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Counting Steps for Exercise? Here’s Some Expert Advice




The Insider:

Hi Andrea! Welcome back to The Insider.

Andrea Kwok:

Hi Andrea, thank you! Happy to be back.

The Insider:

I thought today we might talk about how the non-marathon crowd can safely walk for exercise and not overdo it.

Andrea Kwok:

Sure! I’ve noticed that during the pandemic, there has been an increase in walking-related aches and pains, so this is a great topic.

The Insider:

So you see this among your patients?

Andrea Kwok:

Yes. During the initial lockdown, I think many people were looking for ways to stay active. Gyms were closed, and New York City apartments are not particularly spacious or conducive to physical activities. The most accessible solution seemed to be getting outside and taking long walks.

For most, this was a great addition to their routine and not problematic. But for some who had previously been fairly sedentary, the rapid increase in activity level caused various joint and muscle pains.

The Insider:

Many people are now keeping track of how far they walk on devices like iPhones, and trying to up their numbers all the time. Good strategy?

Andrea Kwok:

When done correctly, yes! Having a daily step goal is a great way to motivate yourself to maintain a healthy level of activity. However, it’s important to set goals that are right for each individual. And if you are trying to increase your activity, tracking steps, heart rate, etc. on a device is a good way to make sure you are progressing safely and appropriately.

The Insider:

Any advice about which devices are best and most accurate?

Andrea Kwok:

There are so many options now, and in my experience all fairly accurate. At least accurate enough for general use. The wearable devices are likely more accurate than the trackers on handheld devices like smartphones.

The Insider:

What would be an example of wearable devices?

Andrea Kwok:

Most commonly I see the wrist devices. They look like digital watches or plastic bracelets. Again, there are many brands that all offer slightly different features. They typically involve a subscription to a service which continuously tracks your movement and other health indicators.

The Insider:

Is heart monitoring something that the average exercise walker should be doing?

Andrea Kwok:

It’s not imperative, and not particularly helpful unless you know what you’re looking for. Anyone with a cardiac history may have been given guidelines from their doctor, in which case that feature would be useful. If a trainer or another professional has given you target heart rate ranges for exercise, it would be useful in that case as well.

The Insider:

Do you have advice about setting reasonable goals for counting steps?

Andrea Kwok:

It seems like 10,000 steps is a widely used target. That equates to roughly 5 miles. Over the course of the day for healthy and moderately active individuals, this is appropriate.

If you’re not especially active and you’ve just started using a step-counting device, I’d recommend wearing it for a few days and going through your normal routine to see what your current step count is. I wouldn’t add much more than 2,000 steps (or one mile) per day, just to avoid overdoing it.

The Insider:

Is it important to spread that out over the day, or do you suggest long-distance walks?

Andrea Kwok:

Either is fine, depending on your goals and your current fitness level.

The Insider:

Being a physical therapist, I’m sure you see the people who have overdone it!

Andrea Kwok:

I certainly have.

The Insider:

What kind of injuries do they typically have?

Andrea Kwok:

Either joint pain or some form of soft tissue injury like tendinitis or muscle strain. Hips, knees, or feet are common sites for pain, as you might expect. However, low back pain after prolonged walking is also common.

The Insider:

Do you find that related to what kind of shoes people are wearing? Are there common mistakes?

Andrea Kwok:

Yes, footwear is definitely important if you are doing a lot of walking. Shoes should fit well: not too tight or too loose. They should be supportive near the arch of the foot, not totally flat. They should also have some cushioning for shock absorption.

The Insider:

Are there things that a walker can do at home to make sure they don’t end up being a PT patient? Not trying to take business away from you, I swear!

Andrea Kwok:

(Laughs.) Yes. It is a little challenging to generalize a preventative program for everyone, as fitness level, health complications, and goals vary. I think the most important thing to consider is the gradual buildup of your walking program. However, a combination of stretching and light strengthening activities would be additionally helpful in avoiding injury.

The Insider:

Can you please advise Insider readers about specific stretching and strengthening exercises?

Andrea Kwok:

Sure. I will give one stretch, one hip strength exercise, and one abdominal strength exercise. Abdominal or core strength is more important with repetitive activity than most people realize.

Please keep in mind that these exercises are appropriate for most, but not all. If you have any injury or condition that prevents safe performance of these movements, or if you have pain as you attempt these exercises, discontinue and consult a medical professional before proceeding.


 

Three Exercises for Walkers

Demonstrated by Physical Therapist Andrea Kwok

Exercise #1: Calf Stretch

Stand with one foot ahead of the other facing a wall, hands on the wall for balance. Keep your back heel down and bend your front knee, leaning toward the wall until you feel a stretch in your back calf. Hold 30 seconds and repeat 3 times on each side.


Exercise #2: Hip Strength

Stand at a wall with your feet together, hands on the wall for balance (you can also use a countertop). Position 1: Bend one knee, keeping your thigh in line with the opposite leg. Position 2: Lift your bent leg out to the side about 45 degrees. Return to position 1 and repeat 10 times on each side. Perform 2-3 sets of 10.


Exercise #3: Abdominal Bracing

Lie flat on your back on the floor or in a bed. Bend one knee up so your hip and knee are bent 90 degrees. Press both hands gently against your upright thigh, resisting by tensing your abdominal muscles. Hold 10 seconds, then release. Repeat 10 times on each side.


 

The Insider:

I wonder if your advice for exercise runners would be the same, or whether there are particular cautions and techniques for runners.

Andrea Kwok:

Running is a higher impact activity than walking, and body mechanics will change slightly. However, the repetitive aspect is the same. The basic concepts and considerations would be the same: importance of proper footwear, importance of appropriate training schedule, and balance of strengthening and stretching exercise as an adjunct. However, the exercises I would give a runner are more dynamic than those I am recommending here for walkers.

The Insider:

What about people who have been runners, but are getting older. Is that a recipe for an injury? Should they start considering long-distance walking?

Andrea Kwok:

There are no absolutes one way or the other. Some people are able to continue running well past retirement age, while other people need to stop and find an alternative exercise in their 30s. It all depends on your body. If you’re consistently having pain during or after running, and have sought appropriate intervention to try to manage the pain but have not been successful, it may be time to switch to a lower impact activity like walking.

The Insider:

Last question, and one you may like! I would imagine that some people go into physical therapy at the first twinge, and others who resist mightily. If you’re an exercise walker, how do you know it’s time to get some PT?

Andrea Kwok:

That is a good question! I think we know when something is truly wrong with our bodies, so if a pain is so intense that you’re inclined to seek medical attention, please do. If it’s dull and nagging but is persisting beyond one to two weeks, I would get it checked out. If you notice that the pain is worsening, or is triggered more easily, that is also a sign to seek medical advice.

I’d just like to note that not all states and insurance plans allow you to go directly to physical therapy for treatment. Some require a referral from a physician.

The Insider:

Thanks again for your great advice, Andrea!

Andrea Kwok:

My pleasure, happy walking!

The Insider:

Are you a big walker yourself?

Andrea Kwok:

As a New Yorker, I think I have to be! But yes, I enjoy going for walks and think that it is a terrific and accessible form of exercise.

The Insider:

Great! Many thanks! See you out on the trail!

Andrea Kwok:

Anytime!


 

Andrea Kwok is the Clinical Director of SPEAR’s West 67th Street location. Andrea earned her Doctorate in Physical Therapy from the University of Delaware. During her time there, she completed a graduate assistantship in the Physical Therapy administrative office and served as class secretary. Prior to her graduate studies, Andrea graduated summa cum laude from Rutgers University with a major in exercise science and a minor in Spanish. Andrea was a founding member of the Rutgers club gymnastics team, where she served as team treasurer.


In her professional career, Andrea has experience working with a wide range of orthopedic conditions, inclusive of sports injuries, mechanical pain, neurological pain, and post-operative rehabilitation. She pursues continuing education with a manual focus, intent on refining her ability to address joint, neurodynamic, and soft tissue dysfunction. Andrea is a large proponent of injury prevention and has participated in movement screenings for high school athletes, active adults, and local residents in the community. She is committed to restoring patient strength and function through targeted exercise and movement training.

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