Hello forum

First stop: the shoe store. If you are fatigued in a manner in which you think you shouldn't be, esp. with the leg cramps, maybe your shoes don't fit right.

+1 shoes are the first thing to look at. A crappy pair of poorly designed shoes or shoes that don't fit properly can do that.

I forgot to add guys, thanks for reminding me.






 

One thing you might at least want to try is those foot analyzer things they have at some stores. You step down on them and they read your footprint to see what is going on. Might give you an idea if there is an obvious problem going on. Other than that, a Dr visit is the other option.

I'll do the first one, maybe my footwear choice is completely wrong. Although I doubt it.

 

Wait a sec... you are an MD and you are looking for OUR advice? Did they have the "no child left behind" policy at your med school or something?

Sorry, I just had to say that. My Lewis Black personality took over for a few seconds there... I hope I didn't say anything rude...

Seriously, Doc, you are five-five, and a chunk. You are woofing over not being able to pound out a 15 mile hike loaded with pack without hurting? I myself would just be satisfied if I could walk five miles unloaded without passing out from low blood glucose!

My prescription: Take smaller bites. Practice makes perfect. I suspect you are going too far too fast. Slow down and work your way back to health slowly and deliberately. Unless you are Doogie Hauser, I will assume that you are not in your teens anymore. The mid-to-late 20's is where we begin to feel the signs of adolescence lost. Your body repairs less rapidly as you get older. It takes more energy expenditure to do simple reflexive moevements that we once did impulsively. If you are especially chunky, it will be harder to take it off. You didn't get fat overnight, and it won't be an overnight journey to get fit again.

Alright, I was avoiding that issue. Deep down I know that my fat-ass is one of the major sources of my problem. I just didn't think I could be hurting due to aging It's probably got more to do with my weight than my age.

Avoid carrying the heavy loads. Your joints, ligaments, and tendons are already stressed enough. with your heavy body.

As others have said, go to a running store and have them evaluate your step and they will make the right shoe recommendations. You can buy the shoes somewhere else or online if you want. (Maybe buy some socks or something to say thanks for the test.)

Get some trekking poles and hike, walk with them. They will help get your heart rate up and take some of the strain off your body.

As far as the weight, you are consuming more calories than you are consuming. Ask yourself if you are using food as drug, as an escape and why that would be. Find other ways to get rid of stress, anxiety and boredom. Exercise, a new hobby, whatever.

Trekkin poles, noted. I need a new pair since my bubba-poor college student-poles gave up long ago. I'll probably use a single one since I like to get out of my door and walk through suburbia until I get to the country-side. A pair of Leki's would be nice I guess.

 

If $ is an issue and you have an REI around become a member  and go to one of their garage sales. I usually see Leki poles at them for around $12.

Since you are trying to lose weight, key your pack to your weight, and start going uphill.  Start with no pack but hike up as steep a hill as you can find (I have 210' elevation gain in a third of a mile).  This has the advantage of working the cardio as well.

Do this for a mile or two to start, others have noted you're being too hard on your joints and ligaments.  You can gain muscle in weeks, ligaments , tendon, and bone density take months, don't overdo them, this is why hill climbing is better.

Do this 3-4 times a week.  Add a half mile or so a week until you are at your target.  After a month or so, put on a 10-15lb pack.  From then on, add a couple pounds for every pound you lose until you are at 35-40lbs of pack weight.  Don't go past that until you've been training for at least six months.

After that you'll be able to hike forever on level ground and you'll think nothing of 5000' elevation gain in a day.

Good advice above...also if you are new to rucking consider getting measured for a pack.  If your pack doesn't fit properly you're working twice as hard, being thrown off balance, being forced to move in a position that doesn't provide the utmost mechanical advantage, etc...

yep to what others have said... if you are an M.D. then you already know better than us what the problem is ie. 5' 5" and 200lbs falls well outside the charts. You also already know from med school what that extra weight does to joints over time.

I'd "prescribe" taking a break from the backpack alltogether and focus on the first things first. I'm not judging mind you since I know there are many things that can cause weight issues and it isn't always as simple as saying dont eat so much... just saying it would be wise to work on moving more inline with the recommended height to weight charts for your age without the added stress from carrying a pack. I assume you already did bloodwork to check for thyroid and other obvious potential medical issues?

I'll do this exactly.

I'm 6'4" and currently around 230lbs.  Back in June, I was about 215lbs, but due to a back injury, I've been out of work since June 24th, and I did nothing physical over the summer.

I had S1-L4 fused on 8/13, and have been told to walk, walk, walk.  I'm up to 4-5 miles a day, and my whole body is beat.  My feet hurt, my legs hurt, my knees hurt, and of course my back hurts.  My doc told me to expect this.

I had a very physical job before my injury and used to work out and run with my wife. Plain and simple, I was in shape.  (Luckily, I have disability insurance, and my job is secure so I can focus on getting back in shape)

If I slid this far back in 3 months, I'd imagine it gets worse the longer you go.  Add weight to that, and the difficulties multiply exponentially.

Start easy, build up your mileage, and don't expect miracles.  If you're hurting, don't carry a pack.  Start out reasonable so you don't injure yourself and get set back that much further.  With extra weight, your joints take hell when you're pounding them.  

I know you said you're a doc, but are you hydrating?  My wife screws up every now and then and forgets to drink enough.....after a day or two, the leg cramps hit her with a vengeance when she's running.

What kind of surfaces are you walking on?  

Anytime I ruck/run, I try to do a route that minimizes the amount of time I spend on paved surfaces.  It's a little easier on the body if you can travel on a surface that isn't man-made.

Also, go see a Podiatrist.  It helped me out a ton.

We're training to do rim to rim to rim in the Grand Canyon about a month from now.   When we got our permit request back they of course gave us the campsites
furthest away from our primary requests, so our first day is like 17 miles down the south rim and back up a thousand feet, then back down that thousand feet
and up 6000 to the north rim for 26 miles that day, and then back down and up 3000' for about 18 miles the third day.  The last day will only be about 2500' and
maybe 8 miles  This was about 20 miles more  and about 4000' more feet elevation gain/loss than our original request.  Before they issued the permit we
had to prove that we actually knew what we were doing since they considered that "impossible" mileage...

So we're training with packs that weigh about 15lbs more than we'll be actually carrying.

Our plan is to do walk on requests for Bright Angel and Cottonwood, but we're prepared to do the full hike if we can't get them.

Good luck with your quest, Doc, being out of shape for your age is no fun.  It's one thing when age or disability grounds you, but it's
worse when it's just your own lack of time or motivation.

At least 60-70% paved surfaces. I know this is a major source of discomfort but I have little I can do to change this :(

 

















 

Hydrating AND maintaining proper electrolytes!  I find that since my normal diet is pretty low sodium, I actually have to work hard to maintain proper balance and not get cramps.

Hope I didn't come across as insulting......I was just sharing some personal experiences.

Good Luck....pain sucks.

I'm not the OP, I was just seconding what you said and adding to it.  You didn't come across as insulting to me at all!

Yea, I know....I was just re-reading what I wrote and realized it could have been a little insulting to an MD.

This is the book you are looking for.

The Israeli Fitness Strategy

I'm not a stuck-up scumbag of an MD, yet man. You sounded like someone trying to give his 2cents and it was appreciated.

 

Cool

Sounds exactly like what I had in mind about getting in shape. I'll pick up a copy. Thanks a lot.

 

Be sure to get some potassium. I had this same problem for a while. I used to try to eat a banana daily to replace potassium, but something about bananas makes me gag sometimes. Truly. Then I found out about molasses. There's twice the amount of potassium of a banana in a teaspoon of molasses. Much more pleasant way to take it.

Going uphill: Why is this better? I am assuming it is like a stairclimber then? There was this guy at work that was seriously-huge. He started climbing the local mountain every day before work. He lost a serious amount of weight. So much so that he looks like a different person altogether. He lost around 130 pounds.

I really should start getting into better shape.

I'm actually glad to hear you say that, man. I was a little worried I came off a little too strong at first. You sound like a humble kind of guy.


Its actually interesting to note how gracious people are in this forum. Another reason I like to hang out here.

I think I should be more careful about my electrolytes, thanks for the potassium comment. I try to drink gatorade-like drinks but they get boring after a while and I just sip water. An electrolyte imbalance could very well be a part of my problem.

*chuckle*  I used to think that too about gatorade, til I looked at the potassium content of it...

Potato skins are *loaded* with potassium!

I find, in this order, that my muscle cramps are caused by dehydration primarily then exacerbated by eletrolyte imbalance.  This is for me in my normal routine.  In extreme heat conditions that can reverse itself.  It took me many years to figure out first that it was dehydration, then several years after that when staying properly hydrated eliminated about 75% of the cramping I used to get I figured out that the electrolyte balance was the other side of the cramping equation.

I'd look at your pack hip belt not supporting enough of the pack's weight as a possible cause of your back pain. Simple way to test it, lose the pack for a while.

The leg cramps, I'd look at a potassium supplement. Any insomnia, or leg cramps in bed? Something I have had happen to me is I would come home after a long hike, lay on the bed, and watch TV for a bit. After a little while I would move my legs just a little bit, which would trigger terrible muscle spasms in my feet, and in my inside thigh muscles. The same thing has happened when I was trying to crawl out a tent in the morning. I suspect what happened was there was a lot of lactic acid built up in my legs, and my lying in bed being still was not allowing my blood to circulate enough to remove the lactic acid. I now stretch my legs a little right after lying down, and that seems to take care of the problem.

All the same things happen to me. That long muscle inside the thigh is called the sartorius, and its the longest muscle in the body. Its also a motherfucker to stretch and prevent from cramping. First time I ever had a cramp there was when I was serving duty in Florida, and running 40-50 miles a week. That muscle fetched up on me in the middle of the night, and schocked me right out of bed, writhing in pain. My wife - not understanding - didn't know what was wrong with me, and started crying. She wasn't the only one, geez! Funny: She admitted to me later that at first she tought I was beating off wildly out of control. I was like WTF! As if.

You know what. I am kind of a lard ass myself and the only thing keeping me from being a full blown lardass is the fact that my work takes me outside on all kinds of weather and I am on my feet all day long.

that said. I would look at (1)hydrating, (2)properly fitting footwear( I will buy the best also but I have to buy certain brands to fit my feet. Having the most expensive doesnt equate to the best fitting)

and then I would say look at finding out if the pack you are using is carrying the load correctly. Same thing here, you can buy the best stuff. But that doesnt mean it will fit correctly.

i didnt read all the posts so I hope I didnt regurgitate something that was already pointed out.

HTH

Thaks for this info. I just ordered a copy.

If I have shoes or inserts or something that is causing me to walk in a way that my body does not like I generally know it in a hundred yards or a few hundred yards.



The miles and miles thing with muscle issues causes me to figure water and or electrolytes would be the answer there.  It is astounding how much water it takes for me to feel like I am staying hydrated while working outside and sweating a lot.  I am a big fella, a bit of muscle and a lot of fat right now.  While I can handle going out in the heat and humidity and mowing grass and working around the yard in the nasty hot weather the consumption of water in gallons is needed.  And I do mean multiple gallons.



The back pain could be the water and or electrolyte thing or it could be your pack or it could be the suspension system of your pack and how you handle weight.



I work security and walk on concrete all night.  Lots of rounds and lots of stairs.  Lately I have been working a ton of overtime and it is almost always on concrete as well.



I spent 300 bucks or so on a pair of good danner boots and some inserts.  I replace inserts often.  While I may not always throw out the inserts I keep fresh inserts in my work boots because I live on concrete an awful lot of hours.



A lot of folks at work go with shoes but I stick with danners since they fit my feet well and the boot enforces a certain sort of foot posture.  Shoes might be more comfortable towards the end of the day but a pair of boots won't let things move far from where I want them.



I am making a few changes so I can stop working so much overtime and mostly spend 40 hours on concrete a week and then do some extra walking outside on trails and what not.



But for how tired I physically get while working too many double shifts I find a real solid pair of boots can help greatly at times.



This has worked for me so far.  I don't pretend to be an expert and often I ignore my own advice on some days.



Since you can find other ways to carry the weight I think I would hydrate in a major way and change how you carry the weight.



I also know that I personally benefit greatly from "stretching" type exercises since they also help strengthen and use some muscles I don't always use when lifting some weights.



A well rounded workout is important.

Adding more hiking will likely aggravate things in the short term. Stretching and core strengthening will help with back and leg pain. Don't overtrain - it could be that you're demanding too much from your body without proper preperation.. Some weight-bearing stretches and abdominal exercises to start. Hiking gets your hamstrings tight and they need stretching with hiking too; as does the IT band. Some foot massaging and back exercises too. Others here have had good ideas too. See a hiking boot store - not the kid at REI. I work in great gear shop and sell boots. The wrong match for flex/stiffness can be a contributor too. IMO, a person doesn't necessarilliy need custom orthotics - so seek a second opinion before laying out $$$ for them.
   There may be something about your stride too. Excessive force when heel striking will wear you out. Think linearly with you knees and legs. Keep you knees in line with you foot/ankle and try and forefoot place and allow your foot to roll. Don't allow your knee to get out in front of your toes with a pack on- especially downhill.  A stiff sole that forces you walk heel-toe like in ski boots can be overkill.
  And BTW : 15 miles is LONG way - depending on vert. Be sure to stretch and rest and feed when taking on big hikes like that.

-JC

This.  Go to a running store and have someone watch your bio mechanics on a treadmill.  Buying shoes without an analysis is a gamble that most people always get wrong.

his, drop the pack and start slower!!!



I dropped 185 lbs a few years ago. I had gained a lot of weight fighting cancer and I had ballooned to 450 Lbs. Just start slow and be diligent.



I am 6 ft 7 and back up to 300lbs!!! It is a never ending job...



Glad to hear you are joining the fat-fight....



Amos1909

One thing I have not seen mentioned is make sure you are getting enough protein and essential amino acids in your diet, this will help your muscles repair after exercise.  I just went through something like this with my wife, we started walking about three years ago and everything was going well for a while.  Then about a year ago my wife started having all kinds of issues, after numerous doctors including specialists could find nothing wrong we figured out it was a protein deficiency along with electrolyte imbalance.

Another thing to look at(while you are walking) is HOW you are walking. I know that we start walking as young kids, and everybody figures they know how to walk, but sometimes we get into bad habits that we don't realize we are doing until we actually pay attention to what we are doing. Look at how you walk, including whether you turn your feet to the inside or outside as you walk. Most people do that without even thinking about it, but it adds to any problems caused by walking. Your toes should be pointed straight ahead, not to the inside or outside. Also, you should probably work on getting into shape before you start training on hauling a pack around. One step at a time.

Thank you everyone for this torrent of information. It has truly been educative for me. I would appreciate further input on this.