Walking Injuries

A thoughtfully crafted walking regimen allows you to reap the rewards of walking while minimizing the risk of injury. Even if you adhere closely to the Consumer Guide® Walking Program, you might still encounter minor aches and pains, as your body adjusts to activities it may not have performed in years.

This article offers advice on managing discomfort to ensure that minor physical issues don’t deter you from sticking to your walking routine. You’ll likely notice unique twinges and aches that are unfamiliar to you. Since you know your body best, it’s important to listen to these signals and understand their significance.

Pain serves as your body's method of signaling issues. Often, discomfort arises from incorrect walking posture, unsuitable footwear or socks, overly hard surfaces, or overexertion early on. If the source of your pain is unclear, consult your doctor.

Aerobic exercises have an ironic twist: while the heart and lungs are the primary targets for training, it’s the feet, ankles, and legs—working tirelessly to support these organs—that often bear the brunt of the discomfort.

To minimize pain and prevent injuries, focus on three key areas: maintaining proper foot care, strengthening the muscles in your feet, legs, and core, and enhancing overall body flexibility.

Walking naturally conditions the muscles in your lower body, but you can accelerate this process by incorporating calisthenics, weight training, or other strength-building activities. To ensure flexibility, make stretching a regular part of your walking regimen.

This article provides a concise overview of the various aches and pains walkers might encounter, ranging from foot injuries to chest tightness. (Note: Individuals with diabetes or circulatory issues should seek medical advice before starting a walking program, as they are more susceptible to foot problems, where even minor injuries can have serious consequences.)

First, we’ll explore common foot injuries. For additional details, proceed to the next section.

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Foot Injuries and Walking

Walking can lead to various foot injuries, though most are preventable by adhering to the guidance provided. We’ve organized this information by specific areas of the foot.

The toes. Starting a walking routine in stylish but uncomfortable shoes will quickly make your toes protest. Most toe pain stems from ill-fitting footwear.

Your feet can change in length, width, and shape over time. As you age, the ball of your foot may widen, and your toes may spread. For this reason, always have your feet measured when buying shoes.

The size labeled on a shoe doesn’t guarantee a proper fit, as sizing varies by brand. Choose a shoe design that closely matches the shape of your foot. One helpful method is to trace your feet on paper and compare the outline to the soles of different shoes in the store.

When trying on walking shoes, ensure they fit well in the toe area. Since one foot is typically larger, fit the shoe to the bigger foot. Ideally, leave a half-inch gap between your longest toe and the shoe’s front.

The toe box—the section of the shoe that holds your toes—should be sufficiently high, long, and wide to provide comfort and accommodate your toes without restriction.

Corns. Corns are small, circular patches of hardened skin caused by friction. Hard corns, the most frequent type, are dry and typically form on the outer edge of the smallest toe or on the tops of other toes; soft corns are damp and usually develop between the toes.

To alleviate corns, consider wearing shoes with softer uppers and more spacious toe boxes. Cushioned pads or insoles can also help by redistributing pressure away from the affected area. If these measures don’t work, consult a podiatrist. Never try to remove a corn on your own.

Ingrown toenails. Few issues are more frustrating for walkers than ingrown toenails. These occur when the edges of the toenail, usually on the big toe, curve into the surrounding skin, leading to pain, redness, swelling, and potential infection.

Preventing ingrown toenails involves keeping your toenails properly trimmed. Avoid rounding the edges or cutting them too short at the corners. Instead, cut the nails straight across using a nail clipper.

Tight toe boxes can worsen ingrown toenails, so switching to shoes with a wider toe area may reduce discomfort. Soaking the affected toe in warm, soapy water can also offer temporary relief. If the area becomes severely swollen or painful, seek advice from a podiatrist.

Bunions. A bunion is a deformity where the big toe joint protrudes outward while the toe itself angles inward toward the other toes. While genetics can play a role, wearing narrow, high-heeled, or tight shoes can worsen the condition. As inflammation increases, the bunion enlarges, becoming more swollen, tender, and painful.

A podiatrist might start treatment by recommending wider shoes and prescribing a custom orthotic device. This insert is designed to address the foot's structural irregularity and redistribute pressure away from the affected area.

For severe, painful bunions that hinder walking, surgery is often the only solution. The procedure involves realigning the toe joint and sometimes removing excess bone.

Hammertoes. Hammertoe is a condition where one or more toes curl downward like a claw. While hereditary factors can contribute, high heels or tight shoes are common culprits. In severe cases, a doctor may recommend an orthotic to reposition the toe or suggest corrective surgery.

The next section covers additional foot injuries related to walking, their causes, and tips for prevention.

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More Walking Foot Injuries

Walkers don’t have to suffer from foot issues. Proper foot care and well-fitted shoes can prevent many of these injuries.

Neuromas. A neuroma is a painful, inflamed bundle of nerves, often found between the third and fourth toes. Tight shoes are a common aggravating factor for this condition.

Neuromas can lead to sharp pain or numbness. Soaking your feet in warm water may ease the discomfort. A doctor might recommend an arch support or a specialized pad to separate the toes and relieve nerve pressure. In some cases, surgery to remove the neuroma may be necessary.

Metatarsal stress fractures. The metatarsals, the long bones connecting to your toes, can develop tiny fractures from walking stress. These fractures are often too small to appear on an X-ray and typically heal on their own without splints or casts. However, healing can take a month or more, requiring a pause in your walking routine.

Blisters. Blisters, small fluid-filled pockets, are a common issue for walkers. While they can occur regardless of footwear or precautions, they become problematic when they interfere with walking or become infected.

Blisters result from friction. Preventing friction is the best way to avoid them. Here are some tips:

If a blister forms, keep the area clean to prevent infection. Avoid puncturing it; let it drain naturally over time. If it bursts, leave the skin intact as it acts as a protective layer. Clean gently with soap and water, then cover it with a gauze pad.

Resting your foot will help it heal. Seek medical advice if you notice signs of infection, such as redness or pus. Those with diabetes or circulatory issues should consult a doctor immediately for any blister, no matter how minor, and avoid self-treatment.

Calluses. A callus is a thickened area of skin caused by pressure or friction. While some callus formation is normal and protective, excessive or hardened calluses can be painful. Switching to shoes with softer uppers and more spacious toe boxes can help alleviate discomfort.

Cushioned pads, insoles, or orthotics can provide relief. A podiatrist can also scrape away thick calluses for significant pain reduction. Never attempt to cut calluses yourself.

Walker's heel. This term refers to a range of heel issues, including bone bruises and heel spurs. It often begins with pain at the heel's base, known as plantar fasciitis, where the tissues connecting to the heel bone become inflamed.

Bone spurs are painful bony protrusions that develop on the bone. Walking on hard surfaces, stepping on sharp objects, or wearing poorly designed or worn-out shoes can aggravate these conditions. Unfortunately, there’s no quick fix. Rest can help, but it’s not always practical for those aiming to maintain their aerobic fitness.

A heel "donut" is a common treatment for heel issues. It’s a foam pad with a hole cut out, placed over the bone spur so the sensitive area is exposed through the hole.

Other treatments include using an athletic bandage to strap the foot or switching to shoes with a cushioned rubber sole and a slightly raised heel. (This design helps transfer walking pressure from the heel to the ball of the foot.) Soaking your feet in warm water can also ease pain. If these methods don’t work, consult a physician or podiatrist.

It’s no surprise that walking can lead to leg injuries. Next, we’ll explore common leg injuries and ways to prevent them.

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Leg Injuries and Walking

Walking is an excellent way to build leg strength, but improper technique can lead to injuries. Below, we outline common leg injuries, their causes, and tips for self-treatment.

Achilles tendon injuries. The Achilles tendon, a thick band at the back of the leg, links the heel and foot to the calf muscles. It plays a crucial role in controlling ankle movement.

Sports medicine experts categorize Achilles tendon issues into three types. The first is tendinitis, an inflammation of the tendon. The second is a partial tear, where some tendon fibers are damaged. The third is a complete rupture, a full break of the tendon. Walkers rarely experience the latter two, as walking typically doesn’t exert enough force to cause such tears.

Tendinitis can result from sudden changes in activity, like abruptly walking on steep inclines after being used to flat surfaces or taking on long hikes without gradually building up from shorter ones. Symptoms include pain, stiffness an hour after activity, tenderness, and mild swelling. Walking becomes challenging and painful with tendinitis.

Ill-fitting shoes can also inflame tendons. Issues include heels that are too low or hard, tight backs that irritate the tendon, or insufficient arch support.

Charles Gudas, D.P.M., a professor of orthopedic surgery at the University of Chicago Medical Center, suggests selecting walking shoes with slightly higher heels or adding sponge pads to the heel area to alleviate Achilles tendinitis and heel spur pain.

Walking can tighten tendons further. To avoid Achilles tendinitis, incorporate thorough stretching during warm-ups and cool-downs. Stretching exercises can loosen calf muscles and offset the tightening effects of walking.

Recommended stretches include standing on your heels and lifting your toes as high as possible or standing on a step with your toes and lowering your heels. Walking barefoot indoors, where sharp objects aren’t a concern, is also beneficial.

Self-care for tendinitis follows the RICE method: rest, ice, compression, and elevation. If pain occurs, stop the activity and rest. Apply an ice pack (wrapped in a thin towel) or a cold compress to the area. Wrap it with a flexible bandage (not too tight), and elevate your leg while sitting or lying down. Remember, pain is your body’s way of signaling an issue—don’t ignore it.

Proceed to the next section for details on shin splints and knee-related issues.

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More Walking Leg Injuries

Here are additional leg injuries that walkers should be aware of.

Shinsplints. Shinsplints cause pain in the front of the leg, below the knee, when weight is placed on the foot. The shin may also feel tender to the touch, and you might notice a rough area along the bone when running your fingers over it.

Despite the name, shinsplints can stem from various issues, such as muscle imbalances, poor walking mechanics, hairline fractures in the lower leg bones, muscle spasms due to swelling, inflamed or torn tendons, or irritation of the membrane between the lower leg bones.

Preventing shinsplints involves careful selection of footwear and walking surfaces. Opt for sturdy shoes with cushioned soles and, if possible, walk on softer surfaces like grass instead of pavement. Adding a sponge heel pad to your shoes can also help reduce stress from hard surfaces.

If you walk on a track or slanted road, alternate your walking direction. For example, switch between clockwise and counterclockwise routes to avoid consistently stressing the same leg.

Walking significantly strengthens the muscles at the back of the leg but does little for the front muscles. This can lead to a muscle imbalance. To address this, focus on strengthening the front leg muscles. One effective method is flexing your foot up and down while wearing ankle weights.

If you don’t have ankle weights, sit with your legs hanging and feet off the ground. Have a friend hold your feet while you attempt to lift your toes. Repeat this exercise in three sets of ten daily.

The knee. The knee joint connects the thighbone and shinbone. Knee pain often involves the kneecap—either beneath it or along its sides. Sometimes, the kneecap doesn’t glide smoothly against the thighbone, leading to irritation and swelling during walking.

If you experience this issue, you may need to reduce your walking. First, try adjusting your walking technique. Many doctors believe knee problems stem from how your foot strikes the ground. (For example, walking in one direction on a banked indoor track for long distances, like 20 to 25 laps, can strain your knees. Even slight slopes can cause issues.)

Many walkers and runners develop runner’s knee, a painful condition where the kneecap shifts side to side with each step. This often occurs when the foot rolls inward during walking or running, causing the lower leg to rotate inward and the kneecap to move inward. Repeated stress from this motion can harm the knee.

Treatment often involves using orthotics in your shoes. Additionally, walkers should perform leg exercises to strengthen and stretch the muscles at the front of the thighs.

Proper stretching is crucial to avoid muscle injuries. The next section delves into muscle-related issues, including spasms and cramps.

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Walking and Muscle Pain

Walking can lead to or worsen muscle pain, often due to overstretching, poor conditioning, or other factors. Fortunately, there are ways to alleviate discomfort and prevent injuries.

Muscle cramps and spasms. A muscle cramp is a sudden, intense, and involuntary contraction of a muscle, which can occur during activity or at rest. These cramps often strike without warning.

Muscle cramps can result from fatigue, cold temperatures, imbalances in salt, potassium, or water levels, poor circulation, sudden impacts, or overstretching unconditioned muscles. To reduce the risk, maintain a balanced diet, stay hydrated, warm up properly before exercise, and avoid overexertion.

If a cramp occurs, gently stretch the affected muscle to relieve it. For example, to ease a calf cramp, pull your toes and the ball of your foot toward your kneecap. Firmly massaging the muscle can also help.

After a cramp, you may feel tightness or dull pain. Applying heat or massaging the area can ease this discomfort. If cramps are frequent, consult a doctor.

Sprains. While cramps and spasms involve painful muscle contractions, a sprain is the partial or complete tearing of a muscle, tendon, or ligament due to overstretching. This causes small blood vessels to rupture, leading to pain as the surrounding tissue swells and irritates nerve endings.

To avoid ankle sprains, stay alert to your surroundings. Navigate carefully around potholes and debris. If you sprain your ankle, pause your walking routine until it heals completely.

The RICE method (rest, ice, compression, and elevation) can reduce swelling. If symptoms persist after using RICE, or if you’re unsure whether it’s a strain, sprain, or fracture, consult a doctor.

Muscle soreness and stiffness. Even experienced walkers often experience some soreness and stiffness. Known as Delayed Onset Muscle Soreness (DOMS), this pain typically appears 24 to 48 hours after activity and usually subsides within a few days.

For walkers, the calf and thigh muscles are most commonly affected. DOMS may result from minor muscle tears and subsequent inflammation. Anti-inflammatory medications like aspirin or ibuprofen, or applying ice to the area, can help alleviate the discomfort.

It’s nearly impossible to entirely avoid muscle soreness and stiffness. However, you can lessen the discomfort by gradually progressing in your walking program, especially in the initial stages.

A slow, steady approach helps your muscles adapt to the stress placed on them. If you experience soreness or stiffness, engage in light exercises. Cooling down after each workout and massaging the affected areas can also provide relief.

Back pain is another issue walkers may encounter. Learn more about walking and back injuries in the next section.

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Walking and Back Pain

Back pain can severely disrupt your walking routine. Below are common causes of back pain and injuries, along with tips to help you maintain a backache-free walking workout.

Back pains. Lower-back pain may indicate a slipped or damaged spinal disc. Some pains arise from exercising after long periods of inactivity. Assess the severity based on the intensity and impact on your mobility. If uncertain, consult a doctor.

While couches and recliners may feel comfortable, few are designed to support back health. Poor posture, like slouching, can strain muscles, ligaments, and discs, worsening back pain and delaying recovery. Opt for furniture and positions that align your neck and spine and support your back’s natural curves.

Many backaches stem from overly soft mattresses. Placing plywood under a soft mattress usually doesn’t help, as it doesn’t provide adequate spinal support. Instead, consider investing in an orthopedically designed box spring and mattress.

Frequently, back pain stems from poor fitness, particularly weak abdominal muscles. The pelvis, which transfers the upper body’s weight to the lower limbs, is balanced on the thighbones and supported by muscles like the abdominals, hamstrings, gluteals, and hip flexors. Weakness or imbalance in these muscles can misalign the pelvis, causing it to tilt forward or backward.

Weak abdominal muscles can cause the pelvis to drop and tilt forward, leading to lordosis, or swayback.

In addition to weak abdominals, insufficient strength in the gluteals and hamstrings can also cause forward pelvic tilt. While the abdominals stabilize the pelvis by pulling upward at the front, the gluteals and hamstrings provide stability by pulling downward at the back.

Strengthening exercises for the abdominals and gluteals are essential. Walking effectively works the gluteals, but the abdominals require additional conditioning through weight training or calisthenics.

If you have back issues or experience pain while walking, consult your doctor before starting or continuing a walking program.

Side stitch. Side stitch, also known as a pain in the side, stitch in the side, or side ache, can be alarming due to its proximity to the chest. There are two primary causes.

The first is improper breathing, which leads to diaphragm spasms. To alleviate this, try "belly breathing": push your abdomen out when inhaling and pull it in when exhaling, reversing your usual breathing pattern.

The second, more common cause is the stretching of ligaments connected to the liver, pancreas, stomach, and intestines. Vigorous walking stresses these ligaments, causing them to stretch and resulting in pain.

To ease side stitch discomfort, grip your side and apply pressure. Avoid heavy meals within three hours before walking. If a stitch occurs, bend forward, take deep breaths, and push your belly out. If the pain is severe or its source unclear, consult a doctor.

Next, learn about various types of chest pain walkers may experience, ranging from heartburn to more serious conditions.

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Walking and Chest Pain

Chest pain during walking can be concerning, especially for middle-aged individuals, as the risk of heart disease increases. However, such pain may not always be related to the heart.

Frequent warnings about heart disease can make even minor chest discomfort alarming, evoking fears of serious health issues. While chest pain can stem from cardiovascular disease, it’s often caused by less severe conditions like heartburn or muscle strain.

In this section, we’ll explore some potential causes of chest pain. (However, any chest pain or discomfort, no matter how minor, should be discussed with your doctor.)

Muscular causes: Chest pain or discomfort can result from muscle spasms. A strained pectoral (chest muscle) or intercostal (muscle between the ribs) can cause significant pain. A pulled muscle typically causes surface-level pain, and movements like swinging the arm across the chest can trigger or worsen it.

Bruised muscles or ligaments may cause pain during deep breaths. Pressure from a hand, mattress button, or even a wrinkled sheet during sleep can aggravate these injuries. Pain from such conditions usually occurs during specific movements or when pressure is applied. Rest and time are typically the best remedies, but consult your doctor for confirmation.

Heartburn: Pain from indigestion, or heartburn, is often mistaken for heart-related pain. However, it’s unrelated to the heart. Stomach acid flowing back into the esophagus causes contractions of its circular muscle. While milk or antacids may offer temporary relief, a simple, balanced diet is the best preventive measure.

Angina pectoris: This type of chest pain or discomfort can occur at rest but often develops during exercise or after a heavy meal. It results from a temporary failure of the coronary arteries to supply enough oxygenated blood to the heart muscle, usually due to blockages in coronary circulation.

Angina is typically not sharp pain but rather a sensation of heaviness, as if the chest is being squeezed or crushed. The discomfort often radiates to the left shoulder, arm, or hand, where it may feel like numbness. It can also be felt in the neck, jaw, and teeth. Pain or discomfort may occur minutes, days, weeks, months, or even years apart.

Angina is a warning signal. Your heart is indicating it’s not receiving enough blood and oxygen. If you experience any pain or discomfort resembling angina, inform your doctor immediately. Be specific about the location and timing of the discomfort to help your doctor better understand your condition.

Other heart-related pains or discomforts vary but are similar to angina. They may be sharp, mild, or numbing. If you experience any of these, especially a heavy chest sensation or pain radiating to the neck or arm, contact your doctor immediately.

Symptoms signaling a heart attack include extreme heaviness in the chest, as if an elephant is sitting there; extreme tightness, like a clenched fist in the chest; or a feeling of stuffiness (similar to indigestion) high in the stomach or low in the throat. If you experience any of these symptoms, seek emergency medical care.

Even if you’ve passed a stress electrocardiogram before starting a walking program, don’t become overconfident. While such tests are helpful, they’re not 100% reliable. Ultimately, your body provides the most accurate warning signs, so pay attention to it.

If you’re committed to walking, use the insights in this article to understand the causes of common injuries and take preventive measures. Staying injury-free is essential for maintaining a consistent walking routine.

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ADDITIONAL CREDITS:

Peggy Norwood Keating, MA, Contributing consultant Rebecca Hughes, Contributing writer