On the second day of the actual Inca Trail hike, one climbs to nearly 14,000 feet of elevation to reach Warmiwanuska, or “Dead Woman Pass” (named for the outline of the mountain – not for any misfortune befalling an ill-prepared hiker). For folks who have not built in the appropriate acclimatization days in Cusco and the Sacred Valley (or other high-altitude destinations in Peru such as Titicaca, etc.), this climb can be a miserable struggle for oxygen.
Acclimatization only really occurs when one sleeps at altitude. So those nights in Cusco (11,100 feet) and in Ollantaytambo (9,100 feet) and the first trail night at Huayllabamba (9,700 feet) are crucial to success later on.
One’s explorations over the first few days in this region can also be built around a knowledge that everyone – no matter their fitness - will be suffering from a lack of oxygen. For this reason, that first afternoon is a walking tour on flat surfaces, with plenty of cafes nearby in which to drink a coca tea, plenty of pews from which to observe the inside of the cathedrals, and plenty of benches from which to watch the comings and goings in the square. The second full day in Cusco can be spent on the outskirts of town, at places like Sacsayhuaman, which are full of short grassy walks and areas to explore. Then the full day in the Sacred Valley has more short walks on rolling terrain as folks visit places such as Chinchero, Maras, Moray and Ollantaytambo.
Luckily, even the first full day of the Inca Trail cooperates nicely as well, as the trail parallels the Urubamba River for the first several miles – gaining just a little bit of elevation at the end of the day to reach the first campsite.