On the Right Path
How to identify and care for common walking injuries
Walking is a wonderful means of aerobic exercise. Though it is less efficient than more vigorous forms of exercise, it shares nearly all their benefits. Additionally, walking has a significantly lower injury risk.
That said, no physical activity is completely risk-free. Below are a few common sources of pain many walkers endure and some tips for how to handle them.
Stress Fractures
Stress fractures happen when bones break down as a result of too much stress being placed on them without allowing ample time for recovery. They present as a bruise-like pain, isolated to the bone. These fractures are most commonly seen in the midfoot and worsen with activity. The pain is typically alleviated by rest, but can take weeks to disappear. If you have concerns, take a couple of weeks off walking and consider biking or swimming as an alternative to training. If pain persists, call your sports physician, who would likely start with an X-ray or MRI to confirm.
Plantar Fasciitis
Plantar fascial pain presents as pain under the heel. It is due to tightness in the thick connective tissue on the underside of the foot. Unlike with stress fractures, this pain is worst in the morning and usually improves or loosens up with walking. Anti-inflammatories – ibuprofen and naproxen are available over the counter – are a good place to start, in conjunction with home stretches directed at the posterior of the foot and ankle. Night socks keep the foot in a flexed position overnight, preventing further tightening of the fascia, a thin sheath of fibrous tissue enclosing a muscle or other organ. These socks are also available over the counter. Further evaluation should be sought if pain is not responding to these treatments, or if pain is severe enough to cause a limp for much of the day.
Hip Bursitis
Hip bursitis, or greater trochanter pain syndrome, presents as pain on the outside of the hip. It is often painful to sleep on at night and tender to the touch. Two common risk factors are tightness of the IT (iliotibial) band and weakness of the hip abductors, the muscles that make you able to lift your thighs out to each side. The combination of these two things causes a friction syndrome as the thick connective tissues that travel from your hip to knee (IT band) rub over the bony protuberance of the lateral hip (great trochanter). Think of repeatedly plucking a tight guitar string with your thumb. This irritation often responds in the short term to nonsteroidal anti-inflammatory drugs and sleeping on a softer mattress or pillow top. However, to get a longer-term fix, foam rolling to loosen your ITB and strengthening exercises for the muscles of the hip will need to be done. You’ll require an experienced physical therapist to guide your program. If these solutions fail, a physician can perform an injection over the tender area to provide some relief.
Runner’s Knee
Also known as patellofemoral pain syndrome, runner’s knee presents as pain in the anterior aspect of the knee, typically due to inflammation under the kneecaps. It is often frustrating to patients I see because the pain is hard to put a finger on and can change in character and location. The pain may occur with exercise, but often is at its worst once the body stops to rest. Sitting for a prolonged period or other prolonged positions can aggravate the knee and cause extreme stiffness when walkers return to activity. Over-the-counter anti-inflammatories are again helpful. Bracing or even orthotics can help align your body to lessen the stress transferred to the knee. However, strengthening exercises directed at your quadriceps and hips may be the best way to prevent the pain from returning.
Dr. Michael Jonesco works in sports medicine at The Ohio State University Wexner Medical Center. Feedback welcome at gbishop@cityscenemediagroup.com.
