Walking - Still Our Best Medicine

The phrase "Walking is man's best medicine," allegedly spoken by Hippocrates two millennia ago, is even more timely today. This fact is particularly true in industrialized societies where new technologies have not only changed the way we work but, even more profoundly, have also affected our life styles by reducing the physical effort of most of our daily activities (with the exception of sports).

Walking can be used for pleasure and improved health by incorporating it into our daily routine. One cannot overrate the many benefits of walking since there is strong scientific evidence to support them.*

* Physical Activity and Heath: A Report of the Surgeon General US Department of Health and Human Services, 1996

* National Service Framework for Coronary Heart Disease. UK Department of Health, 2000

Regular walking has a direct impact on the cardiovascular and musculoskeletal systems, by:

• reducing the risk of coronary disease and stroke,
• lowering blood pressure,
• reducing cholesterol levels in blood,
• increasing bone density, hence preventing osteoporosis,
• managing the negative effects of osteoarthritis, and
• easing back pain.

Regular walking also improves general health and longevity. According to the US Report of the Surgeon General, not only do walkers live longer but also the quality of their lives improves dramatically.

Increased fitness

If you walk regularly means you walk daily, or at least a few times a week for about 30 minutes or longer. When you walk regularly, much like other kinds of moderate and low impact physical activities that involve the whole body, you can greatly improve your cardiorespiratory fitness and function. Also, once you become a regular walker:

• You are less likely to fall and suffer leg or hand fractures because your bones are stronger.
• You are less likely to sustain any injury because your joints have a better range of motion and the muscles are more flexible.

Improved capability to control body weight

Your body weight reflects the balance between the calories you take in as food and the calories you expend through your normal daily physical activities in life. Walking for 30 minutes covers a distance of 2.0 to 2.5 km and burns about 125 calories (520 kiloJoules). This amount may not seem like much, but if you walked five days a week within one year you would burn over 32,000 calories which would burn off more than 5 kg of fat. Moreover, the latest scientific evidence shows that you would derive even greater benefits from walking if you burned a minimum of 2000 calories per week by walking (about 8 hours a week, spread throughout the week).

Improved mental health

Walking, particularly when walking with good company and in pleasant surroundings, reduces depression and anxiety. Walkers also tend to be good sleepers.

Recovery from illness

Gentle walking is often prescribed for people suffering from a variety of medical conditions.

At the beginning you may be able to walk only a short distance at a slow pace, but if you persist you will soon be able to increase your distance and speed up your recovery.

Try to walk naturally, keeping in mind the following tips:

Good posture is crucial to get the best out of walking:

• Keep your head and spine straight.
• Make sure that you are not leaning forwards or backwards.
• Look straight ahead but occasionally look down for possible obstacles.
• Keep the shoulders and arms loose and relaxed, and let them swing naturally but do not force them.

Breathe regularly and steadily – neither too shallow nor too deep:

• Never hold your breath and avoid forcing yourself to breathe deeply.

Frequency, duration, and tempo (pace, speed):

• It is best to walk every day because daily walking allows the good effects to accumulate.
• The longer the break between walking sessions the lower the cumulative effects; if you take breaks longer than five days, the cumulative effect is negligible.
• Low impact but dynamic activities (that is, those activities involving movement such as walking) are more effective in burning fat in the healthiest manner. However, the fat-burning effect kicks-in about 30-40 minutes after the start of walking.
• Walking tempo is very individual and depends on your conditioning, the kind of terrain, weather conditions and your objectives.
• The pace most often recommended is a brisk pace which translates to about 90-110 steps per minute or 4-5 km/hour.
• Slow down if you find it difficult to breathe easily; it is better to walk a little too slow than too fast.

If you experience discomfort or pain while walking, stop:

• Check your footwear.
• Consult your physician or fitness expert.

Shoes are the single most important piece of equipment for walking, but they do not have to be specialty "walking" shoes. Any pair of shoes that you can walk in for an extended time would do. However, if you do not have such a pair and are looking to buy some, we offer the following tips:

• Do not buy hiking shoes unless you plan to walk in rugged terrain. They might be too heavy and not sufficiently flexible.
• Do not buy shoes designated for runners. That kind of shoe has so-called "forward balance" that slightly exaggerates a forward bent body position. Such a position is good for running but not for walking because it changes the distribution of stresses on your legs and lower spine and may cause discomfort.
• The shoes most suitable for walkers are those designed specifically for walking. If walking shoes are not available the next best are cross-training shoes.

Always get fitted for shoes in the evening as your feet swell by the end of the day.

It is important to get a good pair with the following characteristics:

• Is there enough toe space to allow you to wiggle your toes?
• Is there a snug fit and firm support in the heel area?
• Does it have a flexible cushioned insole to absorb shock? (Keep in mind that many walking-shoe buyers ask for too much cushioning in the hope that the extra cushioning will help decrease the discomfort of fallen or very high arches.)
• If your arches are somewhat flat, try molded arch supports that are available at most drugstores.
• When shopping for athletic shoes, ask a sales person for styles with "control" features – soles that designed to stop the roll-in motion. If arch supports or sports shoes don't help, see a foot specialist about custom-molded orthotic shoe inserts.
• If you have high arches, ask for "stability" athletic shoes, which are built with extra cushioning to help remedy this problem.
• If you are prone to ankle sprains, wear high-top athletic shoes that cover the foot and ankle snugly to minimize damage from twists.
• If the shoes don't feel good in the store, don't buy them. Walking shoes do not need to be "broken in" to be comfortable.
• Look for shoes made of breathable material, preferably with some degree of water-resistance.
• When selecting footwear, remember that tight socks or stockings can cramp the toes as much as poor fitting shoes. Wrinkled socks, or socks that are too large or too small, can cause blisters. White performance socks made from fibre that does not retain moisture may be recommended. (Coloured socks can cause skin allergies in some people.)

• Use your shoes only for walking. Wearing them to play sports can break them down.
• Don't take your shoes off without untying the laces or you could damage the heel support.
• Avoid walking in wet shoes. Wet mid-soles (the part between the bottom/outside sole and insole) do not absorb shock.
• As a rule, mid-soles wear out faster than out-soles. Using the wear of the bottom of your shoes, the easiest to notice, is not a good indicator of shoe longevity.

The question "what to wear for my daily walk" under ideal weather conditions is not difficult. Practically speaking, wear anything and everything that is loose, comfortable and sufficiently warm. Clothing becomes crucial when you face inclement weather.

Cold, winter weather

• Wear layers of clothing, preferably made of fabric that does not retain moisture. Cotton, silk, or wool is not a good choice for wearing next to the skin. These kinds of "wicking" fabrics tend to retain sweat smells despite "heavy duty" washing. Pre-soaking garments in a washing soda solution, followed by washing in warm or hot water using a good detergent is a proven remedy for smelly athletic clothing.
• Always wear a hat or some sort of headwear – one third of your body heat is lost through the head.
• Earmuffs and mittens or gloves also contribute to thermal comfort.
• Consider using walking or trekking poles when you expect slippery conditions, e.g., on ice, snow or rain-slicked streets.
• If the weather is really bad consider walking indoors, in the mall for example; a treadmill is another alternative.

Hot summer weather

• Wear lightweight clothing that covers enough skin to minimize UV exposure.
• Wear a hat to block the sun's direct rays.
• Wear sunglasses, again to reduce both glare and UV damage to your eyes (the latter contributes to the formation of cataracts.)
• Consider shifting your daily walks to early mornings, late afternoons, or evenings.
• Drink a lot of fluids – water is the best choice.

It is not clear whether stretching exercises that have traditionally been recommended before any vigorous activity are beneficial or not. However, to be on the safe side, we suggest that you start your walking session at a slow tempo for five minutes, then move up to a moderate tempo and from there gradually speed up to your regular cruising speed. This 5-minute start will help loosen your muscles and minimize the possibility of pulling or tearing them.

At the end of the session, to avoid any possible dizziness from abruptly stopping your physical exertion, slow down your tempo for about 3 to 5 min.

Be aware that wearing shoes or boots even if they fit comfortably but have rigid arch supports can, over time, degrade the natural flexibility of the foot. This is because the very muscles that give the arch its resilient quality will eventually weaken, owing to the unyielding rigidity of the footwear which immobilizes them.

So, no matter how great the shoe, or how careful you are about your health, occasionally going barefoot is beneficial, because being barefoot can partly restore the natural flexibility of your feet. This is why we suggest walking barefoot around the house, in your backyard, on the beach, or any place where there is no obvious hazard to your feet.