So Penny and I met up with Heidi and her 2 dogs for a walk on the beach. Or actually, I guess it was a walk on the Arctic Ocean itself.

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She was quite comfortable hoping over the breaks in the ice, but coming from Lake Michigan winters I was much more skittish about the security of jumping onto and off of basically icebergs. Of course they AREN’T really icebergs, but for my uninitiated brain, they might as well have been.

The breaks in the ice are called leads, and they are the first sign the ice pack is breaking up.

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The ice we were walking on was pretty rotten, and I slipped and slid all over the place, but the dogs had a blast!

We finally made it safely (and dryly!) to sand, and beach combing in Alaska yields some very different finds than back home.

Caribou head:

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Dead seal carcass:

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And baleen from a baleen whale. This is the stuff that hangs down in the mouths of certain whales (baleen whales to be exact) and filters out krill and other food for the whale. Apparently you can clean these up and have them carved into cool designs.

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Looking forward to more ice melt and more sea ice break up, as I’m told the colors of the icebergs as they break away are amazing.

Stay tuned!

 

I made it!

It was close, I wasn’t sure we were going to be able to land – the fog was so thick we waited more than an hour at Prudhoe Bay before we could take off, then attempted 3 separate landings before we finally touched down.

Barrow is, um, muddy.  Really, really muddy.

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(this is the view from my living room)

This place reminds me of any seaside village – just socked in old dirty snow and mud. The people – so far – are super friendly and welcoming, and it makes me excited to be here.

After finally landing, my new boss Heidi shuttled me around a bit, including to the famously high-priced grocery store, the AC. I bought some pasta, pasta sauce, butter, coffee, cream, and a few other odds and ends: $124. If I had paid $25 for this haul back home I’d have been upset. The non-organic Half-n-Half alone was $7.99.

We also took a bit of a tour around, checking out the Arctic Ocean, learning about polar bears, and then taking the dogs for a bit of a run-around on the tundra.

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Penny was in love with the snow! She met two new friends (Heidi’s dogs) and the three pups had a blast running around, getting the leashes tangled, and just being crazy dogs. Penny certainly needed this after being cooped up for so long in her crate.

Back on the road into town, we were lucky enough to have found a few whaling vessels still on the beach after the spring hunt was over. I can’t wait for the first festival in a few weeks when I get to, ahem, try some whale meat.

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The boats are covered in skins, and you could smell just how fresh they were.  Yum!

Looking forward to getting on to the business of physical therapy, which is why I’m here. I’m sure there will be a few boring days of housekeeping orientation type stuff, but it’s a necessary evil. I’ll be getting my hands on some patients soon I’m sure……

Stay tuned…it seems like I have to learn how to shoot a really big gun. So……….this should be entertaining!

 

 

Had a great day in Seattle yesterday with my friend Chris Stanley, who so kindly drove up from Portland to while away my layover day with me. We spent most of the day at the Market, ate some amazing seafood, watched a lady with a parrot and some seriously interesting people, and basically just enjoyed a beautiful day outside!

This morning I woke in a quaint little motel in Anchorage, and I’ll catch a 6a shuttle to the airport for my last flight. I’ll be glad to get my feet on the ground and see what Barrow has to offer!

Penny has done exceptionally well! The mild benzos from the vet seemed to work wonders – and she snored like an old man all night last night! I think she was more tired than I was!

Next post will have my first impressions of my new home, and I’ll do my best to post some pictures.

You can check out my photography website for my favorite photos from my previous adventures: BackpackerPT.smugmug.com

Thanks for following along!

Well, the apartment is empty. The storage unit is kinda full. My North Face duffel, affectionately known as Big Bertha, is really, really full.  As is my heart; I’ve made such great friends here in Austin and it’s been super sad saying goodbye.

Worst of all is leaving behind my niece. But she has gifted me a Pokey (of Gumby and Pokey fame…) that I promised would adventure with Penny and I.

Those of you who read my previous posts thought you were going to get a wonderful recounting of a grand adventure by car up the Al-Can….but circumstances got in the way and now it’s boring old airports. Not nearly as much fun, but once I get to Alaska……watch out!

Gotta go to bed, that 3a alarm is not too far off. Looking forward to a great day in Seattle tomorrow with an old TexPTS friend – he’s helping Penny and I spend my 10-hour layover, then on to Alaska!

Just gave my notice at work yesterday, which means it’s real. I can’t take it back. Well….maybe I can but I won’t.

Already sold several household items, most of my furniture is going to a young relative about to get his first apartment (how easy was that?!), and I’m buying things to deck out the Subie for a 5000-mile voyage.

#PennyTheAdventureMutt doesn’t seem too pleased with her airline-certified crate. She’s been in a few times, but will drag her bed out of it to sleep. We’ll have to work on that. Thankfully it’s not too long of a flight from Anchorage to Barrow, so she shouldn’t have to spend too much time in there. Long enough as far as she’s concerned, and I’m worried sick about flying her, but I’ve pretty much got no choice here.

What’s interesting is how much I need to use my ultralight backpacking skills to pack for this trip. I’ll only be able to keep with me what I can check on the plane or ship ahead (for a pretty pricey penny, I might add). Penny is a piece of luggage, so is the Fat Bike. That leaves a single duffle I can check, plus a small backpack I’ll use as a carry-on. Seems pretty UL for 3 months of living in the arctic……

 

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It’s here! My 2018 Milepost arrived and now I can get down to business! So many options and not enough time for all of it.

I’m trying to decide now how much time to spend wandering around the lower 48 to visit friends before I head to the AlCan itself – AZ, southern UT, friends in Portland, a favorite uncle near Reno, how could I miss Glacier?!, I have to go through Banff….how am I ever going to get to Alaska?!

 

Oh how I love to look at maps!

I’ve been in love with them since we had the boxes of maps in 5th grade (Thanks Mrs. Knarr!) and the wooden rack of pull-down canvas maps in the front of the classroom, showing me all there was to see in my state, in my country, and in the world. It was, looking back on that, likely the beginnings of my wanderlust.

It was right about then that we took our first road trip out west; my dad took 3 weeks off from the steel mill, my mom planned the route and the menus, and the four of us packed into the 1980 blue and white Chevy Blazer to drive to mountains. We saw Mt Rushmore, the Badlands, Yellowstone, Tetons, Devil’s Tower, walked through the site of the Battle of Little Bighorn, read about the standoff at Wounded Knee, camped in national parks and in cow fields, and my love of the road trip took hold.

Thankfully, I’m of the ultralight mindset in terms of my backpacking trips, and hopefully (oh dear me, hopefully!) that can translate to packing for this trip. My big item will be my bike – The Fattie, as she is affectionately known – that I will use for transportation and for exploration around Barrow. I wonder how I can carry a loaded shotgun while riding?

I’ll take suggestions!

But otherwise I need to bring almost nothing – I’ll pack my zpacks arc blast as though I were going on a backpacking trip – and that will be all the backpacking toys I get to bring. I’ll bring the bike and a small toolkit. The dog. I’ll ship a small box of clothes, linens and toiletries….and that will be my life for the next 3+ months.

I’ve been pleasantly surprised at how many people actually HAVE worked in Barrow – and have reached out to me to provide advice and support. This has REALLY helped pacify almost all of my fears and nervousness about the work assignment and the drive.

Can’t wait to plan the route! That’s coming next……

I seriously may have outdone myself this time.

I just agreed to a contract job in Barrow, Alaska.

That would be here:

map of BarrowWhich is really, really, really, really far away.

 

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3,569 miles as the crow flies, but more than 5500 via car and plane.

It’s also pretty barren, cut off from any roads, and it’s accessible only by plane.

The plan is to drive to Fairbanks (maybe Anchorage?) and leave my car, then #PennyTheAdventureMutt and I will make the last leg via Alaska Airlines to our new home:

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I was pretty excited to bring my Fat Bike (the Fattie, as she is affectionately known) to ride the gravel beaches of the Arctic Ocean. But I was warned that might not be such a good idea, at least without bringing a really, really big gun. Or a friend with a really, really big gun.

Apparently POLAR BEARS are a thing up there.

Oh yeah, and rabid arctic foxes.

And apparently I haven’t smelled anything until Penny rolls into rotting whale blubber that’s been festering on the beach for days in the 24 hr sunlight. Can’t wait!!

The adventure starts now – the purging of all my belongings, the minimizing, readying the Subie for the greatest road trip of all time.

Seriously….Can’t wait!

Stay tuned………

 

By far one of the most common ailments I see, and that folks on the trail ask me about, is back pain.  I apologize for the long-and-winding nature of this post, but hear me out.

Back pain can be a tough one to treat, primarily because it’s so very many things; there is no single cause of back pain.  And all of you who talk about bulging or herniated discs, a pinched nerve, or your back being “out of alignment,” or any other anatomical things that someone once told you you had – well, I hate to tell you, but those things are generally irrelevant.

The fact is that far more than half of the PAIN FREE population has massive herniated and bulging discs, pinched nerves, even spinal fractures!  When MRI first came on the scene it was a game-changer: we could now actually see soft tissue in the body.  Before we only could infer what MIGHT be there based on how far apart bones were in X-rays, but now – now we can actually see those discs!  So everyone with back pain (and neck pain, and shoulder pain, and knee pain…) had an MRI.  And guess what?  We saw all kinds of bulging discs, herniated discs, pinched nerves, meniscal tears in the knee, rotator cuff tears in the shoulder, and on and on.  And orthopedic surgeons made a fortune taking all these things out or sewing them back together.

But now guess what?  Many of those patients found they hurt just as bad before the surgery as before.  I’m sure many of you know people who had back surgery only to still be in pain afterwards – and that is because MRIs cannot show pain.  [Heck, there is even a brand new study of meniscal tears in the knee: a group of people had a real meniscectomy (removal of the torn piece of meniscus) and the other group just had a sham surgery.  Do you know which group had the most relief??  Yep, they were IDENTICAL: no differences between those who actually had the torn meniscus removed and those who just thought they did.]  We always assume that any anatomical deviation we see on an MRI must actually hurt, but a wave of new studies is finally starting to take MRIs of people who do NOT hurt.  Their MRIs look exactly like the MRIs of people who do hurt.

I like to use the analogy of your car: imagine that one morning you go to your car to go to work and oh no! it won’t start!  So you call your mechanic in a panic – help, my car won’t start!  Well, he says, go out and take a picture of it and send it to me.  Heck, even lift the hood up and take a photo there, too.  So you do.  And what does the mechanic say?  Well look at that!  you have a huge dent in your driver’s side door…we’d better fix that!

Just as you would never expect your mechanic to figure out why your car won’t start by looking at a photograph – you should not at all expect someone to figure out what hurts based on an MRI.  [Now, I’m not saying there aren’t uses for MRI and X-ray, of course there are, and I refer people for them all the time.  But all an MRI or X-ray is going to show me is if you have a tumor, or a new unhealed fracture, or possibly an infection.  If you have no other symptoms besides pain, don’t bother.  If you have PROGRESSIVE neurological weakness, bowel or bladder problems, fevers, that sort of thing, well then YES, that is when imaging is important.]

 

Now, what does this have to do with your back?  A lot.

I would say I spend more time actually teaching people about back pain than anything else.  If you understand that your herniated disc from 21 years ago, or that old fracture you have, likely has NOTHING to do with your back pain today, then already you are on the road to recovery.  Even if you had an MRI for your first instance of back pain and it showed a bulging or herniated disc, it STILL doesn’t matter, because you don’t know how long that has been there – it might be 10 years old.

So much of pain is mental – well, actually, ALL pain is mental, really – and we have great studies showing that once you learn that you are not actually squishing out disc material, or you aren’t moving that old fracture, then your pain scores go down significantly.  So my first bit of advice to you is to STOP thinking about that old injury which may or may not have ever actually hurt in the first place.  Backs usually hurt without anything actually being “wrong” with them, and that’s a very difficult concept to understand.  But realize that more than 90% of low back pain has NO identifiable cause.

That does not mean we can’t treat it, it just means we can’t identify what it is based on a photograph (which is really the only technological tool we have).  So what IS back pain?

Back pain is usually a combination of muscle pain, joint pain, possibly disc pain, and some nerve irritation.  Nerves don’t have to be pinched to be irritated and inflamed, and sometimes that can be more troublesome than an actual mechanical compression.  The key is to understand that most back pain is a constellation of all these things and that it WILL get better: with time, and with movement.

Stay tuned for what to do if you have brand new back pain, or have been suffering through it for decades……

As a PT, I am not always the best at doing what I tell others to do.  And after that ankle fracture, I was not the best at wearing the boot all the time, or initially doing my rehab as I should.

But as my JMT hike loomed ever closer (August 2014) I started to panic and did so much to try to rehabilitate my very unstable ankle – to not much avail.  But stubborn as I can be, I went on my hike anyway.

I spent a good 5-10 days in near misery: every time I would try to step on a rock with only my forefoot for support, my ankle would collapse – and more than once so did I.  I fell so many times during that first week or so I nearly broke my new tripod.  And my pride……

But then something amazing happened: I stopped falling.  I started being able to support my weight with my forefoot balancing precariously on a pointy rock.  I started going faster downhill.  And it didn’t hurt.

So what happened?

Despite literally MONTHS of aggressive PT trying to improve both my ankle strength (from being immobilized in the boot for 2 months) and my proprioception, I really wasn’t in hiking form.  But the intensity of 15-mile days through the rocky high Sierra was the perfect rehab!  I came away from that trip with a nearly perfect foot and ankle – yes, I’m still a lot slower on the descents than I used to be – but I’m back to running and hiking with only the slightest hint than I ever had an injury, let alone one as severe as a fracturing 2 bones and dislocating my mid-foot (all treated non-surgically, too).

My takeaway from all this as both a PT and as a hiker is the importance of proprioceptive training in the rehab of an ankle injury (and likely any injury of the lower extremity).  All the strengthening I did all summer long, including plyometric jumps and hops, were nothing compared to those first 10 days on the trail.

So once you are stable enough after an ankle injury (meaning no more swelling, able to walk without limping), then go for a hike.  A nice, slow hike in the most minimal shoes you can be comfortable in, staring at your feet, maybe even use trekking poles…just get out there and hike.  But do it slowly (I don’t actually recommend running right out and hiking 221 miles in the Sierra Nevada), gradually increase how fast you walk OR how long/far – never both at the same time – and just hike.

I thought this would be a wonderfully appropriate topic to bring up since I am currently wearing a lovely CAM boot – having broken my mid-foot and ankle a month ago.

One of the most common misnomers in the general population is that people have “weak ankles.”

You may frequently sprain your ankles, or have balance difficulties, or trip and fall a lot, or need “arch support,” or even wear prescribed orthotics.  But the fact is, while most of our ankles certainly can use some strengthening, the problem is not at all that they are weak. The problem is that you don’t know where you are putting your foot when you step on it.

We have a 6th sense that is very important to us called proprioception – our body’s ability to know where it is in space without looking at it.  Close your eyes, stick one arm out and do something with your hand – now mimic it on the other side without looking.  Easy, right?  Exactly.  Your proprioceptive sense knew what the arm looked like, where it was in space, and could easily match it without using your eyes.

When you have an injury of some sort – remember all those “twisted ankles” as a kid?  or perhaps you really did sprain it badly at some point – you interrupt that proprioceptive input to your brain.  And that means every single time you put your foot on the ground – level or uneven, sloped or flat – it’s a crapshoot as to whether or not it lands in the right place to take your weight.  Sometimes there is quite a bit of last-minute correction that happens (there is a ton of great research about what our foot does right before it hits the ground in people with chronic ankle sprains) but maybe your foot is ready to accept weight…maybe it’s not.  If it is turned a bit, or sideways…there you go…you just “tweaked” your ankle again.

So in order to change this, it isn’t so much making your muscles any stronger.  It’s more of a question of getting the muscles to fire in the correct order and improving the sense of what your foot is doing when it’s swinging in the air during gait and when your heel strikes the ground.

The most basic exercise to improve all of these things is as simple as it gets: stand on one leg barefoot.  Try to do it for 30 seconds without falling.  If you can do that, then do it with your eyes closed – 30 seconds without putting the other foot down.  This exercise is brilliant for balance and strengthening the teeny muscles of the foot and lower leg that help hold you up when you step.

Another set of exercises involves drawing the alphabet with your toe in the air.  Take off your shoes and socks and every day write the alphabet at least once – if not 3-4 times.  Try to go through the entire range of motion of your ankle.

To help with proprioception, one of the best ways to do that, interestingly enough, is to walk on uneven ground CAREFULLY, watching your feet.  We can do all kinds of things in the clinic, but in my opinion the best way for a hiker to work this sense independently is to practice what you really need to practice – stepping on rocks and roots and uneven things.  Wear the most minimalist shoes you have and go for a LEISURELY walk for about 15-20 minutes (think about how fast you’d go if your osteoporotic grandma were hiking with you with her cane).  Watch your feet, step carefully, and PAY ATTENTION to what you are doing.  No mind wandering here.  This is not an aerobic exercise, it is what we call a “motor control” exercise – meaning you are working on the connection between the brain and the muscles, not just the strength in the muscles (which, of course, needs to happen a bit as well).  Once this gets a bit easier, try to speed it up JUST A BIT, not a lot.  This means your grandma doesn’t need her cane anymore, but still walks carefully and slowly next to you.  As you become more comfortable then try increasing either speed, OR time on the walk, OR the difficulty of the terrain.  Do not try to make all of them harder at once – you only get to do one at a time.

Now for the hard ones.  These you would do barefoot, in your home, no distractions; they take a LOT of thought.  These are to recruit and then strengthen your tibialis posterior, the muscle that dynamically supports your arch.

This first one will engage this muscle by actively raising your arch:

 

This second one targets tibialis posterior by trying to rotate your tibia:

 

Now, there are people out there who have incredibly floppy feet.  These folks cannot control their arches, the mid portion of their feet have no support, and they have simply just blown out a few too many ligaments that no matter how much they strengthen they are going to have an uncontrollable foot.  In these cases, orthotics or even a lace-up brace may actually be the way to go.  But otherwise, try working on  balance and proprioception first before resorting to “arch supports” or very expensive orthotics.

 

One more quick point about your feet: your arch is NOT a weight bearing surface.  Think of your foot as a tripod: the ball of your big toe, the ball of your pinky toe, and your heel.  The rest of the foot is SUPPOSED to move all around to adapt to surfaces you step on.  Some people are more used to this than others, but the fact is that the normal function of a foot is a mobile one.  I’m not at all recommending you go backpacking in minimalist barefoot running shoes.  But just be careful about trying to fix your “weak ankles” by wearing high topped heavy leather boots with steel shanks in them and massive prescription orthotics.  There is a middle ground, and for most of us that’s where we should be walking.

 

One of the most common injuries to sideline hikers is knee pain. It can start slowly…that dull ache behind your kneecap that grows and grows as you keep pretending it’s not there. Or it can happen suddenly with a quick awkward step or even a stumble.

The second requires a bit of first aid, and if the pain persists more than a few days, possibly a trip to your neighborhood PT.

Let’s spend some time talking about the first one, which is far more common and you can usually treat it yourself.

Pain behind or around the kneecap is called patellofemoral pain and is very common in hikers. And runners. And bicyclists. And walkers. We can’t seem to agree on EXACTLY why it hurts, but everyone does seem to agree that it involves a problem with how the patella rubs against the grooves of your knee. In some people there’s too much pressure on certain spots on the undersurface of the patella (like hot spots), and in other folks it involves weak muscles that allow the knee to move too much when you stand on it.

For both of those types, you can take a lot of the pressure off the kneecap by strengthening the muscles at your hips

While it may seem like you need to strengthen the muscles around your knee, the fact is that for the vast majority of us those muscles are just fine – if anything they’re too strong and work too much. But if your hip and butt muscles aren’t strong enough to support your weight when you stand on one leg (which is what happens every time you take a step), your femur actually rotates inward a bit – because your butt muscles aren’t strong enough to hold it in place.

Try it: stand on one leg in a pair of shorts, do a little squat and see if your knee stays in a straight line over your toes. If it collapses in a bit then you DEFINITELY need to strengthen those butt muscles. If you can do a pretty good job holding everything in place, it’s possible that the problem only happens when you get tired. Try it after a long run, or at the end of a hike. Or even better, with your fully-loaded pack on. That’s a lot of extra control those poor butt muscles need to exert and sometimes they’re just not trained enough to do it.

Here are some of my favorite exercises to target the gluteus medius, hip external rotators, and hamstrings, taken from an article in the Journal of Orthopaedic and Sports Physical Therapy (2009):

The first is called a clam: Lie on your side with your heels and knees together, knees bent to about 45 deg, your head comfortable.  Keep your heels together and raise your knee (like a clamshell), making sure that your hips and back do not roll backwards.  You don’t need to lift up very much – just enough to feel a pull in your buttock or the top of your hip.  Do about 20 on each side, 2-3 sets each.
Next is a straight leg raise on your side.  The key here is not to let the very strong little muscle in the FRONT of your hip do all the work.  In order to keep from cheating, lie with your shoulders, back and heels against a wall.  Slide your foot up the wall, then back down.  This will keep you from rolling backwards and letting the stronger front muscle do all the work.  Again, do about 20 on each side, 2-3 times.  With this one, if done correctly, you may only get about 10 or so before needing a rest…that’s OK.  It’s more important that you do 5 good ones than 20 bad ones.  The whole point of this is to use the correct muscle and teach your body to stop cheating – leading to injury.
Next is what I call a windmill – stand on one leg and keep it straight, then bend at the waist to the floor, lifting your other leg straight behind you (think warrior pose from yoga).  This is what golfers do when they bend down to pick a golf ball out of the cup.  Try and do 15-20 in a row without putting your other leg down, and go at a slightly faster pace than you normally would do an exercise.  Again, both sides, 2-3 sets.
Lunges – both to the front and to the sides, are always good to strengthen the gluteus muscles.
 If you have any elastic bands, loop one around your ankles (you don’t want it to be too stiff) and walk sideways about 20 feet.  Here, make sure your toes keep pointing forward.  They will want to point in the direction you are walking, but this biases that strong anterior hip muscle and doesn’t work the gluteus medius in the back.  Face the same direction as you walk to the left, then to the right.  Try about 5 laps of 20 – 30 feet in each direction.
What’s nice about this set of exercises is that it is a great routine for a lot of lower extremity problems: ITB syndrome, “over pronation,” low back pain, even achilles tendinopathy.  So many of the problems in our back and legs comes from not having enough strength and control over the middle of our bodies, which tends to throw so many things off.
Hope this helps!
CARROT QUINN

dispatches from the wild

Wandering the Wild

Backpacking the Pacific Crest Trail and Beyond