Walking Well: Common AT Health Problems

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The major types of problems are shown in the table below, adapted from the Crouse-Josephs article. Leg and joint pain from the effort and the terrain occurred in 62 percent of hikers. Complaints included 124 musculoskeletal incidents (38.6 percent of the 321 incidents reported). Minor trauma (lacerations and abrasions) and foot problems (mainly blisters) were related types of problems. One hiker was struck by lightning.

Fractures were infrequent (3 of 10 were less severe stress fractures, fortunately). On average, these hikers reported 2.2 health problems each, when the 33 non-responders are excluded.

Health Problems of Appalachian Trail Hikers: Incidents Among All Hikers

Injury or Illness                  No. % of Incidents

Musculoskeletal                       124 38.6

Gastrointestinal Problems         5216.2

Minor Trauma                          4012.4

Respiratory Complaints            288.7

Foot Complaints                      226.8

Miscellaneous                         196.0

Skin Problems                        165.0

Allergic Reactions                   103.1

Fractures                               103.1

Total                                     321100.0

Gastrointestinal problems (diarrhea and enteritis) were quite common. There were four cases of Giardiasis. Many of these intestinal upsets may have been related to improper water treatment or utensil cleaning, possibly because only 7 percent of hikers were fully diligent in using protected water. Correcting this massive noncompliance with accepted sanitary practice is a major problem facing the Appalachian Trail Conference and other trail organizations.

Although this survey records the health problems of successful hikers, it does not describe the difficulties of unsuccessful hikers and their drop-out causes.

With the increase of backpacking, it would be interesting to know how the incidence of health problems while hiking the Appalachian Trail compares with that while engaged in a non-hiking activity. The 180 hikers averaged 163 days on the trail (equivalent to about 80 hiker years). Injury or illness made 92 hikers (55 percent) lose at least one day of hiking, with 4.7 days the average among the 167 who answered this question. Medical help was sought in 25 percent of injuries reported, but only three hikers were hospitalized, suggesting generally mild severity. Comparing their own experience of health problems over a six-month period, thru-hikers would probably conclude that trail exposure is somewhat more hazardous than engaging in their normal activities at home.