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Can We Walk Ourselves Well?

Posted May 15 2010 9:37am

Can Changing How We Walk Alleviate Our Aches and Pains?

We all want good health. . .   We want to be lean, strong, and free from pain, especially pain in our back, neck, hips, knees, shoulders, legs, ankles, and feet. Beyond good health, we want to live life with energy, confidence, and exuding youth. At one time in our lives, we had this pain-free vitality and more. For many of us, the day-to-day grind wore down our bodies, leading to sore, achy and perhaps arthritic joints, weak muscles, more fat, greater fatigue, and even depression. 

Walking—when done optimally and correctly—can give you all this. But, before we discuss that, we need to understand how we came to walk poorly and how improper walking patterns can lead to pain, disability, increased risk of injury, lack of fitness and muscle strength, and most importantly, a lack of spiritual vitality.    

“You Walked Into Pain” — Sherry Brourman, PT, Walking Instructor

Humans have always walked. With the recent discovery of the oldest known human skeleton, Ardipithecus ramidus, nicknamed “Ardi,” we now know we have been walking for at least 4.4 millions years. It is our most natural and most common physical activity.

Yet, walking is not innate. It is learned, through trial and error, in a haphazard way. The infant, toddler, and young child learns to walk by watching his or her parents or caretakers. The child’s ”adult pattern” of walking locks into place by age 8. Don’t believe me, go to the local shopping mall and watch children walk with their parents. More often than not, the child will walk like one parent or a combination of both.

(As a podiatrist, I recently saw a 10-year-old girl who limped for no apparent reason. In talking with her mother, the mother related that she had the same limp due to a hip that she injured in a car accident a decade earlier. The child had taken on her mother’s limp, even though she had no pain or injury.)

Herein we find the first problem with walking: we may be learning to walk by mimicking parents who are not walking correctly. I can hear some of you now: Wait a minute, Dr. Nirenberg, my parents walk just fine! They may, but it is much more likely they do not. Optimal walking is a combination of proper positioning of our joints, correct breathing, coordinated movement of our extremities, torso and pelvis, and good posture. 

The fact is, most people walk wrong. Yes, they get from point A to point B, but they are moving their joints and muscles in a way that will likely exacerbate or eventually lead to muscle-skeletal pain somewhere in their body (i.e. knee, hip, back, neck or shoulder pain). Likely, they have poor posture, and more likely, their body will be asymmetrical. That is, one shoulder may be lower than the other, one hip higher than the other, one hip more anterior, one foot flatter etc. 

 

So we learn to walk by picking up the bad habits of one or both parents. As youngsters, we can run, jump, even bungee jump, and we feel invincible. Slowly though, due to poor walking patterns or an outright injury, or our activities (or much more often our lack of activity), or habits, aches develop. We may strain a muscle here, twist an ankle there, or just get a slow gnawing discomfort in our back, neck, knee, hip, ankle, foot, or shoulder. 

By the way, when I say habits, I am talking about such things as repetitive strain activities (carrying a knapsack, purse, briefcase, or baby or a specific activity that creates wear and tear on the body), diet (obesity or in rare cases malnutrition), and worse of all, poor footwear, which can put the whole body in poor alignment and/or distort and alter foot function (and altered foot function will alter our entire body!).

It only takes one injury to one joint, muscle, or ligament to worsen our walking pattern. Our body is a incredibly inter-related functioning unit and a simple knee problem can quickly lead to back, neck and foot problems.Even if the painful knee subsides after a few weeks, problems with your alignment and the way you walk can remain. For example, let’s say you hurt your knee and for a few days you are miserable. So you begin putting most of your weight on the other leg. When our body makes these kinds of adjustments, we call it a compensation. However, shifting our weight in this manner will often lead to additional compensations throughout your body, and these will further alter the way you walk. Over time, the knee pain may go away, but now, your walking pattern has changed—for the worse—and it is unlikely you are going to return completely to the old pattern.  

As we age, we may start having a pain here and there, and as a result, we may avoid certain activities, perhaps we stop skiing, or playing racquetball or even just stop taking the stairs. We soon find ourselves moving less, sitting more and quickly gaining weight. More weight strains our body more, leading to more aches and pains and even less exercise. Our walk might become further limited and stiff because we are worried about another fall or injury, and in effect we begin walking worse. Ironically, for many of us, lack of exercise and movement was probably one of the big factors that contributed to our problems in the first place. Yet, REST is touted as a good treatment for what ails us. Perhaps it is for an acute injury, but 6 months after an ankle sprain, if you’re still resting, you’re in big trouble!  

Worse, when your body isn’t moving as well as it should it is at even more risk for injury. People often think injuries are random. But, when a person has a poor walking pattern, they are much more likely to become injured. The person may slip on the ice, twist an ankle on the front lawn, or even throw out their back bending down to pick up a quarter. When this happens, they may blame the injury, but the injury is just the symptom of an underlying problem: the person’s misaligned, weak, worn out body.    

Keep in mind: The part of the body that hurts may not be the problem.

For example, in my practice I see many people with back pain due to severly flat feet. Once we get these people into orthotics (custom made, medical grade arch supports) their back pain goes away. 

Some people in pain seek help: they may see their doctor, or a chiropractor, or some cases, a surgeon. But even if they have a back fusion, knee replacement or pop pills to mask the pain, if their poor walking pattern continues, their problems will continue, or worse, new problems or injuries will occur. By now, some of you might be saying, I know how to walk. Of course you do, and if I gave you a golf club and no instructions on how to tee off, you could probably manage to hit the ball. But, your swing would be average to horrible.  Perhaps, your walk is too?

There is poor walking and there is walking well—walking optimally. Correct walking positions your bones and joints in their best alignment, which in turn stimulates muscles that were not moving much to not only move but work well.   

Further, if we are not walking correctly, over time we will see an increased strain on our joints, muscles, and ligaments. This strain is actually micro-trauma.  Microtrauma is very insidious, but when it goes on step after step, mile after mile, its damaging effects can add up.

Regardless of the mechanism of injury, our body will lose symmetry. Lack of symmetry or lack of alignment, will lead to some muscles contracting or tightening and others weakening or shortening. That is, every joint in our body is able to function or move because the muscles around joints oppose and balance each other. For example, in simplistic terms, our middle toe can bend upward (extend) or bend downward (flex), the muscle that flexes the toe is opposed or balanced by the muscle that extends (these muscles are for obvious reasons called extensor and flexor muscles).

When a joint in our body is out of alignment or out of its correct anatomical position, there is a lack of equal and balanced muscle tension on the joint. Thus, one or more muscles will become looser and weakened and their opposing muscles will become tense and tighter.  Muscles under tension, become tired and may go into spasm, and at some point pain sets in. Further, these muscles–already strained–are at risk for injury as soon as you they try to do an activity out of their normal routine. This is often how people end up with the good old “pulled muscle.”

The activity that pushes these already tensed, tired muscles to the breaking point does not have to be something radical like suddenly going for a run on the treadmill or doing a kick-boxing class. It could be as simple as bending down to pick up the newspaper or reaching high up to clean a window.

It does not always have to be a misaligned joint that starts the cycle of muscle imbalance. Muscle imbalances can cause the joints to BECOME misaligned. For example, a body builder may work his abdominal muscles more than their opposing back muscles. This would lead to imbalance affecting numerous joints, including the spine and pelvis.  

Even one joint out of balance (out of position) can potentionally lead to pain and problems anywhere else in the body.   

Modern medicine likes to break up the human body into its component parts or pieces. There are back doctors, foot doctors, hand doctors etc. The reality is the human body functions as a whole unit. For example, a foot that is out of position can affect the hips as easily as a hip joint that is malaligned can affect the feet. Cause and effect go up and down the body, and to an extent in other directions, too.

Now, you might be saying, I feel fine—I don’t have any hip, knee or back pain. And you may not. But, if you are walking incorrectly, you are likely heading toward some kind of loss of function, decreased flexibility and ultimately, pain. Your body just isn’t at the breaking point yet.

Even if your body never reaches the point of giving you pain, incorrect walking diminishes the effect of walking on many of your muscles, leaving them weaker and flabbier.   

Yes! Walking is a skill, just like golfing, but even better: recall that walking is our most common and most NATURAL activity. Because it is natural, we can improve on it–easily–to the point where it can be extremely beneficial.

I can hear some of you now going through all the reasons that you cannot change the way you walk: “it runs in my family”, “I’m too old to change”, “I have bad genes”, “I was born with curve in my back” and on and on.

Listen up! Your body and its muscles are under YOUR control. You can change the way you walk once you understand how to do it. You learned how to walk wrong without any help; now, with proper instruction, you can learn how to walk correctly.  

Right now, there are only a few people in the world teaching correct walking. One of the foremost experts on walking correctly is Sherry Brourman . Recently, I spent a three days studying with her at her Santa Monica studio.  Brourman, or “Sherry” as she likes to be called by her patients,  is author of the book Walk Yourself Well. She is also a Physical Therapist and Registered Yoga Teacher, and super dedicated to helping people walk better. 

When treating a new patient, Sherry will take a thorough history, observe how the patient stands and then she will watch them walk. Often, within seconds of the patient taking a few steps, she will point out the patient’s main walking problem. 

At that point, she would recommend ways for the patient to make small adjustments and often some basic exercises and stretches that will target the patient’s specific walking problem.  

Essentially, walking correctly involves a combination of optimal, unique joint and muscle movement, body posture, and breathing, and most importantly, a new and heightened awareness of your body.   

Developing an awareness of your body is key, and this is why it is  important to work with a good teacher. Often, we can’t see our abnormal walking pattern or our compensations because we are so use to them.  For example, when I first  met Sherry, she immediately spotted my left knee hyperextending. Despite having read her book and studying the science of walking and biomechanics for years, I had never noticed my knee hyperextending until she pointed it out.

Now, I am much more tuned into listening to my body, and I have learned that our bodies, in a sense, “talk” to us.  We just have to listen.

Many of the people who I saw going to Sherry for help were at the end of their medical rope. They had tried everything else modern medicine has to offer, and then–out of desperation–went to her. Sadly, some of these patients went through surgery or even surgeries, and they are still in pain.  As I watched Sherry work with them, I often found myself wondering how much better shape many of them would have been in, had they come to her earlier, perhaps, even before they had surgery.

In fact, from observing Sherry work with her patients, I have come to believe that there are few people who cannot be helped with these walking techniques. Further, I believe millions of surgeries could be avoided, if people first tried to walk correctly.  

Lastly, having spent a lifetime trying to alleviate pain for patients, I want to emphasize how impressed I was with Sherry. She brings an intuitive brilliance to training people to walk. Perhaps, this is because of her understanding of traditional medicine and yoga—a great mix! If you have structural pain and can get to the Santa Monica area, I would highly recommend seeing her for a few walking sessions.  

“Walking is man’s best medicine.” — Hippocrates

After studying with Sherry, I slowly began using her techniques with a handful of my patients who had muscle-skeletal pain and problems throughout their body.   

My most successful walking patient to date is a woman who complained of back pain to the point that every morning she needed to use a heating pad for 30 minutes. She also had another unusual problem: the seam of her pants or skirts always rode up on her left butt cheek.  

This patient constantly would have to pull the seam back into place. Now, after only working with her for 4 sessions, she no longer has a problem with the seam of her pants and more importantly, her morning back pain is gone!  

Further, all the patients who I have been working with are doing better to varying degrees. Of course, a handful of patients walking well and getting well is not scientific proof that walking better makes your body better, but it is very encouraging.   

(By the way, if you step into my common sense chamber for a moment, you would have to admit that it seems logical that walking better will make your mind and body feel better.)   

For now, I am continuing to study, explore, and learn new ways to help people walk better. I am meeting with various holistic and biomechanic experts and seeing what I can learn from them. Ultimately, I believe if  people walk better, they will not only experience increased weight loss and fitness and pain relief, but spiritual vitality. That is, beyond the physical effects that walking well bring, people often find that good, whole-body walking has a very beneficial effect on their emotional state. It can lessen anxiety, alleviate depression or just clear their minds–briefly–of psychological woes.

We should never forget that our mind and our body are tightly linked. Each  effects the other, and walking well will lift your spirits and when done regularly can become meditative and rejuvenating.   

“It is impossible to walk rapidly and be unhappy.” — Mother Theresa

“Everyday I walk myself into a state of well-being and walk away from every illness.” — Soren Kierkegaard

If you are in the Chicagoland or Northwest Indiana area and are interested in learning to walk better, please contact my office – Friendly Foot Care .     

Most exercise and fitness programs require a conscious decision to do them each day. When it comes to walking, you already are doing it. The average person walks 10,000 steps a day. Now, you can just do it better.

How do you walk? Do you walk well? Or poorly? I would love to hear your comments on walking!      

Brourman S. Walk Yourself Well. Santa Monica, CA. 1998.  

Kendal FP. Muscles: Testing and Function, with Posture and Pain (5 ed). Philidelphia, PA: Lippincott Williams & Wilkins, 2005. Klenerman L, Wood B. The Human Foot. London: Springer, 2006.  

Kirtley C. Clinical Gait Analysis: Theory and Practice. London: Churchill Livingston, 2006.  

Kou AD, Donelan JM. Dynamic Principles of Gait and Their Clinical Implications. Phys Ther. 2010 Feb;90(2):157-74. 

Neumann DA. Kinesiology of the Musculoskeletal System: foundations for rehabilitation (2nd ed). St. Louis: Mosby, 2010.   

Oatis CA. Kinesiology: The Mechanics and Pathomechanics of Human Movement (2nd ed). Philadelphia, PA: Lippincott Williams & Wilkins, 2009.  

Perry J, Burnfield JM. Gait Analysis: Normal and Pathological Function (2nd ed). Danvers, MA: Slack Incorporated, 2010.  

Rose J, Gamble JG. Human Walking. Philadelphia, PA: Lippincott Williams and Wilkins, 2006.  

Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby, 2001.  

Subotnick SI. Sportsmedicine of the Lower Extremity (2nd ed). Philadelphia:Churchill Livingstone, 1999.  

Zajac FE, Neptune RR, Kautz SA. Biomechanics and muscle coordination of human walking. Part I: Introduction to concepts, power transfer, dynamics and simulations. Gait Posture 2002; 16: 215-232.  

Links:

Sherry Brourman  

About.com Walking   

The Walking Site   

Walking on Wikipedia   

AARP – The Numerous Benefits of Walking   

Active.com – Walking   

Walk About Magazine

EroFit  

Marathon Walkers  

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