We all know that walking is the safest, easiest form of exercise, so why should you bother reading up on the risks?
Because left ignored, an innocent foot pain or leg pain can become a chronic problem. Each year, nearly 250,000 walkers are hobbled as a result of a walking-induced pain or a nagging old exercise injury that walking has aggravated. As bothersome as the initial problem can be, the real damage is what happens next. You stop exercising, misplace your motivation, and soon gain weight and lose muscle tone.
What it is: The plantar fascia is the band of tissue that runs from your heel bone to the ball of your foot. When this dual-purpose shock absorber and arch support is strained, small tears develop and the tissue stiffens as a protective response, causing foot pain. "Walkers can overwork the area when pounding the pavement, especially when you wear hard shoes on concrete, because there's very little give as the foot lands," says Teresa Schuemann, a physical therapist in Fort Collins, CO, and a spokesperson for the American Physical Therapy Association. Inflammation can also result from any abrupt change or increase in your normal walking routine. People with high arches or who walk on the insides of their feet (known as pronating) are particularly susceptible. You know you have plantar fasciitis if you feel pain in your heel or arch first thing in the morning, because the fascia stiffens during the night. If the problem is left untreated, it can cause a buildup of calcium, which may create a painful, bony growth around the heel known as a heel spur.
What to do about it: At the first sign of stiffness in the bottom of your foot, loosen up the tissue by doing this stretch: Sit with ankle of injured foot across opposite thigh. Pull toes toward shin with hand until you feel a stretch in arch. Run your opposite hand along sole of foot; you should feel a taut band of tissue. Do 10 stretches, holding each for 10 seconds. Then stand and massage your foot by rolling it on a golf ball or full water bottle.
To reduce pain, wear supportive shoes or sandals with a contoured footbed at all times. Choose walking shoes that are not too flexible in the middle. "They should be bendable at the ball but provide stiffness and support at the arch," says Melinda Reiner, DPM, a podiatrist in Eugene, OR and former vice president of the American Association for Women Podiatrists. Off-the-shelf orthotic inserts (by Superfeet for example) or a custom-made pair can help absorb some of the impact of walking, especially on hard surfaces. Until you can walk pain-free, stick to flat, stable, giving paths (such as a level dirt road) and avoid pavement, sand, and uneven ground that might cause too much flexing at the arch, says Phillip Ward, DPM, a podiatrist in Pinehurst, NC. If your plantar fasciitis worsens, ask a podiatrist to prescribe a night splint to stabilize your foot in a slightly flexed position, which will counteract tightening while you sleep.
What it is: Your shins have to bear up to 6 times your weight while you exercise, so foot-pounding activities like walking and running can cause problems for the muscles and surrounding tissues and create inflammation. The strain and leg pain results from strong calves pulling repeatedly on weaker muscles near the shin. "Walkers who walk too much too soon, or too fast too soon, or who go up a lot of hills are susceptible to this injury because the foot has to flex more with each step, which overworks the shin muscles," explains Frank Kelly, MD, an orthopedic surgeon in Macon, GA, and a spokesperson for the American Academy of Orthopaedic Surgeons. Spending too many hours walking on concrete can also lead to this sort of inflammation. Severe or pinpointed pain in the shin could also be a stress fracture of the tibia.
What to do about it: Cut back on your walking for 3 to 8 weeks to give the tissues time to heal. "If it hurts to walk, avoid it," says Joel Press, MD, medical director of the Spine & Sports Rehabilitation Center of the Rehabilitation Institute of Chicago. You might need an anti-inflammatory medication, such as ibuprofen, or cold packs to reduce swelling and relieve pain. In the meantime, keep in shape by cross-training with low-impact exercises such as swimming or cycling. You should also strengthen the muscles in the front of the lower leg (anterior tibialis) to help prevent a recurrence.
Use this simple exercise: While standing, lift toes toward shins 20 times. Work up to three sets and, as you get stronger, lay a 2- or 3-pound ankle weight across your toes to add more resistance. Once you're ready to start walking again, choose a dirt path and walk for 20 minutes at a moderate pace. Increase distance or speed slightly each week. "If your shins start to feel sore, rest for a day or two, and when you exercise again, take it even more slowly," says Byron Russell, PhD, chair of the department of physical therapy at Eastern Washington University.
What it is: Every time your shoe strikes the ground, your knee feels it. Eventually, your kneecap may start to rub against your femur (the bone that connects your knee to your hip), causing cartilage damage and tendinitis. Walkers with a misaligned kneecap, prior injury, weak or imbalanced thigh muscles, soft knee cartilage, or flat feet, or those who simply walk too much, are at greater risk of runner's knee. The knee pain usually strikes when you’re walking downhill, doing knee bends, or sitting for a long stretch of time.
What to do about it: Shift to another type of exercise until the knee pain subsides, typically 8 to 12 weeks. Do some quad strengtheners to help align the kneecap and beef up support around your knee: Sit with back against a wall, right leg bent with foot flat on floor and left leg straight in front of you. Contract quads and lift left leg, keeping foot flexed. Repeat 12 times; work up to three sets per leg. While standing, place a looped band around both feet and sidestep 12 to 15 times to right, then back to left. When walking or hiking downhill, take smaller steps and try not to bend your knees too much, or try walking sideways to give your side hip muscles a workout.
What it is: Walking doesn't usually cause lower-back pain, but the repetitive movement can make an existing lower-back injury worse. It's easy to "throw out your back" when tendons and ligaments around the spine are overworked. Arthritis or inflammation of surrounding nerves can also cause pain in this region.
What to do about it: For general back pain prevention, keep the muscles in your trunk strong. While you walk, engage your abs by pulling your belly button toward your spine as if you were trying to flatten your belly to zip up tight jeans. "Avoid bending over at the waist, a tendency when you are walking fast or uphill," says Schuemann. "Instead, keep your spine elongated and lean your whole body slightly forward from your ankles." A short pull exercise might also prevent slumping by realigning your posture. You can even do it while you walk! Simply cross your arms at wrists in front of your waist and raise arms as if you're pulling a shirt up over your head. Grow taller as you reach up, then lower your arms, letting your shoulders drop into place. Tight hamstrings and hip flexors can also cause postural distortions that put pressure on the lower back, so be sure to keep those areas flexible, too.