Walking Speed: an important indicator of health
There’s a lot you can tell about someone simply based upon how they walk! As healthcare practitioners, simply observing walking characteristics and gait speed can tell us information about:
- Balance confidence
- Overall health
- Ability to recovery from hospitalization and surgery
- Life Expectancy
- And much more!
In fact, walking speed is sometimes identified as the ‘sixth vital sign,’ suggesting it is just as important as blood pressure and heart rate.
If we know walking is so important, the next question we can ask is: “how we can optimize our ability to walk?” In our Age-Proof Your Body exercise class series on March 4th, we discussed the phases of walking, efficient walking mechanics, and exercises designed to maximize your walking capacity!
The Phases of Walking
Each phase of walking requires different demands of our body. In a simple form, walking can be broken down into two phases:
- Stance Phase: the period of time one leg is on the ground
- Swing Phase: the period of time one leg spends swinging forward, off the ground
In each phase, different problems can arise, leading to reduced speed and impaired efficiency of walking. With the below exercises, we address three common areas of breakdown during the Stance Phase:
- Midstance is when your foot is on the ground while the other leg is swinging forward. In other words, the foot on the ground is balancing the whole body! We frequently see deficits in balance lead to problems such as shortened step length.
- Push Off is when your foot is behind you, as you are pushing off the ground. Often times, the musculature that facilitates a powerful push off can become weak and stiff over time, leading to deficits such as decreased walking speed.
- Shock Absorption is when your heel lands on the ground in front of you. After the initial contact, your leg needs to absorb the force of your body moving forward. After knee injury or with knee arthritis, for example, we commonly see individuals walking with very ‘stiff’ knees, creating deficits in your ability to dissipate force efficiently as you walk.
While we often see the deficits mentioned above, a few simple exercises can help ensure you continue walking and living your best. They are great practice to optimize your mechanics and maintain and improve the strength and balance necessary to walk well!
1. Calf Raises:
a. Why this is beneficial: The calf is a major muscle that too often becomes stiff and weak as we get older. Strengthening it can help drive an effective and powerful push off for walking! It will help with your speed and endurance as well.
b. How to do it: Standing with your feet about shoulder width apart, next to something stable you can hold on to, lift your heels and press up onto your toes. You should drive the motion through your big toe, making sure your ankles do not roll out to the side. Once at the top of your motion, slowly descend until your feet are flat and repeat. Complete 15 repetitions per set, doing 2-3 sets total.
c. Where it should be felt: In the calves! Make sure to get a nice calf squeeze at the top of the motion.
d. How do I know if I’m doing it correctly? If you are feeling it in your calves and feel weight moving through your big toes, you are likely doing it correctly! One common compensation we see is moving too much forward/backwards- you should only be moving straight up towards the ceiling and slowly back down.
e. Modifications – a bit less challenging: if you cannot get all the way up onto your toes, it’s okay to start doing only part of the motion. Just make sure it’s slow and controlled and you can progress towards lifting higher!
f. Modifications – a bit more challenging: While holding onto something stable (such as a countertop of a clean/dry sink), lift one foot up and complete the exercise with the opposite foot that’s on the ground. In other words- do one leg at a time!
2. Single Leg Balance:
a. Why this is beneficial: balance is an extremely critical component of walking. By simply practicing maintaining your balance, you can improve your balance, walking capacity, and reduce your risk for falls!
b.How to do it: Standing next to something stable in a safe area (such as a countertop of a clean/dry sink), lift one foot up and balance on the other foot. Try not to touch anything with your hands!
c. Where it should be felt: You might feel your foot, ankle, calf, hip, or even core working with this exercise!
d.How do I know if I’m doing it correctly? It’s normal to feel a little bit of wobble in the ankle and throughout your body. In fact, that can be good- it’s important to challenge yourself (but make sure to be somewhere safe to hold onto if you need it!). If you are balancing and a little bit wobbly, you are likely doing it correctly.
e. Modifications – a bit less challenging: with one foot up, simply place a fingertip or a few on the countertop to support yourself. Alternatively, you can try ‘tandem stance balance’ by putting one foot directly in front of the other, pictured below. Try holding this for 30 seconds with each foot in front!
f.Modifications – a bit more challenging: with one foot up and not holding on to anything, simulate the motion of walking by tapping very lightly in front of you and then tapping very lightly behind you. There should be little to no pressure in your foot as it moves back and forth.
3. Mini Lunge:
a. Why this is beneficial: this is a great leg strengthening exercise that will help with the shock absorption phase of walking!
b.How to do it: Take a normal step length forward and then drop your weight downwards, towards the floor, creating a small bend in the knee. Most of the weight should be on your front foot. Push off and return to your starting position. Make sure your chest stays up throughout the exercise!
c.Where it should be felt: In the front of your thigh (quadriceps), back of your thigh (hamstrings), and potentially your buttocks area (gluteals).
d.How do I know if I’m doing it correctly? If you are feeling it in the appropriate places, keeping your toes straight, step length average, and chest up, then it should be correct! As you step forward and bend the knee, make sure your knees do not go past your toes or roll inwards.
e. Modifications – a bit more challenging: The more you bend the knee / the lower you go (think about being an elevator going downwards), the harder this exercise becomes!
As we mentioned above, one of the most important health indicators is how fast you walk. As you practice walking, whether it’s in the mall, your neighborhood, in a hallway in your house, or even in the grocery store, try picking up the speed for a short distance (think 10-100 yards). The more you practice fast-paced walking, the easier it will become!
We also often recommend devices to measure your walking, such as a Fitbit. Using a ‘wearable’ device can provide a baseline of how much you typically move and walk throughout the day. We have seen great success in improving overall health by gradually increasing the amount that our patients walk throughout the day!
What to do next:
We would love for you to try each of the exercises, speed walking, and distance walking, and let us know how they go! Feel free to comment here, on Facebook, or let us know directly.
If you have specific questions or would like a consultation, the MovementX Doctors of Physical Therapy are happy to set up discounted one-on-one sessions with the Northern Virginia Family Practice members. If you have any medical concerns or have been experiencing painful symptoms for more than a week, please contact your primary care provider.
As you improve your strength and these exercises get easier, let us know! We would love to hear your successes and how strength and exercise has improved your life.
The Age-Proof Your Body class series
This walking and running class presented on March 4th was part of an ongoing Age-Proof Your Body Exercise Class series, introduced by Northern Virginia Family Practice and MovementX. The series is comprised of 8 classes that cover a variety of topics from strength and mobility to balance and posture. If you would like to attend an upcoming class, please contact NVFP directly at (703) 379-8879.
Dr. Natasha Lewry Beauvais received her B.A. from Yale University and her M.D. and Master of Public Health degrees from the University of Connecticut School of Medicine. She completed her residency in Family Medicine at SUNY Stony Brook and at the Mount Sinai School of Medicine Jamaica Hospital Family Practice Residency in New York City. She emphasizes caring for the whole family and for the whole person and values patient relationships built through long-term continuity of care. An athlete on the crew team in college, Dr. Beauvais used to be strong and fit. Like many of you, she fell away from fitness when life got busy. But like you, she has recommitted to staying strong, and now can be seen at Gold’s gym in South Arlington nearly every morning before waking up the kiddos. During the day, she will be seeing patients at Northern Virginia Family Practice, a personalized medical practice.
Dr. Joshua D’Angelo received his B.S. from the University of Michigan and his DPT from the George Washington University. He is a Board Certified Orthopedic Specialist by the American Board of Physical Therapy Specialties. He is passionate about personalized healthcare, utilizing the movement system to improve quality of life, and the patient-provider relationship. Dr. D’Angelo injured his back when he was 18 years old playing basketball. He didn’t get much relief until he saw his physical therapist, who utilized his hands, hearts, and words to guide Dr. D’Angelo through the healing process. It is now Dr. D’Angelo’s hope to provide the same high-quality care to others in a flexible, convenient, and personalized fashion through MovementX, a mobile physical therapy, and movement health practice. You can reach Dr. D’Angelo via email at firstname.lastname@example.org