What it feels like: A dull aching pain in the front of your lower leg between the knee and ankle.
Is it serious? No, but the injury can progress into a stress fracture if you keep exercising.
What causes it: Shin splints occur when tissue between leg muscles and the shinbone (tibia) become inflamed. When it comes to walking, the repeated motion of your legs hitting a hard surface can provoke this stress injury. "Shin splints especially tend to happen if you start to walk aggressively and haven't been walking for a long time." says Jessica Flynn, MD, a sports and dance medicine expert at Lahey Clinic in Boston.
How to prevent it: If you're new to exercising, aim to walk just 15 to 20 minutes a day and gradually build to longer periods of time. And, says Dr. Flynn, make sure you have properly fitting, supportive footwear. Your sneakers should be roomy enough so your toes don't touch the front, but not so large that your heel slips out when you walk. Running and walking stores usually have knowledgeable staffers who can fit you with a good pair.
How to treat it: Rest from fitness activity, advises Brian Donley, MD, director of the Center for Foot and Ankle Surgery at Cleveland Clinic in Ohio. Icing right after a workout may also help. Shin splints take anywhere from one to six weeks to heal.
What it feels like: Your knee aches and may throb or swell.
Is it serious? It's usually not, but talk to your doctor, especially if you have trouble walking or bearing weight.
What causes it: There are many reasons for knee pain, but walkers can usually blame it on inflammation from overuse, says Dr. Flynn. Common underlying problems include tendinitis, osteoarthritis, and Runner's Knee, a term referring to misalignment of the kneecap. Overpronation, when your feet roll inward when you walk, can also strain your knee.
How to prevent it: Your quads control kneecap movement, so strengthen those muscles. Try lying flat on your back, lifting one leg 45 degrees off the floor quickly, then slowly letting it down until your heel is one inch from the floor. Repeat 10 times for three sets. If you overpronate when you walk, an orthotic inserted into your shoe may correct your form and keep your kneecap in line, according to Dr. Donley.
How to treat it: "Back down on exercise until your pain gets better," says Dr. Donley. An over-the-counter anti-inflammatory medication, such as Motrin, can bring relief and reduce swelling. Chronic knee pain sufferers may sometimes require steroid injections.
What it feels like: Throbbing pain and usually swelling in the foot or ankle that progressively worsens the more you walk on it.
Is it serious? No, but see an orthopedic surgeon if you're experiencing these symptoms.
What causes it: A stress fracture is a tiny crack in a bone that may or may not show up on an x-ray. "When it comes to walking, small, repetitive forces fatigue the bone," says Dr. Donley. When one becomes overloaded from absorbing the impact of your feet hitting the ground, it literally breaks. Women over 40 are more prone to stress fractures, thanks to bone density issues.
How to prevent it: Up your mileage gradually so your skeleton can sustain long treks. Practice good bone health by getting enough calcium and Vitamin D in your diet, and make sure your walking shoes have good shock absorption—another reason to take extra care when selecting sneakers.
How to treat it: More rest: Stress fractures typically require you to take four to six weeks off the injured foot to heal completely. Depending on the severity of the injury, you may be put in a cast or walking boot. When you start walking again, your doctor may advise you to wear an orthotic for additional support. In rare cases, surgery is needed to insert pins that help the fracture heal.
Blisters, Calluses, and Corns
What they feel like: Blisters are swellings filled with fluid which may or may not cause pain. A callus is a thickening of skin that is usually caused by pressure and can hurt when something rubs against it. A corn is the central core area of a callus that extends deeply and is commonly found on top of the toe.
Are they serious? No, unless they become infected. If you see redness or swelling, talk to your doctor.
What causes them: Ill-fitting shoes are probably the culprits. Friction can create all three conditions, especially when your feet repeatedly rub against the insides of your footwear.
How to prevent them: "The first most essential piece of walking equipment is a well-fitted, well-supportive walking sneaker," says Bryan Markinson, DPM, Chief of Podiatric Medicine and Surgery at the Leni and Peter W. May Department of Orthopedic Surgery at Mount Sinai School of Medicine in New York. Look for footwear with a rigid sole and a back that hugs the outside of your heel. If you’re prone to corns, make sure the top of the shoe is high enough to accommodate your toes. Keeping your feet dry can also stave off blisters. Invest in wicking socks that remove moisture from skin, rather than cotton or nylon socks that let your feet sit in sweat.
How to treat them: Whatever you do, don't pop a blister—that could lead to infection, according to Dr. Markinson. Put on a clean bandage on it, instead. When it bursts on its own, leave the skin on to act as its own sterile dressing. Moisturizing lotions, like AmLactin, soften corns and calluses, while lubricating ointments, like Vaseline, reduce friction around them when you're wearing shoes. If a corn or callus is really bugging you, a podiatrist can shave it down.
What it feels like: Tenderness or pain around the toenail.
Is it serious? Walkers can encounter various toenail conditions, including blood blisters, thickened toenails, toenails breaking down, and ingrown toenails, where the toenail pushes into the skin. All can be serious if they become infected, so seek treatment if pain persists more than a couple days. However, if you have diabetes or nerve damage, get your feet checked out immediately.
What causes it: Your sneakers are often to blame. If they're the wrong size, your toes repeatedly hit the front of the shoes, causing trauma to nails.
How to prevent it: Find shoes that fit. "Make sure the shoe is not too large so the foot slides with every step, and not too short because then your toes will hit the end," advises Gregory Clark, DPM, head of the Division of Podiatry at Scripps Clinic Medical Group in La Jolla, California. A little grooming also goes a long way: You can avoid these conditions by clipping toenails so just a small amount of nail extends over the skin. Don't trim nails too deep in the corners—this can cause ingrowns.
How to treat it: Stop exercising if nails are inflamed or painful. Ice and elevate the sore toe. Once the nail feels better, cut it to the proper length. A doctor will trim the affected portion of an ingrown toenail. In extreme cases, he may use local anesthesia to remove an entire side of the nail.
What it feels like: Tenderness on the bottom of your foot. It may feel like an ice pick going through your heel, and pain is usually worse in the morning.
Is it serious? No, but see your doctor to rule out something more serious like a stress fracture.
What causes it: The plantar fascia is a band of tissue that stretches along the bottom of the foot and connects the heel to the ball. Every time you take a step, you put that area under stress. People with very high arches, flat feet, or ankles that pronate may be predisposed to this condition, according to Dr. Flynn. Not stretching enough before walking can also bring it on.
How to prevent it: Stretch three times a day, including first thing in the morning and after walking, recommends Dr. Donley. Target the Achilles tendon, calf muscles, and the plantar fascia. One good exercise is standing with your toes on a step, dropping your heels, and holding for a long, slow count to 10.
How to treat it: Take a break from walking. To relieve pain, stretch by rolling your foot on a frozen water bottle or tennis ball. If pain doesn't go away, a doctor may suggest you wear a night splint to stretch your foot, Achilles tendon, and calf while you sleep.
What it feels like: A tight squeezing pain, most commonly in your calf muscles.
Is it serious? Not usually, but see your doctor if the cramp doesn't go away.
What causes it: There are lots of different causes, says Dr. Flynn, but it could be that your muscles just aren't used to exercising—which is why cramps often occur when you're doing something strenuous, like walking uphill. A cramp can also be a sign that you're dehydrated or low in potassium, an electrolyte that comes out in sweat.
How to prevent it: Start your fitness routine slowly and build up to walking longer distances and tougher routes so you don't overwork yourself. Drink plenty of water to avoid dehydration, and get some potassium in your system by eating a banana or sipping a sports drink like Gatorade that's infused with the electrolyte.
How to treat it: "Stop, stretch, and hydrate," says Dr. Flynn. Try the calf stretch from the previous page.
What it feels like: A sharp, sudden pain in the ankle that fades into a dull pain.
Is it serious? A sprain means you have "acutely stretched the ligament," says Dr. Donley. Most aren't serious, but if you have difficulty putting weight on your foot, get it checked out to rule out a fracture.
What causes it: "It's usually a sudden twisting in your ankle and it gives out on you," says Dr. Donley. This often happens when you take an awkward step.
How to prevent it: Watch where you walk. Sprains most commonly occur when you're walking on uneven surfaces like grass or cobblestone. Plan your routes so most are on flat pavement, and use caution when going over rough surfaces. You can also work on strengthening your ankles. Dr. Donley recommends this exercise: Hold a resistance band with your hands and step one foot into it. Kick that leg out to the side against the force of the band pulling it back in. (Your doctor or a therapist can advise you on proper form.)
How to treat it: In most cases, a sprain gets better with time off the foot. Icing and elevating it above your heart can help reduce swelling, according to Dr. Flynn. If pain continues, your doctor may recommend you wear a brace (an Ace bandage or something stiffer) and, in more severe cases, go to physical therapy.
What it feels like: Dull or sometimes burning pain in the back of the heel or ankle.
Is it serious? Not usually, but it shouldn't be ignored since a bad injury to the Achilles tendon can require surgery or prolonged therapy. In very rare cases, it can lead to a rupture of the tendon, which calls for immediate surgery.
What causes it: Tight calf muscles. "When we get older, our tendons and ligaments are not as elastic as they can be," says Dr. Clark. Drastically upping your miles without preparing your body for it can also put you at risk.
How to prevent it: Stretch your calves once they're warm, like when you get out of the shower. During your walks, warm up with a five-minute stroll, then stop and stretch. Don't forget to do so at the end of your walk, too. Try this exercise: Stand with your hands against a wall, plant your feet on the ground, and take a big step back with one foot. Hold for 10 seconds, then repeat with the other foot. By now you know the drill, but it's also always a good idea to build up your walking routine gradually.
How to treat it: Rest. Your doctor might suggest you ice the foot or take an anti-inflammatory medication if you experience swelling. A night splint may be recommended to keep the tendon in a lengthened position. When you start walking again, gel heel inserts in your shoe can take pressure off the tendon.
Lower Back Pain
What it feels like: Dull or sharp pain in your lower back, buttocks, or back of leg.
Is it serious? Not usually. These aches most commonly occur in people who have a history of back pain prior to exercise. But get it checked out especially if there is radiating pain, numbness or tingling down the legs, which may signal a pinched nerve. You need to find the root of it to prevent it from getting worse, says Dr. Flynn.
What causes it: Most commonly it's a muscle strain. But it could also mean one of the discs in your back is bulging and pinching a nerve, and the pounding movement of walking aggravates it.
How to prevent it: Make sure your posture is correct when walking; speak to your doctor for suggestions. Lower back pain is also more common in smokers, so don't smoke. Obesity strains those muscles, as well, so eat healthily and keep your weight in check.
How to treat it: If your discomfort is a sudden, one-time injury caused by walking, stop exercising until you speak with your doctor. However, research has shown that moderate activity can alleviate chronic back pain—so if you have a history of it, your best bet may be to lace up those walking shoes and get a little exercise in each day. Depending on your situation, your doctor may recommend physical therapy or steroid injections.
Originally published on FamilyCircle.com in May 2010.
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