Breaking down barriers to a good walk

I've taken to walking the streets of my neighborhood during the coronavirus pandemic. It's a way to get out of the house when most of us are spending more time at home than ever before. It's a simple and effective way to get exercise.

Many doctors and public health organizations — such as the American Heart Association, the Centers for Disease Control and Prevention and the American Diabetes Association — promote walking for exercise. For good reason, too; walking can help people manage their weight and reduce their risk for heart disease, stroke, Type 2 diabetes, depression and some cancers.

People who promote walking for exercise emphasize how easy it is — no gym membership or pricey equipment required.

And yet, walking is not completely free of discomforts or barriers to access. For instance, certain consequences of walking may dissuade people from a regular practice, such as blisters. Also, physical problems, such as arthritic knees, may keep people from taking it up even though walking can help joint problems.

The easiness of walking poses another paradoxical problem.

“A lot of people don't consider walking to be exercise,” says Jessica Schwartz, a New York-based physical therapist and spokeswoman for the American Physical Therapy Association. In her practice, Schwartz often sees more injuries after a walkathon than after the New York City Marathon. That's because people don't think they need to train for a 5- or 6-mile walk.

If you are one of the 80 percent of Americans who don't get the recommended 150 minutes of physical activity per week, it's best to work up to those distances gradually. “Walk up and down your street several times. Then add an extra block,” Schwartz says.

“Physical and psychological barriers are a normal part of getting started with exercise,” says Heather Vincent, a specialist in sports medicine and director of the UF Health Sports Performance Center at the University of Florida. This is true for any exercise, she says. “If you're currently sedentary, you may experience some discomforts.”

It's not uncommon to feel twinges or stiffness as you start on a walk, but you may just need a warm-up period, Vincent says. “Give it a few minutes,” she says, if you're doubting the wisdom of pushing on in the face of specific sensations — a stitch in your side or an achy knee.

As you walk, your blood is flowing to joints and muscles. Keep breathing deeply. Those early twinges should let up soon enough, Vincent says. “Walking is wonderful for chronic aches and pains.”

A 2015 review of 26 studies found that in people who have chronic muscle or joint pain, those who walked for exercise had less pain and better mobility than those who didn't exercise.

Vincent says, however, it's a red flag if you start moving and the pain worsens in intensity, especially if it's a sharp or radiating type of pain. “That's something that probably needs to be checked out,” she says.

The benefits of walking go beyond arthritis pain. “Walking is probably the best exercise you can do,” says Loretta DiPietro, professor of exercise science at George Washington University.

It's aerobic, which is good for cardiovascular health. It's weight-bearing, which is good for bone health. It works your muscles, which helps with leg strength and stability. It benefits your brain and your mood, making you feel better.

And it helps you control your blood sugar. DiPietro conducted a study of inactive people 60 and older with a risk of diabetes. When participants took a 15-minute walk after eating a meal, their blood glucose levels came down quickly.

Schwartz talks about dosing — how far you walk and at what intensity. There's a huge range that can satisfy the novice to the extreme athlete.

And if you run into obstacles, here are some ways to deal with them.

Blisters

“Footwear is important,” Vincent says. Wear comfortable-to-you shoes — and lace them properly. Lacing should be snug, she says, “but not so snug that you can't squeeze a finger under laces.” A good fit means some space around the toes, and your heel should not slide against the back of the shoe.

For other foot problems, a podiatrist may be able to assess and treat with orthopedic insoles.

Gastrointestinal problems

If you fear the sudden urge to go while out walking, plan a route around lavatory access, such as in public buildings, but check for good ventilation in advance. And carry hand sanitizer.

Runners who have experienced runner's diarrhea can plan their eating and exercise routine ahead of time. Don't eat right before a walk and avoid caffeine and high-fat foods.

Air quality, heat and humidity

Allergens and air pollution can trigger shortness of breath in sensitive people. Avoid air-quality problems by using indoor spaces, keeping a safe distance from others and wearing a mask. Those with exercise-induced asthma should carry inhalers.

As for those hot summer days, Vincent says, “The best times to get out are early or late.” Wear sunglasses and a brimmed hat for further protection from the sun — and find routes with lots of tree shade.

Hand swelling

Some people find their fingers swell on long walks, particularly on warm days. It's not clear why this happens, although that doesn't keep people from theorizing everything from blood pooling to low salt levels. The only study on the phenomenon found that 29 percent of women and 16 percent of men noticed some swelling of their hands after walking. Anecdotal reports on hiking forums suggest that using trekking poles helps prevent swelling. Some doctors advise stretching and fisting your hands while you walk.

Motivation

Vincent calls this the biggest barrier: “The drive to get out there and do it.” Fitness trackers help many people set and keep goals.

Schwartz says that socially distant walking with a buddy or a family member can help with motivation. And, she says, if buying a new pair of sneakers helps you start a walking program, then go ahead and do it.