Father and son hiking

Walking for Exercise

Precautions for different surfaces
Author: Matt McMillen

Walking is one of the simplest and safest exercises. It’s recommended for almost everyone, including people with bleeding disorders. You can do it alone, with family or friends, or with your favorite canine companion. Stick with walking and you will improve your overall fitness, lower your blood pressure and bad cholesterol, and build strength and stamina. It can also help you obtain or maintain a healthy weight.

“Walking is low-impact. Depending on how brisk your pace is, it can be an excellent cardiovascular workout,” says Cindy Bailey, PT, DPT, OCS, SCS, director of the physical therapy program at the Hemophilia Treatment Center at Orthopaedic Hospital of Los Angeles. “Just be sure to walk on a level surface when you first start walking as a workout.”

To get started, all you need is a good pair of walking or running shoes and a surface to walk on. But be careful with uneven surfaces, poorly maintained paths and rocky trails, especially if you have target joints in your lower body, such as your knees and ankles. Still, if you take some precautionary steps, you can reduce your risk of bleeds and injury, and walk with confidence.

Bailey tells her patients to spend the first four to six weeks of their walking regimen on the same surface, whether it’s a packed dirt trail, a soft track or a cement sidewalk. “Each surface has a different rebound. If you don’t use the same surface during those early weeks when your legs are getting used to the effort, you risk ­getting shin splints or tendinitis in your lower limbs,” she says. “Shin splints are common for anyone ­starting a walking program of any type on any surface.”

Here are a few things to keep in mind when deciding where to walk:

Outdoor Tracks. If you have access to a school track, you’ll likely find the surface somewhat soft and rubbery, a good combination for walking. But stick to the outside lanes, Bailey advises. Runners pound the inside lanes, wearing them out and making them harder on the feet and ankles. Also, avoid cinder tracks. “They’re uneven and unstable,” she says. If the track has no rules against it, Bailey also suggests that you switch direction each time you circle the track to balance the additional strain that comes as you round the banked curves.

Hiking Trails. As long as they are well-groomed, dirt trails in parks are a good choice. “Unless they are ­pebbly or rocky, they’re totally fine,” says Bailey.

Mountain Trails. “Mountain trails offer the most difficult level of walking,” says Heidi Lane, PT, DPT, PCS, a physical therapist at Intermountain Hemophilia and Thrombosis Center in Salt Lake City. Until you’ve been walking for at least six weeks, steer clear of mountain hikes, cautions Bailey. They can be steep, uneven, with loose rocks and other natural debris.

Treadmills. Treadmills are the easiest on the body because their walking surface, or deck, is firm, but with some give. Lane advises her patients to be careful as they get on and off a treadmill. The moving surface can be tricky until you get used to it. She also suggests altering the degree of incline during the workout to help prevent shin splints.

Sidewalks. Overall, sidewalks are a good option. Watch out for tree roots and other hazards that can crack the concrete and spoil a walk. “Use caution when stepping off a curb,” says Lane.

Grass. A nice soft surface, grass can be deceptively dangerous and is especially hazardous when wet, says Lane. “You may not be able to see it, but grass can hide uneven ground.”

Committed to Fitness

Women exercisingMatthew Barkdull, 38, sticks to sidewalks for his brisk daily walks in Salt Lake City, where he’s a licensed mental health counselor. “I speed walk five or six blocks to work from the commuter train each morning and then back again after work,” Barkdull says. He has severe hemophilia A and troublesome ankle joints.

Barkdull belonged to a gym, but the treadmill eventually lost its appeal. “I decided to save some money and walk outside.”

Rick Waines of Vancouver, British Columbia, who has severe hemophilia A, also enjoys walking. But he has to be careful on his neighborhood’s uneven surfaces. “That means extra grinding for my ankle joints, which can no longer tolerate such abuse,” says Waines, 46, an audio interpreter for visually impaired theatergoers. “I walk 15 to 30 minutes a day and have to go slower than I used to.”

Proceed with Caution

Check in with your physical therapist before you start a walking program to set realistic goals and determine the best and safest ways to reach them. Both Bailey and Lane recommend patients start off slowly with walks of 10 to 15 minutes every other day. Gradually increase the time you walk as your body adapts to the effort.

With a little planning and some precautions, you can walk your way to better mental and physical health.