Treating Common Walking Injuries
By Kathy Shillue
Physical Therapist at Beth Israel Deaconess Medical Center
Walking is one of the gentlest and safest forms of physical activity, but injuries do happen. Here's what to do if you suffer from one of these common walking injuries.
This occurs when you
'turn' or twist your ankle and often happens when you are walking or running on uneven ground, or going down stairs. It is actually an
injury to one of the ligaments in the ankle--the most commonly injured is a ligament on the outside of the ankle, just under and in front of the ankle bone.
The injury can range from a mild over-stretching or slight tearing of some fibers of the ligament to a more severe, complete tear of the ligament. You may have
pain, tenderness, swelling and bruising. If you cannot move the ankle, cannot put weight on it or take even a few steps, or have point tenderness to the bony areas (not the soft tissue) you should see your doctor right away to make sure it isn't a more serious injury.
Treatment for mild sprains is
RICE: Rest, Ice, Compression, and Elevation for
48 to 72 hours.
Rest means your should stop your exercise and try to avoid any painful activities for a few days and even consider using a cane or crutches to take some weight off it.
Ice the painful or swollen area for about 20 minutes at a time several times per day.
Compression can help keep the swelling down and can be done with an ace bandage wrapped (not too tightly) around the ankle and foot.
Elevation is done by lifting the foot above the level of your heart. You don't have to keep it elevated all day, but the more it stays elevated, the less swelling will accumulate.
It is often easiest to combine the ice with the elevation, and do them at the same time. Once the swelling begins to resolve (at about 48 to 72 hours), you can start to do some gentle exercises to regain full motion. Then the exercises progress to strengthening and balance training on that foot and a gradual return to sports.
This is an injury
caused by repetitive trauma. The symptoms are
pain and tenderness of the lower leg, often described as an ache.
It is caused by
overuse of the muscles on the front compartment of the leg or medial leg. These are the muscles that control your foot and ankle, so they can get stressed with walking especially if you try to do much at one time, or walk on uneven surfaces that cause your ankle to do a lot of rolling back and forth.
The treatment is
rest, or a reduction in exercise to reduce the stress to those muscles. Ice can also be helpful in reducing pain. Since the injury is caused by repetitive trauma or overuse, the treatment also involves a
gradual return to full exercise with an emphasis on reducing the stress to the leg. That means that you should not skip your
warm up, and remember to
wear good supportive shoes, and progress your walking gradually. You might have to
avoiding walking on hard pavement initially and find a track or grassy surface to walk on, or use a
cushioned inset to the shoe.
When to Seek Further Medical Evaluation
If the pain does not resolve, you may have more than simple shin splints. Similar pain can be caused by a stress fracture of the tibia or leg bone, or a compartment syndrome. A compartment syndrome is caused when repeated trauma to the muscles causes swelling and increased pressure inside the compartment or fascia band that contains the leg muscles. If you have long-standing or chronic symptoms of leg pain, you should seek further medical evaluation.
Any new exercise program is likely to cause some muscle soreness. Muscle soreness is caused mainly by eccentric exercise, which occurs when the muscle is lengthening while it is working, like the muscle on the front of your thigh when you are walking down hill or down stairs. (Conversely, concentric exercise is a shortening contraction, like your thigh muscle does when you walk up stairs). Most exercise involves both concentric and eccentric work so you really can't avoid it, especially if you are walking because one set of muscles will be lengthening while the opposite set with be shortening.
The heavier the workout, the more soreness you are likely to have. You can prevent too much soreness by
starting slow and progressing gradually. That means that if you increase the speed of your walking, don't also increase the distance, and vice versa. Also, be aware that walking up OR down hills is harder than flat surfaces and you may need to slow down when you encounter them.
The soreness is the worst in the first couple of days afterwards and
resolves in about a week. Heat or cold can help ease some of the soreness: use a
hot pack, heat wraps, ice packs or cold or hot water whirlpools for 15 to 20 minutes at a time. Soreness like this can make you not want to continue walking, but you shouldn't let it sideline you completely: as soon as your muscles become accustomed to walking regularly, they won't become sore. You can
adjust to a slower pace, however, to make your muscles work less.
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted March 2010