Walker scan 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 Schumann, a physical therapist in Fort Collins, CO, and a spokesperson for the American Physical Therapy Association. 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.
Run your opposite hand along sole of foot; you should feel a taut band of tissue. 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 footed at all times. Off-the-shelf orthotic inserts (by Dr. School's or Ionic, for example) or a custom-made pair can help absorb some 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, PM, a podiatrist in Pankhurst, 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.
You may be more likely to develop ingrown toenails if your shoes are too short or too tight, which causes repeated trauma to the toe as you walk, says Ward. What it is: A bunion develops when the bones in the joint on the outer side of the big or little toe become misaligned, forming a painful swelling.
Walkers with flat feet, low arches, or arthritis may be more apt to develop bunions. Cushioning the bunion with OTC pads can provide relief, and icing it for 20 minutes after walking will numb the area.
Severe cases can require surgery to remove the bony protrusion and realign the toe joint. What it is: The Achilles tendon, which connects your calf muscle to your heel, can be irritated by walking too much, especially if you don't build up to it.
Repeated flexing of the foot when walking up and down steep hills or on uneven terrain can also strain the tendon, triggering lower leg pain. What to do about it: For mild cases, reduce your mileage or substitute non-weight-bearing activities such as swimming or upper-body strength training, so long as these don't aggravate the pain.
“Avoid walking uphill, because this increases the stretch on the tendon, irritating it and making it weaker,” says Schumann. Regular calf stretches may help prevent Achilles tendinitis, says Michael J. Mueller, PT, PhD, a professor of physical therapy at Washington University School of Medicine in St. Louis.
In severe cases, limit or stop walking and place cold packs on the injured area for 15 to 20 minutes, up to 3 to 4 times a day, to reduce inflammation and pain. When you return to walking, stick to flat surfaces to keep your foot in a neutral position, and gradually increase your distance and intensity.
What it is: Walking doesn't usually cause lower-back pain, but the repetitive movement can make an existing lower-back injury worse. 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. What to do about it: Treatment varies from simply wearing roomier shoes to surgery, depending upon the severity of the neuroma.
Limit your time spent hoofing it in heels, and if you must wear them, travel in comfy shoes like supportive ballet flats and then slip on the more stylish pair. 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 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 Orthopedic Surgeons.
You should also strengthen the muscles in the front of the lower leg (anterior tibialis) to help prevent a recurrence. 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.
“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 to do about it: Instead of walking, ride a stationary bike, swim, or do some other non-weight-bearing activity for a few weeks, says Kelly, who also suggests an OTC anti-inflammatory medication to ease the discomfort.
Eventually, your kneecap may start to rub against your femur (the bone that connects your knee to your hip), causing cartilage damage and tendinitis. While standing, place a looped band around both feet and sidestep 12 to 15 times to right, then back to left.
Women may be more vulnerable because their lower muscle mass and bone density don't always act as adequate shock absorbers. “You need to get off your feet to avoid loading the bones,” says Sheila Duran, MD, a physiatrist and an associate professor at Rush Medical College.
Replace walking shoes when the interior cushioning has worn down, to ensure that you have adequate shock absorption. To optimize bone health, do lower-body strength-training twice a week and eat calcium-rich foods like yogurt and cheese and greens such as kale, or take a supplement.
Peripheral artery disease is a form of atherosclerosis, the same condition that leads to most strokes and heart attacks. The classic symptom is cramping, tight pain that's felt in muscles “downstream” from the narrowed artery.
Similar to angina, the pain caused by peripheral artery disease comes from working muscle cells that are “starved” for oxygen because of obstructed blood flow. The medical jargon for this kind of pain is intermittent claudication, from the Latin claudication for limping.
And it's common for people to cut back on their activity level without realizing it, which can mask the problem. But researchers have found that tightly structured, supervised exercise programs can help people increase the amount they can walk before their leg pain kicks in.
But the track record of these revascularization procedures is mixed, and some studies suggest that the results from a structured exercise program can be as good, or even better. Like peripheral artery disease, chronic venous insufficiency is a condition of poor circulation, but it involves the veins and the blood's return trip back to the heart and lungs.
Our arteries are springy and help push blood along, but our veins are relatively passive participants in circulation. Tiny valves inside the veins even out the pressure and keep the blood from flowing backward.
In people with chronic venous insufficiency, the valves are damaged, so blood tends to pool in the legs and feet instead of traveling “north” to the heart. As a result, the valves don't close properly, so even more blood flows backward, adding pressure.
Symptoms include swelling, inflammation of the skin (dermatitis) and the connective tissue underneath (cellulitis), and ulcerated, open wounds on the bony “bumps” of the ankle. The symptoms from a mild case of chronic venous insufficiency can be helped by lying on your back and using a pillow to elevate your legs, so blood flows downhill to the heart.
If you're sitting for long periods, pointing your toes up and down several times can flex the vein-pumping leg muscles. More serious cases needed to be treated with compression stockings that squeeze harder at the ankle than at the knee.
Some people coat their skin with talcum powder or wear thin, regular stockings underneath. Devices called “wire dinners” hold the stockings open, so people can push a foot and leg into it.
They use one of several minimally invasive techniques, performed through catheters inserted into the veins under ultrasound guidance. The lumbar region of the spine consists of the five large vertebrae that form the small of the back.
When spinal stenosis occurs in the lumbar region, lower back pain can be a symptom, but often it's the legs that are affected. The pain can resemble the pain caused by peripheral artery disease: cramping tightness that increases with walking, although it's often felt in the thigh rather than the calf.
Now the preferred medical term seems to be neurogenic (which means originating from the nervous system) claudication. Vertebrae, disks, and other parts of the spine impinge on the spinal cord and nerves branching off of it.
An MRI or CT scan will often be ordered to confirm a diagnosis, but imaging studies shouldn't be used to make one. Treatment usually begins with physical therapy and exercises aimed at strengthening back and abdominal muscles.
The most common procedure is a laminectomy, which involves cutting away part of a vertebra to create more space for the spinal cord and nerves. Bone spurs and portions of the disks and facet joints can also be removed to relieve pressure.
Diabetes may also deplete the body's store of neurotrophic peptides, chemicals that normally repair and regenerate nervous tissue. Diabetic neuropathy can make walking difficult, but leg pain may improve with exercise.
Pain relievers, tricyclic antidepressants (amitriptyline, desipramine, duloxetine), and anticonvulsant (carbamazepine, gabapentin, pregabalin) are used to control the burning and tingling sensations from neuropathy. Disclaimer: As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
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