Don't let pain, fatigue keep you from walking

We'll bet our pedometers: If you asked your doctor to write one prescription that could boost your health, ward off disease, and keep you trim and upbeat, the Rx would be walking.

Unfortunately, some side effects of aging -- joint and back pain, foot problems, fatigue, and poor balance -- make many women chuck their sneakers just when exercise could do them the most good.

Don't give up, says Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston.

"There are very few women who can't overcome these obstacles," she said.

In fact, she says, most women can stick with a walking program for a lifetime. Whether you're starting out or ramping up, or just want to maintain your pace for the long haul, here's how to walk past any roadblock.

1. Ease back and knee pain

When you're aching from arthritis, an injury, or everyday wear and tear, it's easy to let your workout slide, but walking has been proven to reduce all these pains, says Dr. Roger Chou, a professor at Oregon Health and Science University who recently co-authored new medication guidelines for lower-back pain for the American College of Physicians.

If your joints are really complaining, it helps to shed extra weight. A Danish review of studies concluded that overweight patients who lost at least 5 percent of their body mass experienced significant symptom relief.

To feel better instantly during your walks, try slowing your pace. Researchers at the University of Colorado found that obese walkers cut the stress on their knees by 45 percent by downshifting from 3 mph to 2 mph. And as long as you cover the same distance, you'll actually burn slightly more calories because you're exercising for a longer period of time.

2. Strengthen key muscles

Adding moves such as squats and leg extensions to your routine two or three times a week will work the quadriceps, the muscles on the fronts of the thighs that support the knees. Do one or two sets of 10 to 15 repetitions.

Also make sure to include gentler movements: "Slow, controlled activities with some twisting or sideways movement -- like yoga and tai chi -- can improve knee function and reduce pain," says Katherine S. Rudolph, Ph.D., of the University of Delaware. A couple of times a week, pop in a yoga or tai chi DVD.

3. Move through moderate back pain

If it's your back that's keeping you sidelined, remember this: Studies show that you'll heal faster if you stay active.

"It might hurt a bit while exercising, but you won't do permanent damage -- and you'll recover faster," says Chou.

Keeping your back strong may prevent muscle spasms and tightness, experts say. What's more, you might also find yourself coping better psychologically.

"If you learn that you can function despite having some pain, you'll be less likely to limit your activities," he says.

4. Banish fatigue

For years, research has shown a link between regular exercise and decreased fatigue. A recent University of Georgia analysis of 70 studies confirms that working out boosts energy levels by about 20 percent. The lift may come when exercise triggers the release of dopamine, a "feel-good" mood-regulating neuroïtransmitter, says Patrick O'Connor, a professor of kinesiology at the University of Georgia.

Lace up your shoes and log 20 minutes or more of walking at least twice a week, and you'll feel more charged up in as little as four weeks.

5. Fight foot ailments

Up to 7 million Americans suffer from plantar fasciitis, a condition in which the tissue connecting the heel bone to the toes becomes inflamed. It's common in active people, particularly in middle age, when the ligaments in the foot get more slack, putting pressure on the arch. It may start as a mild pain that feels like a bruise under the heel, and it often becomes severe.

Try this stretch: Sit in a chair with one leg crossed over the other. Take hold of top foot and pull toes back toward shin to stretch arch. Hold to a count of 10; repeat 10 times. Do this stretch first thing in the morning, plus two or three more times each day.

A study from the University of Rochester School of Medicine found that 94 percent of patients who did the stretch felt a significant decrease in pain and some reported being completely pain free.

6. Strengthen legs

Strong legs can prevent a trip from becoming a nasty fall. In one study, volunteers who did a 16-week resistance-training program of knee extensions, leg presses, and calf raises improved their overall leg strength by 7 percent -- the group who did no strength work experienced an 8 percent drop -- and recovered from tripping 20 percent more often. A few times a week, break up your walk with a few calf raises and step-ups on a curb.