Hiking With Someone Who Has a Chronic Illness: What Actually Helps
What to Know Before Hiking With Someone Who Has a Chronic Illness
Hiking with someone who has a chronic illness doesn't need to become a big production. You're heading outside with somebody you enjoy spending time with. You might just need to be more flexible about the distance, pace or what happens if the day doesn't go to plan.
They could spend all week looking forward to a hike and wake up feeling rubbish. They might feel great at the trailhead, then run out of energy sooner than expected. Other days, everything goes smoothly and you end up talking nonsense in the woods for half the afternoon.
A diagnosis won't tell you how far someone can walk or what help they need. They're usually the best person to ask, and a quick chat beforehand can save a lot of awkwardness later.
Pick Somewhere You Both Actually Want to Go
It's easy to get caught up worrying about what someone can manage and forget to ask where they want to walk.
Maybe there's a waterfall they've wanted to see for ages. Maybe they'd rather find a quiet forest track with somewhere decent to sit. They might already know which routes suit them and which ones aren't worth the trouble.
Start there, then look at the actual route.
We've learned that short doesn't always mean easy. Some tracks save their worst climbing for the return, while others make you work before you've even reached the good bit.
Our Maungatautari Northern Enclosure walk caught us out like that. The little forest loop sounded straightforward, but getting to the entrance involved a steep uphill walk from the car park.
It's the sort of thing worth knowing before you commit to a track.
Distance is only part of it. Climbing, uneven ground, toilets, shade and somewhere to rest can make a big difference. We've covered those details more thoroughly in our accessible hiking guide, including the things an easy trail rating might miss.
You don't have to pick the easiest walk on the map. Just find somewhere you're both keen on that suits the day.
If You're Walking Together, Actually Walk Together
There's a habit faster hikers have that gets annoying pretty quickly.
They charge ahead, reach a junction and enjoy a five-minute break. Their friend finally catches up, and because the faster person has already recovered, they're ready to head off again.
Meanwhile, the person behind hasn't stopped once.
It's a rubbish arrangement on any group walk, especially when someone's already dealing with fatigue, pain or other symptoms.
Find a pace that works for both of you. That might mean walking side by side, letting your friend lead or taking longer breaks than usual. When you stop, make sure everyone actually gets to rest.
And there's no need to keep mentioning how quickly you'd normally finish the trail. Nobody enjoys being reminded they're slowing someone down.
You can still have your big hiking days with plenty of climbing and sore legs afterwards. Not every walk needs to be one of them.
If you're out with a bigger group, talk beforehand about what happens if someone wants to head back early. Splitting up can work when it's safe and everyone has a plan, but figuring that out halfway up a hill isn't ideal.
Help Without Taking Over
There's a difference between offering someone a hand and deciding they need one.
Carrying shared gear, checking the route or offering to drive might help. Other times, your friend might be perfectly happy handling those things themselves.
The same goes for walking poles, braces, wheelchairs or other mobility equipment. Don't grab something or try to physically help without asking. What looks helpful to you might actually make things harder.
Often it's the little things anyway. Finding somewhere comfortable to stop, checking the next section of trail or allowing plenty of daylight for the return.
Ask when you're unsure, respect the answer and get on with enjoying the walk.
Most people came along because they wanted your company, not somebody hovering over them all afternoon.
The Hard Part Might Come After the Hike
This one's easy to miss if you haven't experienced chronic illness yourself.
Someone can enjoy the entire walk, laugh all the way back to the car and still spend the next few days feeling considerably worse.
For people with ME/CFS and some people with Long COVID, physical or mental effort can trigger post-exertional malaise (PEM). It's a worsening of symptoms after activity, not ordinary tiredness or sore legs.
The CDC explains that symptoms typically worsen 12 to 48 hours after exertion and can last for days or weeks. Pushing through those limits can make things worse rather than improve fitness.
Not everyone with a chronic illness experiences PEM. Some deal with pain flare-ups, dizziness or unpredictable fatigue. Others can manage demanding hikes without those problems.
And what someone manages today might be completely different next week. We've talked more about that side of things in our guide to hiking with chronic illness and unpredictable energy, including why a walk that felt fine last time might be too much now.
If your friend says a particular hike could leave them unwell for days, take that seriously. They don't have to look exhausted for it to be true.
When the Walk Doesn't Go to Plan
Picture a decent day out. You've driven an hour to reach the trail, the weather's finally behaving and there's a lookout you've been wanting to see.
You're already partway there when your friend says they need to turn around.
Of course you might feel disappointed. You were looking forward to it too. But explaining how close you are to the lookout probably isn't going to help.
Maybe a decent rest does the trick. Maybe there's a shorter way back, or perhaps it's time to head for the car.
Remember, turning around doesn't mean the walking's finished. If you're halfway through an out-and-back trail, there's still half the distance to cover. Better to make that call while there's enough energy left to get back safely.
Sometimes the walk doesn't happen at all. Someone can have their bag packed, genuinely want to come along and still wake up feeling too unwell to go.
It's frustrating when you've organised your weekend around the weather or finally found a day you're both free. But we'd rather somebody cancelled than dragged themselves out because they felt guilty.
You can still go hiking yourself and catch up another day. Nobody needs to prove how unwell they feel just to cancel a walk.
Getting Back to the Car Isn't Always the End
There's still the drive home, food to sort and whatever your friend normally needs to do afterwards. If they've already used most of their energy, those ordinary jobs can be another hurdle.
Offering to drive or help with shared gear might be appreciated. So can checking in the following day, especially if delayed symptoms are something they deal with.
It doesn't need to become a medical interview. You're just seeing how they're doing.
For longer or more remote walks, it's worth talking about what happens if someone becomes seriously unwell. They might have medication, warning signs or an emergency plan they'd like you to know about. How much they share is up to them.
And don't automatically put sudden, severe or unfamiliar symptoms down to their existing condition. Get appropriate medical help when needed.
Don't Make Their Illness the Whole Day
Being thoughtful is good. Asking if someone's okay every five minutes gets old pretty quickly.
Sometimes your friend might appreciate a few hours when their health isn't the main topic of conversation.
You can still complain about the weather, argue about who brought the better snacks, stop because something moved in the trees or spend far too long looking at a view.
We've had walks where the thing we remembered most wasn't the destination. It was the wildlife, some unexpected little detour or a conversation that kept going long after we'd forgotten what started it.
If someone needs to sit for a while, sit with them. Maybe you've found a pretty good place to spend twenty minutes doing absolutely nothing.
Not every stop needs a discussion about symptoms or how far you've walked.
You're still two people spending time outside together. Let the day be fun.
Before You Head Out
Check the full route, including the return, and have a shorter option in mind. Look at the weather, daylight and how you'll contact help if something goes wrong. Don't assume you'll have mobile reception.
Pack enough food, water and suitable clothing, along with navigation and basic emergency supplies. If your friend carries medication or mobility equipment, let them decide what they need and whether they'd appreciate a hand.
Comfort matters too. Shoes that don't rub, an easy-to-reach water bottle and clothing that suits the weather can make a day out much nicer.
You don't need special gear just because you're hiking with someone who has a chronic illness. If what you've already got works, use it.
Final Take
Hiking with someone who has a chronic illness isn't about knowing everything that's happening with their health. It's about enjoying a day together and being comfortable when things don't quite go to plan.
Some hikes will go exactly as expected. Others might involve more sitting around than walking, an early return or a change of plans before you've even left home.
You can still enjoy long, difficult hikes yourself and have a brilliant afternoon doing something quieter with somebody you care about.
We head outside for the places, the fresh air and whatever we might find along the way. But some of the best memories have more to do with who came along than how far we walked.
There's a lot more to a good day outside than reaching the end of the track.
Hiking With Someone Who Has a Chronic Illness FAQ
What should I ask before hiking with someone who has a chronic illness?
Ask what kind of walk they'd enjoy, what pace suits them and whether there's anything useful to know before you head out. They don't need to explain their entire medical history. Knowing what works for them on the trail is usually more helpful.
Is a short hike always better for someone with a chronic illness?
Not necessarily. A short trail with steep climbs or difficult ground can be harder than a longer, flatter walk. Look at the whole route, including the return, and choose something that suits the person and how they're feeling.
Can hiking make chronic illness symptoms worse?
Yes, for some people. Activity can trigger fatigue, pain or other symptoms depending on the condition. People with ME/CFS and some people with Long COVID may experience post-exertional malaise, where symptoms worsen after exertion and recovery can take days or longer.
What if someone wants to turn around halfway through?
Find out what they need and work out a safe way back. A rest might help, or it might be time to return to the car. Don't pressure someone to continue just because the destination is close. There's still the walk back to think about.
Can someone with a chronic illness still do difficult hikes?
Yes. Some people regularly tackle demanding hikes, while others need shorter routes, more rest or may not be able to hike safely at certain times. A diagnosis alone doesn't tell you what someone can manage. Their own experience, current symptoms and relevant medical guidance are better places to start.