‘Use it or lose it’: Physical therapy helps Washington man summit Mount Kilimanjaro

SPOKANE — Pain. Searing in its intensity and relentless in its recurrence. Each step a terrible mantra.

You’re never going to climb again.

That’s what ricocheted through Brad Rimpela’s head as he descended from Mount Whitney on July 4, 2016. At 14,505 feet, it’s the Lower 48’s tallest peak and the standard route up the ancient mass of granite gains a lung busting 6,148 feet in 8.8 miles. But the uphill wasn’t the problem for Rimpela, who’d trained diligently for this climb. After all, the 43-year-old had dreams of climbing the tallest peak on five continents and had already knocked two off the list.

But before he did any of that, he had to get down. And gravity was exacting revenge for every foot he’d gained on the ascent, every step sending his knees into songs of agony.

Eventually, he hobbled into camp and, once he’d returned to Spokane, went to a doctor. One of the better orthopedists in Spokane, he was told. Rimpela’s IT band — a band that extends from the hip to the outside of the knee — was injured.

Specific cause?

Unknown. The doctor told him he couldn’t do much, handed him some pain killers and a list of exercises and sent him on the way.

“I was in such bad pain,” he said. “I felt like I was never going to climb again.”

That’s a common refrain, said Trey Nichols, the founder of Northwest Mobile Physical Therapy Specialists. Whether it’s climbing, biking, running, hiking or any innumerable other outdoor sports, he has plenty of patients who think their days on the trail are over.

This is it, I’m too old. Too broken. Hello, couch.

“That’s kind of a story for a lot of my patients,” Nichols said.

And that was Rimpela’s attitude, at first. After Mount Whitney, he had to wear a knee brace for six months. Even after that, the pain lingered and he “took a few years off” doing only light workouts in hopes of “maintaining some semblance of shape.”

But Rimpela, a former bodybuilder and the kind of guy who, when on a vacation in some tropical paradise spends at most one-half hour lounging on the beach, turned 40 and decided he’d pick up that dormant climbing goal. Next objective?

Mount Kilimanjaro.

Knees willing.

He was supposed to go in 2020, but the pandemic prevented that, a fact that gave Rimpela more time to train. He started going to the Wellness Tree and started working with Nichols. For his part, Nichols could uniquely relate to Rimpela’s situation. He used to be a raft guide and dealt with his fair share of outdoor recreation-induced injuries. He became an enthusiastic supporter of Rimpela’s summit dreams.

The first thing Nichols noticed about Rimpela?

He was about as flexible as a “2×4 board.” And his IT band was tight as a piano string. But instead of stretching or rolling the band directly, a common approach, Nichols had Rimpela stretch the muscles around the IT band, particularly the front and back of the hip and thigh.

“The goal was to reset his muscles and joints to move as they were designed to,” Nichols wrote in an email. “Once this was achieved, the next goal was to restore the strength and stability of his hips, knees, ankles, and back too. Once countless lunges, squats, single leg Romanian Dead Lifts and Bulgarian split squats (to name just a few) were dialed in, he started to reload his movements with weight and speed.”

It was a monthslong process featuring lots of stretching and strength and conditioning training. One in which Rimpela was “constantly focused on a successful and pain-free trip to Africa.”

The work, while certainly tailored to Rimpela’s case and goals, represents a broader shift in understanding how to rehabilitate injuries, Nichols said.

It’s a common misconception that when you’re injured it’s best to rest and let the injury heal, Nichols said. As physical therapy has become a more evidenced-based practice, however, an old adage is proving its worth: Use it or lose it.

The science backs it up. Increased blood flow from activity speeds up healing times a fact that has changed recovery recommendations. At the same time, the importance of mobility and flexibility to overall health has influenced how physical therapists work with patients.

“If you take a month off from whatever you’re doing, yeah, the pain is going to be better, but you’re going to get weaker,” Nichols said.

Nichols helped Rimpela regain — and improve — his flexibility, mobility and strength.

And so, on July 3, 2021, Rimpela started out from camp on the flank of Kilimanjaro. It was 10 p.m. He hiked through the night, summiting around 5 a.m.

“It’s amazing,” Rimpela said of summiting. “It feels like you can almost see the curvature of the Earth. You can see for hundreds of miles.”

But the true test had just started.

“I was more nervous about the downhill than going up,” he said.

Those fears proved unfounded. Rimpela returned to camp with no knee pain, a startling fact considering the agony he’d been in just a few years prior. Now he’s preparing for his next objective: Argentina’s 22,837-foot Aconcagua.

“Get help,” Rimpela said. “I would enlist the help of a professional. It’s definitely something you can overcome. I think a lot of people just live with injuries or pain thinking it can’t be fixed.”