When reading any of the trip reports I've written on Climber.Org, keep in mind that 30 years (1990) ago I couldn't hike at all. In fact, walking down a flight of stairs hurt so much I had to turn around and back down holding onto the rail.
By the late 80s my knees were shot and I was looking at a wheelchair, only 30 years old and only 20 SPS peaks climbed. No specific injury, just pain walking downhill. Over time it got to the point that my legs would occasionally buckle and I really couldn't hike or climb safely. I tried resting. I tried doing easier trips. I tried pushing through the pain. Nothing seemed to alter the downward spiral.
The Pacificare HMO I belonged to put me on 2400mg of Ibuprofen per day, without mentioning to me that it would (not might, but WOULD) cause organ damage. When I found out the risk from a co-worker, they admitted there was no informed consent and finally agreed to MRI testing (which they had adamantly refused earlier). All the scans were negative.
Eventually I found a way to get out of the HMO and gained access to 'real' doctors. The doctors couldn't figure out how to make it possible for me to even walk down a stairway. Three months of physical therapy didn't help. Ten thousand dollars of arthroscopy didn't help. Three MORE months of post-operation physical therapy didn't help. I could work the silly machines in the gym, but I couldn't function in the real world.
One day after work a group of us went out for a drink. I dropped my napkin and squatted instinctively to pick it up. Both knees buckled and I ended up laying on the floor of a crowded bar. First I despaired. Then I got serious about fixing this thing and took control of my life.
I had an inspiration based partly on a conversation with Dale Van Dalsem (who I believe had worn his cartilage completely away, but could keep the bones polished by walking frequently). A conversation with a chiropractor added a critical tidbit: Joints don't have blood vessels. Cartilage is nourished by fluid in the joint, and when I stopped moving I stopped the nutrients the joints needed.
The arthroscopy tape revealed nothing wrong with the parts of the joint they could get to. 'Fillet of Knee' was an option but no one was going to recommend surgery that could actually injure me just to find out if they could see any problems the MRI and XRays didn't show.
What if the problem wasn't fixable but WAS something I could work around? My mental model was a rusty hinge, which would bend if you forced it but would loosen up and achieve a full range of motion if you worked it back and forth slowly without going to far or using too much pressure.
In the beginning I would hurt myself if I walked at two miles per hour for just two minutes. Doing that just once meant my knees ached the next day. I found that 1 minute at 1 mile per hour seemed to do nothing, so I did nothing very frequently!
I got a treadmill and set a timer on my computer. I worked at home so I had the freedom to get up and walk for one minute out of every fifteen minutes ALL DAY EVERY DAY. From when I got up until I went to sleep. I'd sit at my computer, hobble over to the treadmill, back and forth all day. The change was slow, but it started right away! I discovered that each week I could increase EITHER the speed OR the time (not both) by 10%. Occasionally the increase was too much and I would have to back down for another week.
I discovered that if you want to do it at all, you have to do it frequently. Even after I could walk OK, I still couldn't pick up that dropped napkin. That's when I bought a 'Marcy Bar' - a small weight machine with a 180 pound stack that I could use to pull UP and reduce my effective body weight while I did squats. Using the same basic technique of frequent minor workouts, I made a mark on the bar... and each week I would squat a quarter inch lower until eventually I could bend my knees to 90 degrees. Then I reduced the weight so my legs had to work harder, and so forth.
It took six months to work up to 4mph treadmill sets that lasted 45 minutes each, 90 degree squats supported by both legs but with just my body weight, and slight squats on one leg at a time with an extra 100 pounds of weight on my shoulders. The therapist told me to stop with the weights or stop coming to his office, so I had him prepare my final bill and walked away.
At the prior suggestion of the physical therapist I used the treadmill both up and downhill facing both forward and backward. (Wow, can you ever get a quad burn going uphill backwards at high speed!) The tilt on my treadmill wasn't enough, so I got automotive jack stands that achieved a 20% slope (twice as steep as modern trails). Still it wasn't the real world - on a treadmill there are no uneven steps and no stumbles.
Once I could hold four miles per hour on the treadmill, I tried a half-day hike. I discovered that frequent use of the treadmill was the only way to avoid pain in the real world. Think of Alice, running to stay in place. If I hiked in the morning and skipped the treadmill in the afternoon, I would hurt the next day. There could be no deviation from my ritual or I lost ground. Still, I was going down stairs facing forward and I was in pretty good shape from all the treadmill time.
By 1990 I was living in Northern California where the DHS (Day Hiking Section of the local Sierra Club chapter) did predictable-difficulty dayhikes twice a weekend. They were the final piece of the puzzle, and I will always be grateful for the people who were there when I needed them - supportive but not competitive, there were easy hikes on Sunday and harder hikes on Saturday with encouragement to move up whenever you were ready. That time and those people are gone, but having hard core dedicated nice people around you is invaluable.
In 3 or 4 months I worked my way up from 5 mile to 25 mile hikes, without ever stopping the daily treadmill routine, and never looked back. I was working too hard to do much in the Sierra, but I routinely led 20-30 mile local day hikes for a couple of years. Basically, I started REALLY climbing the SPS Peaks List in 1994, just 5 years before I finished the list. I did as many peaks in 1994 as in the previous decade, and in the following years I climbed 40, 45, 58, 43, and 34 peaks - not all of these were in the Sierra, but most were.
In 1997 I managed to climb at least one SPS peak in every month of the year. In the late 90s I finished my SPS leader credentials (M rating), and I also found time to climb three continental high points (Elbrus, Aconcagua, Denali), plus some climbing in Nepal and Mexico, etc, I discovered that I have to push myself at least every other week or my knees start to hurt again. Do it often, or don't do it at all.
I've backed off a bit now, trying to balance a social life with my need to keep walking, and I live with a bit of knee pain as a result. Ten years of hard hikes every couple of weeks have left me in pretty good shape. I'm more resilient in my 50s than when I was 20. It's a curse, in a way, but being forced to stay in shape isn't all bad!
-- Steve Eckert
PS: If you find this useful, or if you have a similar experience to share, please let me know. I didn't write it to say what a smart guy I was. I wrote it to encourage others to take charge of their own future.
PPS: In 2010 I finished the DPS list. Day hikes aren't as good for me as backpack trips, but at least I got to see new places!