Learn how to Walk!

Did you know that a majority of folks over a certain age do not walk properly?


Sitting at the mall, at a park we can watch people walk around browsing, shopping, and just strolling leisurely. One can't help but notice that people have individual walking patterns.

Crowd Of People, Crowd, People, BlurSome slouched, some straight-backed, some shuffle, and some use assistive devices such as a cane or walker. Gait deviations can be readily observed mostly in the older adult population.

Changes in the pattern can be the result of surgical procedures, including hip or knee replacements, fractures, or simple arthroscopic procedures. It is also common that pain from arthritis or degenerative joint diseases can cause compensatory movements that result in gait abnormality.

Neurological conditions such as a stroke causing paralysis or weakness on one side of the body can significantly alter one's gait symmetry. 

Neuropathy from diabetes resulting in reduced or loss of sensation in the lower extremities can also impact gait. Nerve injuries to the leg can also cause conditions such as drop foot losing the foot's ability to lift when the heel strikes the ground to walk. Impaired coordination, as in the case of Parkinson's disease, multiple sclerosis, ALS (Amyotrophic Lateral Sclerosis), Cerebral Palsy are just a few examples of movement altering conditions.
Walking seems to be an effortless and insignificant movement for us, bipedal beings. However, it is incredible to realize that we are superbly designed to meet the demands of this simplest mode of ambulation.

Events occur every moment we walk. There are various stages of walking. These are:

1. Stance Phase - This is that period where the foot is rooted to the ground.
2. Swing Phase - This is that phase of the leg where it gets off the ground, swings forward, and passes the stance leg.

During the Stance Phase, these events on foot occur Heel Strike, Early Flatfoot, Late Flatfoot, Heel Rise, and Toe Off.

Sitting at the mall, we can watch people walk around browsing, shopping, and just strolling leisurely. One can't help but notice that people have individual walking patterns.

Some slouched, some straight-backed, some shuffle, and some use assistive devices such as a cane or walker. Gait deviations can be readily observed mostly in the older adult population.
Changes in the pattern can be the result of surgical procedures, including hip or knee replacements, fractures, or simple arthroscopic procedures. It is also common that pain from arthritis or degenerative joint diseases can cause compensatory movements that result in gait abnormality.

Neurological conditions such as a stroke causing paralysis or weakness on one side of the body can significantly alter one's gait symmetry. Neuropathy from diabetes resulting in reduced or loss of sensation in the lower extremities can also impact gait. Nerve injuries to the leg can also cause conditions such as drop foot losing the foot's ability to lift when the heel strikes the ground to walk. 

Impaired coordination, as in the case of Parkinson's disease, multiple sclerosis, ALS (Amyotrophic Lateral Sclerosis), Cerebral Palsy are just a few examples of movement altering conditions.

Walking seems to be an effortless and insignificant movement for us, bipedal beings. However, it is impressive to realize that we are superbly designed to meet the demands of this simplest mode of ambulation.

Events occur every moment we walk. There are various stages of walking. These are:

1. Stance Phase - This is that period where the foot is rooted to the ground.
2. Swing Phase - This is that phase of the leg where it gets off the ground, swings forward, and passes the stance leg.

During the Stance Phase, these events on foot occur Heel Strike, Early Flatfoot, Late Flatfoot, Heel Rise, and Toe Off.

 FRONT FOOT: Heel Strike
FRONT FOOT: Early Footflat

BACK FOOT: Late Footflat 
 BACK FOOT: Heel Raise
BACK FOOT: Toe Off

Swing Phase occurs once that same foot leaves the ground alternately for the other foot to be in a stance, and the swing leg ready to get back to the Heel Strike position again. This is the gait cycle, the process with which we bring our body to a specific direction at a certain speed.
Swing Phase 

Deviations from this typical walking pattern can cause abnormalities in a movement that, if left uncorrected, can result in pain syndromes from muscular imbalance and abnormal loading on specific joints. Problems could arise, including back pain, hip, knee pain, and foot pain. In the weaker older adults, it can cause severe falls from poor balance.
A considerable amount of information is available about the complexities of walking. In this topic, however, I just want to share tips on how to walk effectively with less energy expenditure by efficiently utilizing the muscles of the legs.

Also relevant is injury prevention by ensuring the proper body and joint alignment towards our center of gravity to avoid unnecessary loading and stress to these structures.

1. Heel-Toe Walking.
Try this exercise: In standing, consciously step forward with the heel first, making sure the knee is entirely straight, before lowering the forefoot in contact with the ground surface. Do so with the other foot. If unsteady on your feet, hold on to the kitchen counter or wall to steady yourself.

 Doing this will make your quads muscles contract to stabilize the knee joint, while the anterior tibialis muscle (muscle on the front of the lower leg) pulls the foot up towards the shin. This pattern ensures stability and prevents knee buckling.

2. Reverse this pattern when walking backward. It then becomes Toe - Heel walking. That is, the toes touch the floor first upon stepping back, followed by the heel. This helps with effective weight transference and less up and down motion making the gait pattern smooth and level and less tiring.

3. Side Walking.
Walking sideways in a Toe - Heel pattern with about shoulder-width distance between each foot helps with lateral stability. It activates muscles of the hips, the buttocks, and inner thighs, as well as the usual muscles of the legs during walking. You can hold on to again, a wall or counter, for stability if unstable on your feet.
 (Image credited to Hep2Go.com, an exercise prescription program for Rehab Professionals)

OTHER HELPFUL EXERCISES THAT HELP WITH WALKING BETTER:

1. Heel and Toe Raise - Holding onto a counter, table, or wall for support, go up on your toes (tiptoe) and hold this for 5 seconds. Holding this position for at least 5 seconds, ensure more muscle recruitment necessary for strength and stability. Repeat for about 10- 20 times as many times as able during the day.

In reverse, rock back on your heels, lifting the toes up, holding it again for 5 seconds, holding on for support to prevent falling backward. Again, repeat this about 10 - 20 times as able.

Stronger muscles on the legs provide ankle stability and rigidity that help with shock absorption as each foot hits the ground. This is important as the foot is subjected to the load of the bodyweight itself up to threefold as it is the first structure that hits the ground during bipedal ambulation.

2. Mini Squats / Wall Slides - A simple exercise that strengthens the legs, promotes the recruitment of all muscles necessary for bearing body weight and joint stabilization.

With your back against a wall, feet planted at about shoulder-width apart, bend knees slowly as tolerated, only halfway down for better tolerance. Hold this position for 5 seconds, and straighten up, go back to the initial position. Repeat this about 10 times or as able.

These simple tips are especially helpful for older adults who are weaker and unsteady on their feet. It is a good start towards improving the walking patterns, promoting ease of ambulation, and even fall prevention.

One can always consult with a doctor or a physical therapist for an evaluation and assessment of any gait or walking difficulties.


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