio to hear the news and sports games live. Use headphones so your music does not disturb wildlife or other hikers.

Slow down and do your hobby on the trail. Chances are you dreamed that your thru-hike would involve plenty of time to enjoy a hobby and hike, but your hobby got waylaid for making miles. Go back to your roots and spend some time hiking the hike you dreamed of. Go fishing! Doodle in your sketchbook! Play your guitar! Make elaborate camp meals! Paint watercolors! Take out your tripod and do some pro-grade photography! Balance your hike with what you love.

Read. Carry a book or e-book. Sure, it makes your pack a little heavier, but some of the most accomplished hikers in the world have told me that the extra weight is worth every ounce.

Write or journal. Your writing doesn’t have to be about your trip. You could be working on the next great American novel. Writing helps you process your life and can make the mundane seem interesting. If you don’t want to write just for your own sake, write letters to send to folks back home.

Third, take care of your feet. Especially watch out for blisters, which are another major reason people get off the trail. If you do get blisters, take extra care to clean and drain them, and not let them get infected.

Be appreciative of the bad times along with the good. Mother Nature isn’t always going to play nice, but realize that the bad times are there to teach you things about yourself. How often do people get to walk through rainstorms? I mean, it’s kind of cool, especially compared to sitting at a desk. Remember, this is what it’s like to truly be living. Remember that no matter how bad things are now, this too will pass. Thru-hiking is exhilarating because of the contrast between highs and the lows. The trail teaches us to live in the present, but also to keep everything in perspective.

I was super stoked to stumble across an ancient cedar tree on the Chinook Trail. I couldn't help but appreciate how lucky I was to be hiking in nature.

Know what to expect in upcoming sections of the hike. If you know the next section will be harder, you can prepare yourself for it mentally. Of course, you can freak yourself out a little bit, too. But sometimes knowing, visualizing, and preparing your mind and body for a difficult section can save you from a situation that feels so traumatic that you want to quit afterward.

My friend Cam “Swami” Honan, who has hiked perhaps more than anyone else in the world, suggests this mental trick: Try watching yourself from above. Pretend you’re watching a movie where the star is you. You’re looking at yourself from above, an omniscient audience watching the main character about to enter a daunting situation. By taking this perspective, suddenly you detach yourself from any pain and start thinking of the situation objectively. Whatever suffering you’re feeling starts to feel like it’s happening to a character. What would you yell at the screen in the movie theater? “That hiker is about to go above treeline in a storm. Dumbass should stop and hunker down in his tent for a while!” It helps you put your situation into perspective instead of just feeling sorry for yourself. It helps you realize you’re not a victim of nature, the weather, or your pain. You have power in these situations and in making smart decisions. You can make things better on the trail.

Always have something to look forward to! The miniature ponies of the Roan Highlands are a highlight of the AT.

Set mini landmarks to be excited about and look forward to. The trail will go on for a while. Walking will become your job. Just like you have weekends to help break up your desk job, you’ll need mini vacations from your vacation. Whether it is a zero day or a visit from a loved one, or a side trip into the big city or to scale a peak, give yourself some mental treats once in a while. Just like you planned your itinerary by thinking of it as a bunch of shorter hikes back to back, start thinking of your thru-hike as a bunch of shorter trips back to back.

HIKE YOUR OWN HIKE

IN PRAISE OF ZEROES

William “Pi” Murphy is a huge fan of zero days.

Many hikers name their days by how many miles they’ve hiked: “Phew, a 20!” “Who were you with when you did your first 30?” Some even say more extreme numbers—35, 40, even 50-plus. These numbers seem competitive. They seem progressive. But sometimes, the best progress is a zero.

Everyone needs time off. There’s a temptation to characterize a long hike as a lot of time off—from your job. However, a long hike is, well, long and hiking. And neither one of those is easy. A zero isn’t all about making it easy. It’s about having a sustainable approach to hiking. Many will say that recovery time is as important—if not more important—than training time. Ask yourself: Would you rather get a few more miles now with the chance of injury or start the next week rested and recovered, ready to go the whole hike?

Some folks cherish their zeroes. On one hike, I accumulated over thirty zeroes. Some folks like neroes instead, where they hike a few miles away from the expenses of a hotel and other town temptations, but still take a rest day. That’s not to say I always forgo hiking for days in town. I’ve also gone two-plus weeks without a zero, but it left me thinking about quitting.

In my experience, taking less than one zero day per week leads to injury and frustration, neither of which is good for the goal of completing a long hike. If you haven’t hiked before, I suggest planning on a full zero every week, or maybe even one after every five days of hiking. Try to use that zero for resting only—not for walking back and forth across town, doing laundry, getting groceries, etc.

To me, zero days are the key to a sustainable hike. Plan them in, both for time and for budget. You’ll need a break from the so-called vacation of a long hike.

—William “Pi” Murphy

After a hard day on the trail, think of where you started that morning and all the things you have seen and done that day. It helps you realize that one day on the trail is so much more living than you get in a week at home. Even on a hard day on the trail, I feel like I experience and do so much more than in a day at home. It makes me feel accomplished. It lets me appreciate the difficulty and gives it meaning: I had to push to achieve all that I have done.

Remind yourself of why you are out here. Look back at all you have come through and ahead towards all you will see.

Use food as a morale booster and motivator. I’ve found that hikers start thinking like dogs. Give yourself food treats to motivate yourself through the lows. Whether it’s a chocolate bar at the top of the hill, a special freeze-dried meal for dinner at your next camp, or a big steak dinner in town, food and treats can be a simple, easy fix to make your trip feel easier.

Change your social group. Every year, people end up quitting because they don’t like the crowd of hikers they’ve fallen in with. An easy fix is taking a week off the trail and letting them get ahead. No one says you have to hike with certain people. Don’t worry about hurting their feelings. You came to the trail with a goal, and people you don’t like shouldn’t be what stops you from finishing.

Remind yourself of why you’re here. Look at your find your “Why Hike” answers (see the “Introduction”). If you’re thinking about quitting, take a zero day (or several). After a few days of sitting, watching bad TV, and eating ice cream, your body will likely ache to get back on the trail. You’ll think, “Was I really about to leave the trail for this?” This has worked for me as a helpful way to put the difficulties on the trail in context. If that doesn’t work, think about your worst day at the job you left for the trail. Is the trail really harder than putting up with that copy machine again? I didn’t think so.