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Care & Maintenance of Your Body Parts

By Annie Getchell - March 3rd, 2004

One pink autumn morning, my girlfriends and I were midway through a sunrise hike just a few miles from home. Gretchen, who moves like a determined little hummingbird, was stepping lightly down a slab when she slipped on some dew-dampened lichen. We could see her grimace in midair - she was hurt before she ever hit the ground. When Gretch tried to put weight on her knee, she crumpled in pain. Piggybacking her down the mountain, I made bad jokes to cover our worries, and reminded myself how easy it is to come undone. Gretchen spent the ski season on crutches, in physical therapy, and moping on the couch.

For someone like me, whose body reads like a sports-injury inventory, it's pretty amazing I've never suffered a severe backcountry trauma. However, just one glance at my rippled shins and scarred-over patellae reveals a historic map of high-impact events. A below-the-boot ankle break, running stress fractures, miscellaneous suture tracks and fading memories of road rash are topped by a few more recent indignities, including a broken toe (not to mention a busted thumb; various tears, sprains and dislocations; major lacerations and minor burns; mangled teeth; stitches in at least five places; several concussions; and countless contusions).

You'd think I'd be more careful. And I am, now that I'm nearer 40 than 30.

Super fitness standards, bombproof plastic boots, fat foam skis, dynamic ropes and sticky rubber - even shock absorbers on bike forks - all help you cover a lot of country in the span of an afternoon, at a pace faster than humans were designed to go. While lightweight, techy toys make even the most unlikely terrain navigable at high speeds, they also increase frequency of a factor we'll call "catastrophic deceleration." Your preferred sport generates its own peculiar idiom for this syndrome: skiers make "face plants," mountain bikers "pop endos," climbers take "whippers" - sometimes "cratering" - and paddlers get "laundered" in holes or surf. Whatever. Catastrophic deceleration is part of the learning curve, and resultant injuries mark mileage along the path.

Even though you may not think much about a cracked wrist or sprained thumb, the accumulated trauma from all those little injuries usually amounts to vague muscle soreness, acute back and joint pain, even headaches later on - well after age and experience have encouraged more conservative velocities. (My husband now refuses to consider any new sport that requires a helmet.) For instance, the repercussions from overtaking a Ford Fairmont while bicycling, plus a few other grounders over the years are now manifested by a chronic neck grievance that screams if I neglect my daily stretches. Similarly, David, a lean and lithe outdoorsman, recalls a neck injury from a particularly august skiing wipeout. "Now even the shortest falls or missteps on the trail really jar my spine in the same place," he says.

Common workplace maladies can really go crazy in the wilderness. Pay attention to your desk setup and driving postures. If you're suffering from computer-related tendonitis in your wrists don't ignore it and then climb hard all summer. Treat the condition seriously: Consult with a bodywork specialist, even switch sports for a while if you have to. The short-term sacrifice will allow you to enjoy your preferred method of navigation longer.

Skiers


  • Keep in mind that the heroic sort of "linked recoveries" tele skiers make as they wrench and plunge down a gully can be as grueling as a full-blown face plant. Back, hips, knees and ankles take a beating whether you fall or not.
  • The worst (but not necessarily most common) injuries are fractures from windmilling body parts. Don't over-tighten your bindings in thick crud; pinheads beware, your bindings won't release.
  • Similarly, a broken toe from augering into thick spring cement is often the result of pin bindings. After such an injury, for which there's nothing to do but tape and bear it, I switched to cables.
  • There's not an alpine or tele skier out there who hasn't tweaked a thumb at least once from touching a hand down at speed. Train yourself to make a fist as you fall so your thumb isn't exposed.
  • Collarbones are known to snap loudly as you reach out stiff-armed to break a fall. Learn to tuck and roll.
  • Shoulders suffer impact from overly aggressive pole plants. Use your poles to initiate your turns and as balance points rather than as dynamic supports.
  • Hate to say it, but backcountry skiing is a helmet sport. Tree-skiers should consider their odds accordingly.

Backpackers


  • Knife cuts and burns from fires and camp stoves are extremely common. Be prepared with sterile dressings.
  • Twisted ankles occur most frequently to those who do not wear full ankle boots. Hyperextended knees happen when you lock your legs under load.
  • Obvious foot maladies include blisters, infected toenails and painful corns or warts. Break in your boots, carry moleskin, and keep your nails trimmed.
  • A warning to hut workers who boast about their hauling ability: Those excessive loads may well come back to haunt you. Many a voyageur succumbed to painful - even fatal - hernias. They usually didn't live long enough to complain about their knees.
  • Tingling or numb hands, and chafed spots on shoulders or hips, result from a poorly fitted pack. Ask your favorite outfitter for some help in custom-fitting your pack. Learn to use and adjust the shoulder stabilizer/load-lifter straps.
  • Consider using ski poles to relieve stress on knees (tendons/cartilage) during ascents, and lessen shock while descending. If the constant click-click clicking drives you nuts, rig a rubber cap on the tips.
  • "Crotch itch" happens, regardless of gender. Clean your undies whenever possible on the trail. Pack baby wipes or sanitary towelettes if you're prone to yeast infections.
  • Occasionally, lower back trouble may be traced to an ill-fitting or overloaded pack, but more likely from not lifting a heavy pack correctly. Learn how to lift loads properly at a gym if necessary.

Paddlers


  • Recognize the limitations of your sport sandals - they're great for amphibious use and preventing clammy feet, but they do NOT protect you from shoreline hazards like poison ivy, brambles or barnacles. They also leave your dogs exposed to world-class sunburn and the occasional dropped sharp object.
  • Misuse/overuse abuses extend to rotator cuffs and tendons along the arm. Remember that you should be engaging the torso muscles when paddling - not just the ones in your arms.
  • Regularly open and stretch your hands to avoid blisters or stiff joints.
  • Stiffness in back and hips may be due to tension resulting from poor seat ergonomics. Work out your seating arrangement before you leave: Adjust foot braces and custom-outfit the seat with strategic pieces of foam padding or a camp rest so you're comfortable and supported.
  • Sometimes you just need to get out of the saddle. Whenever possible, hop out and walk along the shore if you feel uncomfortable.
  • Practice shouldering your craft with a partner or employ a nearby tree. Find the least stressful way to balance the boat during a portage.
  • A perpetually wet derriere is prone to diaper rash. Carry dry pants and an alcohol swab or baby wipes on long trips.

Injury Prevention Tips


  • Don't be a weekend warrior - this is a primary cause of backcountry mishaps. If you absolutely can't manage some physical activity during the week, at least try to warm up slowly for the adventure. Be honest about your fitness level or you may over-commit yourself and pay later with stiff joints and inflamed muscles.
  • Stay hydrated! Dehydration contributes to cramps and injuries on many levels. Clumsiness and inattention, symptoms of both hyper- and hypothermia (often a result of dehydration), can cause you to make painful mistakes. If your body, which is roughly 62% water, is down by just 1-1/2 liters, your endurance may be reduced by about 20%, and oxygen uptake (heart/lung efficiency) drops about 10%. Additionally, water helps to lubricate joints so you move with more fluidity.
  • Take a yoga, dance or stretching class. Active people often dismiss these disciplines as too passive, yet by stretching you can lengthen stride (saving time and steps on the trail); learn to relax rather than tense entire muscle groups (for increasing reach and holding power on a steep wall); improve posture and spinal equilibrium (for better balance and centered movement); and generally create a more supple and resilient machine.
  • Re-evaluate your fitness program. Is your body fatigued before you even hit the trail? After years of running, the daily wear and tear made recovery from strenuous trips very difficult for me. A switch to low-impact walking and cycling for aerobic maintenance made a big improvement in my trip energy levels as well as recovery time.
  • Another training-related problem to bear in mind: road crowns. Seek varied terrain for your workouts.

Triage


  • All wilderness travelers should be equipped with knowledge of basic first aid as well as CPR. Carry a small first aid kit with at least the basics: moleskin, tape, sterile bandages, alcohol swabs, triangular bandage for slings and splints, knife with scissors and tweezers, plus non-prescription or prescription anti-inflammatories. A major mishap will tap into your creative splinting abilities. Analgesic balms like arnica or Tiger Balm are popular topical treatments for sore muscles and tendons in the field.
  • Immediate treatment makes a huge difference in recovery time: Dip a PakTowl or bandana in an icy stream or fill it with snow to make a cold pack for even a minor strain.
  • Ibuprofen, the active ingredient in non-prescription anti-inflammatory drugs like Motrin or Advil, has become a staple in most backpacks. Ibuprofen (better known as "Vitamin I" to athletes over 30) is best used in moderation, and should be used to aid in recovery from strain, rather than to mask pain during an activity.

Injury Recovery


  • Discuss your injury with a professional, even if you don't have an examination. Follow any recommendations about rest or periodic icing.
  • Consider consulting a personal trainer or physical therapist for exercises that heal, restore and strengthen the affected area.
  • Also consider a visit to some type of massage therapist who can help you to identify exact areas of pain so you can focus on relaxing and releasing tension. Learn steps for self-massage or ways a partner can help.
  • As difficult as it is to rest, allow time to heal. Don't blow off any prescribed therapy, and be realistic about the strain. Lack of attention to a nasty sprain left me with an ankle that absolutely refuses to bend into a frozen boot.

It goes without saying that anyone venturing beyond pavement or popular trails should be prepared to manage basic injuries like burns, cuts and sprains. Besides a first aid kit, this might mean carrying collapsible trekking poles (which would have been ideal in my pal Gretchen's case, since the likelihood of a second injury to her rescuer was high). Or - dare I say it? - a cell phone.

When treatment is far away, prompt and decisive response to seemingly slight injuries can make all the difference to speedy recovery. If the trauma extends to the head and back, you're talking full-on evacuation, which takes exponentially more valuable time. Sober stuff. Remember, confidence makes a big difference in how you move, whether you're boulder-hopping or portaging a canoe, but so does plain old prudence. Sometimes when I'm off on a solo journey and too tired to pay attention, the sage voice of an octogenarian friend reminds me: "When in doubt, don't."



Outdoor writer Annie Getchell cut her climbing teeth in the Cascade Range of Oregon and Washington, a classic training ground for all-around mountaineering. Then she met her match: a man with all the same kinds of alpine footgear. She soon found herself cragging around New England's granite, where she took her first leader falls. For the past twelve years she's enjoyed peak bagging; aid climbing desert sandstone walls; summiting granite towers in Canada; sporty limestone hangdogging in Sardinia, and (reluctantly) ice climbing Quebecois waterfalls. "All the different forms combine to make me feel secure in the mountains and sure of my judgment--I know when I am afraid," she says.

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