How To Start a Walking Program After Injury

According to the Centers of Disease Control and Prevention, The Physical Activity Guidelines For Americans recommend adults get at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of high-intensity aerobic activity per week. 

Walking is a great way to meet these general activity guidelines as it requires no equipment or skill, and has been shown to improve sleep, mood, memory, bone density, and even joint health in numerous studies

Let’s say you’ve recently received a new hip or knee and want to start walking your dog around the neighborhood again.

Or maybe you’re suffering from an episode of low back pain and can’t walk around Costco or the mall to go shopping. You’re going to miss the big sale! 

How do you start walking again when you are limited by pain, stiffness, or weakness? 

See a Physical Therapist

Start with your local physical therapist! 

A physical therapist can perform an individualized assessment to determine how to address your limitations. Therapists have interventions that can target swelling, pain, stiffness, and weak muscles that may be affecting your ability to walk properly. 

If you think you may benefit from physical therapy services, follow up with your doctor to request a prescription and call JACO Rehab at (808) 381 – 8947 to schedule an appointment! 

If you have already followed up with your physical therapist and have been cleared by your doctor to initiate a walking program, here are some easy ways to get started! 

A Note on How to Check Your Exercise Intensity

A great way to determine whether or not you are reaching an appropriate level of intensity with water walking is to track your heart rate. 

Most smart watches have a feature that can track your heart rate with exercise, or you can easily take it manually by counting the number or beats felt in 30 seconds at your radial pulse (found directly below your thumb/wrist on the palm side of your forearm) and multiplying it by two. 

An easy way to determine your maximum heart rate (HRmax) with exercise is to subtract your age from 220.

So, if you’re 50 years old, your HRmax is 170 beats per minute.

Once you have determined your HRmax, you can multiply that number by either 70-80% for moderate intensity exercise or 80-90% for vigorous intensity exercise to determine your target heart rate for a bout of exercise.

So, if you’re 50 years old with a 170 beat-per-minute HRmax, 70% of your heart rate will be about 119 beats per minute. If you want to exercise at a moderate intensity, you’ll aim to maintain a heart rate of at least 119 beats per minute. 

Now that you have your desired intensity level, start with 10 minutes of walking, working up to a moderate intensity level to make sure you get the cardiovascular benefit. Ideally, you would aim to walk for at least 30 minutes 5x/week at a moderate intensity to meet the recommended activity guidelines. 

Water Walking 

Luckily, we live in Hawaii! 

If you have access to a pool or the ocean, water walking is one of the easiest ways to start a walking program as it decreases the compressive force of gravity which feels great on joints. 

According to a recent study published in The Journal of Sport Health and Science, water walking and land walking were shown to elicit similar cardiovascular benefits when done at the same intensity. That means you’ll get similar benefits from water walking as land walking, even though it feels “easier” on the body.

And if you’re worried about falling, the same study demonstrated that water walking presented less of a fall risk.

If you want to challenge the intensity of your water walking, you can grab some foam dumbbells, wrist or ankle weights, or even a pool noodle to add some light resistance. 

Interval Walking 

When starting a walking program after an injury, a good rule of thumb is to avoid uphill, downhill, and uneven terrain. These terrains are too challenging to start with and require more muscle strength and stability, which can initially cause discomfort and increased swelling, especially with tendon injuries and joint replacements. 

Instead, a great way to initiate a walking program and gradually increase its intensity is with interval training on a flat surface.

Interval training during a walking program means performing several smaller bouts of walking measured either in distance or time. Each bout is followed by a period of rest. Adding a rest period after a walking interval would decrease the intensity of the workout so your heart and muscles have a chance to recover.

A simple example would be to walk 2 blocks followed by a 30 second standing rest period. Then, you would walk another 2 blocks and rest another 30 seconds. 

During that 30 second rest, you can choose to stretch if you notice any stiffness throughout your body. This is a great way to mitigate any muscle discomfort you may feel when getting started on a walking program. 

The distance or time that you walk all depends on your individual level of fitness and goals! 

There are ways you can “overdo” it. To avoid increasing pain or causing reinjury, only increase your walking time and mileage by 10% every week. Aim to walk at least two, but no more than three times per week. 

Once you can complete a set interval series on flat ground without any discomfort, you can increase the intensity of your workouts by: 

  • Uphill and/or downhill walking 
  • Walking through gravel, grass, or sand
  • Wearing ankle weights, arm weights/dumbbells, or a weighted vest 

Eventually, you’ll be able to tolerate 10-30 minutes of exercise without intervals, which is great!

The 10% recommendation still stands—now that you’re feeling great, stay disciplined in your program. Take care in increasing your intensities, distances, and time. Challenge yourself with a 10% increase in one of these variables at a time, and tune in to how your body feels after each bout.

What If I Overdo It?

If you accidentally “overdo” it and start to feel lingering pains after exercise, it’s okay! Don’t panic.

Before starting your walking program, get clear instructions from your physical therapist about what to do if you start feeling pain during your exercise program. Recommendations may vary between injuries.

One thing is consistent for everyone, though… Don’t just stop everything. Do what feels good for your body. You may need to decrease your distance, time, or intensity by a few notches while the body recovers. You may need to take a week off of your walking program and work on strengthening only. Sometimes, it’s okay to go backwards to move forwards. You can progress your walking program again once your body is ready.

Reach Out!

If you have any questions or concerns regarding initiating or progressing your walking program, we would be happy to help! 

Please call JACO Rehab at (808) 381-8947 to schedule an individualized assessment. We also offer running assessments at our town location when/if you are ready to take the next step in your recovery. Mahalo!

Written by Jennifer Lewis, DPT

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