SectionHiker.com Backpacking Gear Reviews and FAQs 
If something bad happens to you on a hike and you’re alone or with a friend, would you be able to self-rescue, or would you need to contact search and rescue and request help? That is a question I ask myself whenever I go hiking. It dictates the routes I take and what I carry in my backpack. Calling for help is the last thing I want to do because our local search and rescue teams are volunteers and calling them out puts their health and safety at risk, especially now with the added complication of the Coronavirus Pandemic. I’d only do that if it was the last resort and I really mean as a last resort if I couldn’t crawl out of the backcountry by myself.
Badly Sprained Ankle
This topic is fresh on my mind because I seriously injured myself recently on a strenuous hike and hiked out on my own power without having to request search and rescue assistance. I was descending Mt Jefferson, the third highest mountain in the White Mountain National Forest when I heard a loud pop! and twisted my ankle, miles from the nearest road, just above treeline, on a very rocky trail called the Castle Trail. I was scrambling over one of the rocky outcrops on the trail called castles when I put my foot down on a tree route and my ankle collapsed under me, rolling my foot sideways way beyond its normal range of motion. That popping sound is a characteristic of a serious sprain, the most serious kind, and the one that takes the longest time to heal.
I knew it was a bad injury, but once I confirmed that there were no bones sticking out, I decided I would try to hike out on my own power or at least get as far as I could toward a road in case I had to be carried out on a litter. While I had some pain, the swelling hadn’t kicked in yet and I could still put weight on the foot. I thought about calling my wife or sending her a message on my inReach satellite messenger but decided not to, until or if, it was necessary. There was no point in worrying her if I could get out on my own power. She’s the person who I leave all my trip plans with and will call 911, which is how you initiate a search and rescue call in New Hampshire if I’m overdue on a hike or backpacking trip.
Emergency Decision Making
I am trained in Wilderness First Aid and one of the realities that they drill into you is that it takes one hour for help to arrive for every quarter-mile you are from a trailhead. I was 2.7 miles from the nearest trailhead which meant I’d have a long wait for help to arrive. It’s not like a city with 7-minute ambulance response times. That’s why you need to be as self-sufficient as possible on hikes. I knew there was a caretaker at one of the RMC camps on Mt Adams about 1.5 miles away and he could probably get to me pretty quickly if it was an emergency and he had his radio on. But a fully staffed rescue team would probably take much longer to muster and arrive. I’d packed enough extra insulation to spend the night out if I had to as a precaution, which I do on all of my above-treeline hikes.
I knew that the pain would increase when the swelling kicked in and that I needed to get a move on before that happened. I couldn’t turn around and climb back up the mountain because that would take me even farther away from a road. Continuing down the Castle Trail I was descending would have required 3.5 more miles of hiking to the highway at the Bowman Trailhead off Rt 2, but I decided that was too far and getting a litter up that trail if I needed one, would be difficult and very time-consuming. Even if I did make it to the Bowman Trailhead, I’d be stuck there without a car and without cell phone access, since I know there’s none there. Getting anywhere, especially during the Pandemic would be difficult since no one in their right mind is picking up hitchhikers, people are not giving friends rides, and there are no other means of transportation in the area, private or public. My wife and I have one car and I had it.
I reasoned that the best course of action was to hike out The Link Trail, which was 1.6 miles to the Caps Ridge Trail. That would put me 1.1 miles from a major trailhead, should I need to call in SAR assistance. I’d also parked my car there. That section of the Caps Ridge Trail is below treeline and reasonably easy to hike as White Mountain trails go. Getting a litter up and down it wouldn’t be trivial, but it seemed like the best option if a littler would be required. Time was of the essence because once the swelling kicked in, my ability to walk, let alone hike, would cease.
This topmost section of The Link Trail is a little challenging to hike, narrow, and full of roots and rocks, but I’ve hiked it before, so I had a good idea of what to expect. The trail maintainers have also been through this year and cleared out the winter debris. My ankle ached, but I still had decent mobility, and the swelling still hadn’t kicked in. I made to the Caps Ridge Trail after an hour and decided to keep going the 1.1 miles to the trailhead.
I was relieved when I made to my car. I drove home, praying that the injury would be minor and heal quickly. But by the time I got home, my ankle had swollen up and was the size of a Navel Orange. Bruising has started to appear on the skin around the ankle and it’s still swollen. I iced it all last night, alternating with compression and elevation, but it hurts like the dickens this morning, and I can barely walk. We’ll see how today goes, but I’m thinking that a hospital visit may be warranted to see whether a cast is necessary to immobilize it. Yes, it bums me out because I’d had some big plans for hiking this summer, but it is what it is. I’m sure I’ll be back on my feet in a month or two. At least it will give me a chance to catch up on some fly fishing, while I strengthen my ankle again.
Can You Self Rescue?
I thought I’d lay out my reasoning for others to see in this article. I think it’s important that hikers and backpackers consider the risks they incur to themselves and others when hiking and have the ability to self-rescue themselves or their companions if necessary. It is easy to become complacent about your ability to get help in backcountry areas now that so many people have satellite messengers and personal locator beacons, but nothing has really changed except your ability to communicate. Search and rescue teams are still staffed largely by volunteers and it takes as much time to reach victims as it always has because they have to hike in on foot to reach them.
There’s a lot of emphasis in the hiker, backpacker, and trail runner communities about minimizing the amount of gear you carry in order to travel as fast as possible, but not so much on your ability to make good decisions in emergency situations or the need to carry enough supplies and gear that you can stabilize a patient, including yourself until help can arrive.
- Do you have the wilderness first aid training necessary to make good accident mitigation decisions in the backcountry?
- Do you have the right navigation tools and information to know which way to go?
- Do you carry enough gear to stabilize a companion or yourself until emergency help can arrive?
Shit can happen to anyone in the backcountry, no matter how much or how little experience you have. But there are some outcomes you can influence if you’re better prepared.
Wishing you a speedy recovery! Thanks for the breakdown and analysis of your self-rescue; very insightful.
Get well soon, Phil!
Get well soon. You will be back on the trails before you know it.
Here’s to a fast recovery. Thank you for converting your painful experience into insights and information that the rest of us can absorb and (hopefully never have to) use. Looking forward to your posts during your recovery.
Hope you have a speedy recovery, glad you were able to hike out on your own and make it home.
Ouch! Hope it heals up quick. I miss being 20, could sleep it off.
I had the same situation a couple of years ago on the AT – took a spill on an ice patch and badly sprained my ankle. After assessing that I could still walk (though in pain) self-rescue was the best option given a heavy snowstorm was underway and getting worse. I also knew I could hunker down if needed as I had my tent and plenty of food, but knew time was of the essence with regard to mobility. I’d like to underscore Phil’s comments on swelling – if you can move, move, because when the swelling takes over moving won’t even be an option (or even getting your shoe/boot on).
Though I also had a good outcome, overall I consider myself very lucky – had the sprain been a break it would have been a different game. It also made me reassess my self-rescue capability as well, and now I carry gear I had deemed unnecessary previously – SAM splint, Keto tape, elastic wrap. The extra ounces are nothing compared to the peace of mind of knowing I am better able to take care of myself.
Good article on a problem that is far more common than people think.
Funny, I never heard the swelling issue discussed in Wilderness First Aid (I’ve taken that class 4 times to be recertified for guiding) but it seems really important, even vital from a self-rescue standpoint. On the flip side, you could do more harm than good. All the more reason to build in a self-assessment protocol on when to keep moving.
Agreed on the risk of further injury, but my comment with regard to “move” is based on an assessment that you can move with minimal (or manageable) pain. If you can get vertical, and moving, you can probably be sure nothing’s broken but you do take the risk of aggravating the injury. That being said, what we would do in a situation like this is clearly different than if we sprained our ankle in the back yard – sometimes you just have to do what you have to do, especially when alone.
Philip, so sorry to hear about your injury! Thank you for sharing your thoughtful analysis and decision-making. My one trip on the Castle Trail was on a day when a solo hiker froze to death not far from where you got injured; attempting to self-rescue and carrying enough gear in case you can’t self-rescue are important topics. Wishing you a speedy recovery, and looking forward to our next hike.
Excellent overview of what to consider as far as being prepared and self rescue. Point well made regarding the status of search and rescue teams in the Covid times. In my opinion too many people only think about themselves and don’t understand how they could impact others.
Thank you for making your mishap an informative warning for the rest of us. I have been getting great advice and recommendations from your articles for years. Get well soon.
Used my Garmin Inreach almost exactly a year ago for SOS when I fell at a state park and seriously injured my knee while hiking down a ravine. After about 5-10 minutes of assessing the situation, calming myself down, and taking some ibuprofen I tried standing. I was able to stand after the fall, but as I turned to the right my knee crumpled and down I went again. Sitting with my back against a rock with both legs stretched out in front of me I couldn’t lift my right leg. That’s when I knew it was bad. Not a lot of swelling in the knee joint, but it looked like my knee cap was a couple inches lower down my leg from where it should have been. :)
This park is somewhat remote (for Indiana) not well attended, with no cell service, so I knew at 8:30am on Friday it could be a while before another hiker came across me. I always tell my wife where I am going, what my initial hiking route will be, and when I expect to be home, so I knew she would call the authorities after a certain amount of time had passed, but it could easily be nightfall by the time I was found.
Took about 1.5 hours after hitting SOS on the Inreach for local S&R to mobilize and find me. Then the EMT’s had to pull me up the side of the ravine on a litter, where a DNR gator took me through the woods back to the trailhead and a waiting ambulance. Got to the local hospital around noon and had surgery to repair a completely ruptured quadriceps tendon later that afternoon.
How far were you from a trailhead?
Had an interesting factoid to share from the urgent care doctor I saw the other day. He recommended NOT taking ibuprofen for the first 3 days after the accident because the (I’m paraphrasing here) it suppresses the platelet formation that closes up the wound and starts the healing process. Afterwards, fine. But that initial phase, Tylenol as needed.
That is great to know. Like you, I have taken WFA many times and never heard that but it makes sense.
Hoping for your speedy recovery and return to the trails!
Following up on that point. When people come in many weeks after a broken bone and show no sign of healing, the first question he asks is whether they are taking ibuprofen.
I was about .75 miles from the nearest trailhead. But it was mostly back up the rock strewn, wet and slick ravine I had just come down.
A humorous bit during the whole situation was when the EMT’s arrived. One of them was examining my injury, taking my vitals and asking me questions like “did you hit your head when you fell?” (I hadn’t). Then he said “I’m going to start on IV on your hand. Have you ever had fentanyl? I said no, I had not and that right then I really wasn’t in much pain. His reply: “Well, I’m going to give your a little fentanyl anyway because with what were going to have to do to get your out of here you probably will be . :).”
Got to keep your sense of sense of humor when the shit hits the fan!
Philip, were you using your Pacer poles? If so, do you think they gave you some extra support on the way out?
I wasn’t using any poles when I had the accident. I was climbing down a short cliff face…
If the pacer poles did give me extra support on the hike out, I wasn’t conscious of it.
But they make GREAT poles/crutches for moving around my house now foot still very swollen) because I can put a lot of weight on the handles.
Wow, nicely done. I seriously sprained an ankle on Jefferson years ago. I managed to make it to Lakes of the Clouds and then thanks to a good wrapping job and some hardcore pain meds, finished my hike out to Crawford Notch.
I was giving way to let someone pass as I was descending Mt. Whitney and I fell and twisted my ankle. Luckily it was my last day on trail completing JMT. I was probably 8 miles to the parking lot.
What I realized was that the adrenaline will keep you going in the few hours after the fall. And that is the best time to get to a trail head/road etc. Got to keep moving if you are able to. The next day is when the swelling/pain gets you.
Sorry to hear of your injury. I lost my summer/fall season a couple years ago when I broke my foot near the Sphinx/Great Gulf junction on day 2 of a 5 day trip. I elected to self rescue instead of hitting the SOS button. It took over 8 hours to make the hike back to the Great Gulf lot and another 5 hours before I was in an emergency room. I was thankful for 3 things on the walk out: constant access to a cold stream to soak my foot, stand-up comedy on the phone, and whiskey.
Josh – that is a long hike out! Jeez.
“… when I put my foot down on a tree route [root??] and my ankle collapsed…”
Right at the treeline boundary. The low side of the last castle.
Hope you’re back on your feet soon, Philip!
Thanks Partner! If not I’ll be HoppingHiker.
Hoppy,
I’m glad you made it out OK and appreciate your sharing the decision making process regarding getting back to the trailhead. I liked the point you made about complacency in this age of satellite messengers and PLBs, that nothing has really changed except our ability to communicate. Once, I had to use my inReach to call S&R on a day hike gone bad. One of the responding Rangers told me to always plan properly and not to rely on the device. He was worried about a complacent “I can always call for help” attitude.
Another salient point was considering the difficulty facing a possible rescue party on the various routes available to you and whether or not you’d have cell coverage. If in a self rescue situation, my personal feeling is that it’s a good idea when you have a signal to let someone know what happened, where you are, and what route you plan back, just in case you’re not able to make it all the way there. If you do make it to safety, update them ASAP.
Please mend quickly. Once you get to the point you can hike again, you might consider one of the ankle braces that fit inside the shoe. I used one for about a year after a bad ankle injury that included fracture as well as high and low ankle sprain. It wasn’t uncomfortable and really helped.
Good advice about informing someone of your post-accident recovery plan. I probably should have done that. Ankle brace already acquired based on a recommendation from a friend.
Philip, I think this is one your most important posts. I’ve fallen crossing a river and broke a rib, fallen face first and got a mild concussion, and I’ve twisted a bad ankle a few times over the years. What I’ve never done is step back and think it through in terms of pre trip plans with my wife and preparation if something bad happens. I will now, so thanks for that. I hope you are back on the trail soon.
Last April I was out in Yosemite and attended some Search & Rescue talks. You can imagine how many people can get into trouble at a place like Yosemite where the steepness of some of the trails and elevation are not what people find at Disney. The S&R guys took us through a number of rescues with details on some deaths from swift water, falls etc. In the high season they can have 5+ rescues a day and categorize them as:
Walk Out – the victim can walk with some help and guidance to the trail head. They may need ankle or knee wraps or braces.
Crutch Out – the victim can make it to the trail head on crutches with help and guidance
Ride Out – If they can get a horse up to you, and you are not too heavy they may be able to pack you out.
Carry Out – This is a litter carry. One thing they have done is to mount a single ATV wheel and tire under the litter so that most of the weight is on the tire and the team’s main work to control the decent, not carry the dead weight of the victim and litter. On the more popular trails with wider smooth trails this works well and has application even on some of the rougher trails. I never seen a rig like that anywhere else.
Fly Out – just what it means, a helicopter ride to the valley floor or to a hospital. The rescue and trip to the valley floor or hospital is free, but if you get transferred to an air medical helicopter as the Forest Service aircraft have to be on station for the next rescue or ambulance you better have good insurance.
Sorry to hear about this. Having done SAR I wish everyone had your attitude and aptitude.
I had to come down Bever Brook Trail a few years ago with two torn MCLs. That sure was painful.
Not the same but made me think of this. Broke my leg horseback riding back in 2003. At the time, I was wearing tight, high ankle riding boots. The tightness of the boot actually prevented my broken ankle from swelling and helped stabilize it. Fortunately, I was in a group, the others immediately rode back to the stables to get a car for me, but let me tell you, the wait is miserable. It probably wasn’t more than a half hour or so and it was agony just sitting there alone waiting for help to arrive. I wasn’t even in pain. It just drove me nuts not being able to move and being all alone like that was even worse. It felt like help would never arrive.
Just made me think that might be a consideration as well. We all like to do something during a crisis. When we can’t, it can make it feel worse than it is. Having to sit waiting for a rescue should be a last resort. I’ve hurt myself plenty of times on trails, but I’ve always exited on my own steam, even when I can barely walk. My principle is if walking will make it worse, don’t or consider it carefully, but otherwise, keep moving. It might be slow doing, but you can make it with care and planning.
Enjoyed your article and brought back some great (non-injury) memories.
I worked on the RMC trail crew for three summers and lived in Randolph for a bit after finishing at UNH. Never any serious injuries thankfully but a good reminder.
Phillip here’s hoping for a speedy recovery. One item to consider carrying is a SAM splint; sometimes it can make the difference between walking out or being rescued. It helps with pain as well. Here’s a link to the SAM splint webpage with examples of how to use the splints in various situations. https://www.sammedical.com/assets/uploads/spl-507-card-7.pdf
I’m reminded of the story by Doug Berman (yes, that Doug Berman: Bongo Boy, Not a Slave to Fashion from Car Talk) in one of the hiking accident books (Peak Experiences) about how he broke his leg on the Valley Way trail while snowshoeing alone and managed to crawl his way back to his car and drive to a friend’s house nearby who got him to the hospital. Y’all are hard core.
I feel I should also comment that I have taken WFA twice and also don’t remember them saying that you need to move before swelling starts. This is the first I’ve heard of that.
Happy healing!! I hope you get to do a lot of fishing in the meantime.
So sorry about your injury. Glad you’re safe and hope you heal well. Personally, I almost never hike alone, precisely because it can be so easy to put a foot wrong and get hurt. The only time it happened to me, I was very glad to have companions help me get out. I’m not saying that others should necessarily avoid hiking alone, since many people prefer solitude. I’m just saying that having companions shifts the risk calculus.
Very sorry to hear about the injury; thanks for sharing your experience. I was on Jefferson over the weekend and can picture those rocks. I now carry the Garmin InReach communicator for situations like that. Not to signal an SOS (hopefully) but to communicate my status – e.g., “sprained ankle, descending slowly” – if cell coverage fails.
I have heard that you shouldn’t remove your boot to check your injury because the boot acts as a soft cast – and you might not be able to get your foot back in. Is that correct?
Get better soon!
Glad to hear you made it back successfully. I was wondering if it would have been a good idea to bind your ankle with whatever you had available, i.e., duct tape, bandana, t-shirt, etc. It would have helped stabilize your ankle and help with the swelling.
I think you did an excellent job of planning and reacting to an emergency. After getting caught in the dark after a hike went longer than expected, I now consider other contingencies if things don’t go as expected, i.e., it gets dark, it gets cold, it rains, I twist *my* ankle, etc. I feel much better as a solo hiker if I’ve thought about how I would handle unexpected (but possible) problems while hiking.
You could certainly add compression, but I felt that the “swelling clock” was ticking and boogied out of there before it was really necessary.
I had extra clothes I could have used for the purpose like rain pants.
The greatest frustration is likely realizing that you get sidelined from doing what one loves. Been dogged with plantar fasciitis since last August and any attempt to “work through it” only sets one back. Hang in there and do continue to write us.
The pipeline will keep flowing, don’t worry. I still have lots to say and now plenty of time to write it!
Merci
I’m really tired of the “why you should ditch your hiking boots for trail runners” articles that seem to appear on every hiking blog. This story is a likely example of how boots might have prevented the injury. I say “likely” because I didn’t notice that the writer mentioned what kind of footwear he was wearing. Andrew Skurka recently opined that it is “farcical” that boots provide valuable ankle support compared with trail runners. I commented on his article that his statement was both wrong and arrogant. This article reinforces my preference for boots. Lately I’m using both Keen Durand’s and Vasque Breeze III’s. On almost every hike, there’s a time or two when my ankle starts to roll on an uneven rock or root and is immediately protected by the ankle collar. So if you prefer trail runners or low-cut hiking shoes, great… just quit disparaging hiking boots!
Don’t think so. I’ve rolled my ankles plenty of times in leather boots. But I am likely to need additional ankle support for up to 6 months following this injury. I’ll be evaluating boots and ankle braces for that task.
Followup comment. I don’t have any problems with people wearing hiking boots, because I get that some people prefer them for hiking. Quite a few people actually. I certainly prefer them in winter for instance. The only reason I advocate trail runners is for climates that have a lot of water crossings, rain, or mud because they drain and dry quickly You can find a lot of trail runners that are not lined with waterproof/breathable fabric. But you can’t find many mids or real hiking boots that aren’t. That’s my main beef with boots for 3 season hiking.
I take your point about the fast drying of trail runners vs. boots. It’s the smugness of many blogs, I’m not talking about yours, in dismissing hiking boots and suggesting they don’t really offer ankle support. And then there are the people who claim that wearing hiking boots makes your ankles weaker because it doesn’t allow you to exercise them enough. I think that’s ridiculous. If you are out there hiking, climbing hills and descending hills, you are exercising your whole body, ankles included, whether you’re wearing boots or any other kind of footwear.
I don’t know if boots provide more ankle support or not and it’s not really a debate that I think anyone can resolve. If you like boots wear them. I’ve buried a half dozen pairs of leather hiking boots in my time (back when you could resole them) and they worked just fine for hiking.
I’m glad you’re on the mend now. When I contacted you earlier today Kurt, I mean Philip, I hadn’t read yet about your accident. What an informative narrative too. Also I hadn’t been able to get off an apologize message about the name mixup, before you responded. I thought wow how did he do that so fast?
But dido on grandpa’s thought about making contact about route one will be taking out before going if possible. Perhaps if no way of making immediate contact, maybe just leaving a note behind, before leaving any main trail would be better than nothing?
Philip,
A real adventure story. Thanks for the tip about ibuprofen. I will carry Tylenol now in case of bleeding.
Here’s a hypothetical: If your car had been at Bowman instead of Caps Ridge trailhead, what do you think you would have done?
Frank T.
Don’t even want to think about it.
Phillip, you make a point all should heed. No matter how conditioned you are for hiking , (you obviously are) one misstep can take you where you didnt plan on going. I have hiked and backpacked the Whites and most northern New England trails, since the early 70s. There are very few flat and level trails, and the majority are root, rock and loose footing. I have many times had that “turned ankle” and quite a few slip and falls, at times saved a spine by that pack on the back cushion against rock. Last year, coming off a day hike with my wife in Acadia, we were literally 100 feet from the parking lot, when she turned her ankle on a granite step, and after carrying her to the car, it was obvious it was a bad sprain. Having to spend the remaining days of the vacation, car touring, she was miserable.. I will add, having suffered a bad broken ankle in 2011 (surgically repaired with pins and screws), I believe my Asolo hiking boots are a benefit to support of the ankle. I’ll do local hiking in trail runners, even my ECCO sandals…but for serious trail work it’s hiking boots for me..
Now comes the hard part – recovery. I strained the MCL in my left knee in December. In June I finally followed my doctor’s advice regarding exercise, either swimming or a horizontal exercise bike. It’s coming good but we can become our worst enemy by not following expert advice and exercising patience rather than muscles. Have a good recovery Phil.
Already on top of it.