Don’t even talk about (insert exercise), do you even walk?

I just came across an article that proposes walking to be as effective as running for your health. I was immediately interested to read about the content of the study. Wouldn’t you? Physiotherapists can use something as simple as walking to promote health and to improve quality of life.

This made me think back at the different forms of physical activity and exercises that are easily available, and the different exercise trends over the last few years. What is trendy and popular usually attract the masses and keep people motivated to keep active.

For the year 2017, the top fitness trend from the annual survey of health and fitness professionals is ‘Wearable Technology‘. I’m not shy to admit that I own (links are added not because I’m sponsored, but for your information if you would like to buy one for your exercise):

  • Fitbit Surge watch
  • A wireless Bluetooth sports earphones (without heart-rate monitoring though)
  • Smartphone for my loud music
  • An amateurish heart-rate monitor with chest-strap from Decathlon (which my wife often rolls her eyes at me because it is quite inaccurate compared to what she uses at work

tech savvy runner

Did it get me interested to exercise? Yes! I was quite excited to run with my earbuds and was actually planning my weekly mileage.

Deep down, will it keep me motivated to continue exercise for a long time? I doubt so. These are fun tools to play with but probably not going to usher you to the running track when you don’t feel like doing so. Sometimes, I still need to fall back on my intrinsic motivation (health, look good, maintain IPPT results) to do my exercise and that is really most important.

However, it doesn’t take much push to ask me to walk 10-15 minutes to the MRT station, climb 3 flights of stairs to work instead of taking the lift, walk from Orchard Rd to Little India. Inherently, I’m wired to walk but maybe not extremely motivated to do very intensive exercise. Probably explains why it’s not difficult for me to keep in shape when people around me are complaining of weight gain and poor fitness.

I would like to stress the benefits of regular physical activity (the opposite of sedentary) and this is extremely important to everyone, including the healthy and the not so ‘healthy’, with aches and pain.

So what can be the benefits of walking, and how much benefits should I expect if I start a walking program?

Even dead people walking are popular now, so let me try to convince you to ‘Make Walking Great Again’!

walking dead

Here are some selected research trials for the use of walking for diseases/disorders:

For Lower Back Pain – Keep Moving

In this randomised controlled trial, 6 weeks of 20 to 40 minutes of aerobic walking, 3 times a week has been shown to be as effective as strengthening exercises for lower back pain.

Another randomised controlled study found that patients in the walking program who were given a walking diary and a pedometer and asked to walk at least four days per week results in improvement in pain and disability similar to usual physiotherapy or a group exercise program. Patients started with at least a 10-minute walk (1,200 steps daily) with the goal of achieving 30 minutes of moderate-intensity physical activity (such as a brisk walk) five days per week. They were supported by weekly telephone calls. All patients also were given a booklet that explains back pain. Cost was lowest for the walking program, and sustained adherence with treatment was highest.

This randomised trial showed that primary care patients participation in recreational physical activities improve back pain, but performing back strengthening exercises was associated with worsening of backpain symptoms.

Based on all these findings, my recommendations for prescription would be determined by a few factors, such as:

  • pre-existing medical health
  • physical activity and fitness levels
  • availability (time/days of the week)
  • associated conditions that may affect ability to walk, like lower limb pain, dizziness, etc.

Prescription of an intervention plan is always patient-specific and I stress that even for identical twins with the same DNA would require different intervention plans. Only from a holistic interview and assessment, can I then suggest a safe, effective and pragmatic program.

Prevention of Health Problems

Walking is as effective as running for your health, as long as you expand the same amount of energy to reach the therapeutic level. The more, the better (most of the time).

“Assuming a slow jogging speed of a 12 minute mile, compared to a walking speed of 17 minute miles, you would need to walk about 50 percent further to expend the same energy as running,” lead author Paul Williams explained to me. In terms of time, “you would need to walk for about twice as long.”

If you have lower limb problems that do worse when you run, selecting a walking program is an alternative. The downside is that you got to spend more time to achieve the same results.

Walking away the blues

Rumination is the focused attention on the symptoms of one’s distress, and on its possible causes and consequences, as opposed to its solutions. People who ruminate constantly think about ‘how and why things have/will go wrong’ and the negative consequences that may come out of it. This is very common in people who suffer from anxiety and depression.

A 90-minute walk in a quiet greenery has been shown to be better than walking in a noisy highway for these people. The results show that walking in the nature has reduced the amount of ‘brooding about the negative aspects of one’s lives’. This is a small scale study and much more research into this area needs to be done but early data shows that walking in a relaxed environment probably can help in some way.

For people suffering from clinical depression, walking can also help. In fact, exercise is a very important part the treatment plan.

“Walking has the advantages of being easily undertaken by most people, incurring little or no financial cost and being relatively easy to incorporate into daily living.”

We do not know what is the optimal dose of walking for treating mood disorders. A study has shown that using the recommendations endorsed by most National Health Organizations (Singapore’s Health Promotion Board endorses this too) of 150 minutes of exercise at moderate intensity or 200 minutes of walking every week resulted in women “having more energy, socialized more, felt better emotionally, and weren’t as limited by their depression” when researchers followed up after three years.

When can walking be bad for you?

Can you think of anything that can go wrong when you walk? Probably a few words of wisdom when you go for your next walk:

  • Walk without reading on your smartphone, be safe
  • Music is great, but try to go for ‘open’ not ‘closed’ earphones or headphones. They still allow environmental sounds to be heard and this is safer when you walk along busy sideways, park connectors or across the road.
  • If you are currently suffering from knee or heel pain due to any reason, probably good to discuss with your physiotherapist/doctor if walking is the most appropriate activity now. Usually, it is not the activity but the amount or duration of activity.

 

I hope you have learnt something from this post and once again thank you for reading!