Question:

Dr. Bryan,

Everybody seems to have a theory, I've have just purchased a treadmill because I really want to get my body back to into shape.  Obviously walking is good for overall general health. What I would like you to clarify, will walking help me define muscle tone in my legs because I've been told over and over that it won't do anything to tone my  leg muscles  or my buttocks, and I find that very hard to believe. If you could you answer this question I'd really appreciate it.

Maria

Answer:

Maria,

A treadmill will definitely tone your legs and all the muscles you use for non-treadmill walking. There are some differences in that occur with gait patterning with a treadmill because the ground moves underneath you and you walk to keep up. If you are conditioning for an event you will want to train for the exact conditions of the event such as hills, flat and combination of both. The treadmill is great for indoors cardiovascular health, I usually recommend using them at the same heart rate and duration that you would experience outside. Don't go by displayed miles per hour, it should be easier on the treadmill to go the same speed as you would outside. That's the key to getting muscle tone that is controversial. I hope you get the results you are after, please feel free to contact me if you have any other question.

Cheers to your health,

Dr. Bryan

Question:

Dr. Bryan,

I feel pain on the inside of my calves about half way between knees and ankles when I walk, especially first thing in the morning. When I walk fast for exercise, I can usually get the pain to a reasonable level by mile 2, and then it comes back the day and the next day. A friend said I have shin splints. Do I have this? If so, what can I do about it? I really want to increase my training mileage for the relay.

Joanne

Answer:

Joanne,

This is a common tissue response when conditioning, your description does sound you are experiencing ‘shin splints’ it is inflamed connective tissue in the calf region usually next to the tibia bone. It is a good sign that exercise makes it feel better, it means by increasing circulation and mechanical action the painful tissue becomes normalized. After exercise stretch and ice the areas that were painful initially. Make sure your shoes are correct for supporting your feet, over-the-counter inserts can be helpful if your feet arches are high or low. Massage work is great for shin splints, it won’t feel good at the time, but help restore proper circulation sooner. Please let me know if I can be of further help.

Cheers,

Dr. Bryan

Question:

Dr. Bryan

Help, I’m swelling up. When I’m walking my hands swell to the point I have to put them on top of my head to keep going, sometimes I just stop. My legs also swell but not as badly. Is this normal? Can I prevent this? Thanks for any advice.

Mary Lou

Swelling is common for long distance walkers and usually worse in hot weather. Limb swinging and gravity forces cause fluid to escape the bloodstream making the limbs swell. The forearms and hands swell more than legs because leg muscles are contracting which pumps the fluid back up toward the heart. To decrease arm swelling keep elbows bent in a position similar to that of running when you walk and have occasional intervals of lifting hands over shoulders. When finished put swollen part above heart level to drain faster. Good luck with your training.

Cheers,

Dr. Bryan

Question:

Dr. B,

I want to be on a Walk The Valley Relay team with my co-workers but have concerns about possible injury and slowing them down. I have sprained my ankles a number of times over the years (now 55) and want to know if there is anything I can do to prevent twisting an ankle during training and the event? Thanks for any advice.

W. Davies

Dear W. Davies,

If you have a known unstable ankle and it has been that way for a while, it is best to work one on one with a sport injury professional to rehabilitate it completely to ensure success with the relay. Joints that are unstable for a long time modify pain signaling and pain is not a good indicator for the actual faulty joint biomechanics. In simple terms, it will be worse than it feels. Accurate assessment and home care exercises are the first step to stabilize it. Library and bookstores have ‘do it yourself’ rehab books, which can be helpful but don’t offer the trained observation perspective a professional can. Please let me know how you do.

Cheers,

Dr. Bryan

Question:

Dear Dr. Bryan,

I have been trying to get a walking program off the ground, but for approximately one year have been suffering from plantar fasciitis in my left heel.  It is sometime extremely painful and I cannot go barefoot at all.  I wear special arch supports in all my shoes.  This has been slowly improving but extended time on my feet tend to aggravate the ache and pain with weightbearing.  In addition, I get low back spasms when I walk.  I know this is exascerabated due to excess weight I am carrying, however, this happened to me even when I was not.  Are there specific exercises that can help me get back to a point where I am able to walk for exercise and health? Thank you for any guidance you may be able to give me.

C Valloud

Answer:

Catana,

Thank you for your inquiry about plantarfascitis, it can be mildly annoying to crippling depending on the severity. In your case it is good that it is only on one side and slowly improving. Single sided plantarfascitis is usually from a mechanical cause such as high arch foot, increased body weight and not the right shoe for your foot type. When it is in both feet there is usually an added circulatory and metabolic component.

The spasms in the back are most likely increased from your backs attempt to stay light on your left foot as you walk. This is called an ‘antalgic gait,' which means you hurt and walk differently to protect and minimize the pain signal. It's a catch-22, the foot fells better as you walk but the back will hurt, which will promote the foot hurting. The good news is when you fix the foot the back pain should some reduce as well.

Here is what I would recommend for you: Keep protecting your feet as much as possible with thick sock or slippers around you house. I usually recommend an over-the-counter arch support (Bio-Soft or Superfeet) in the shoes they will fit into and blue-gel heel pads in the shoes that won't allow the full length inserts. It looks like you have that part covered already.

Use non-weight bearing forms of exercise (cycle, pool) to keep going on your conditioning and stretch for muscle balance afterwards. Non-aggravating exercise is very important to step up circulation, increase overall sense of well being and help in weight loss.

Specifically for the foot; in the morning spell A-Z using you big toes as if they were a pen before getting out of bed. In the morning and evening perform ‘Around the world' exercises (see below) one set on each leg. In the afternoon or evening golf ball trigger point release (see below) your foot.

These are the best things to do for plantarfascitis, they need to be done consistently to obtain and keep the results. If your back pain maintains or gets worse it would be a good idea to have it checked out and rule out a difference in leg length. Please let me know if I can be of further help.

Cheers,

Dr. Bryan

Around the Worlds: Stand with feet shoulder width apart hands on hips. Keeping both legs straight balance on the right leg moving the left forward away from the right to 45 degrees for 15 seconds. Keep the right foot/ankle completely still throughout the set. Next move the left leg behind to 45 degrees for 15 seconds. Next move the left leg to the side 45 degrees for 15 seconds. Next move the left leg in front and across the right as much as possible toward 45 degrees for 15 seconds. Next move the right leg behind and across the right as much as possible toward 45 degrees for 15 seconds. Switch legs and repeat the same movements standing on the left leg.

Golf Ball Trigger Point: In a seated position place a golf ball under your right foot, bare or with sock on. Very gently move your right foot over the ball identifying a point of significant muscle and fascia pain. Stabilize the golf ball with your left foot and slowly apply downward pressure on to the golf ball to 80% of your maximum comfort level without moving over the golf ball. After the pain reduces and tissue elongates (approximately 20 seconds) slowly apply more pressure up to the 80% of maximum level again. After the pain reduces repeat the application of pressure to 80% again. After 1 minute release all pressure and gently roll over the ball to find another Trigger Point and repeat the 3 step pressure sequence. In general, trigger 3 to 5 points on each foot for 1 minute 1 to 2 times per day. It is important not to roll on the golf ball with high force as this will cause inflammation and promote plantarfascitis. GBTP provides gentle stretching of the painful tissue allowing more normalized circulation