Exercise As Preventive Medicine: Aerobic Walking

Special Guest Post by Dr. Mort Malkin
Author of "Aerobic Walking — The Weight Loss Exercise"

 

Once upon a time, even after Hippocrates, people thought disease and death were part of life, inevitable and a matter of destiny. Appeals to gods, priests, and shamans were the pathway to cure. Drums & magic were considered especially cogent. Today, people still think heart disease, hypertension, diabetes, and cancer are a matter of destiny … or maybe genes. Only medication will save you.
 

Yet, Centers For Disease Control and Prevention statistics say that 70% of all chronic disease can be prevented by a healthy lifestyle. The basic components of such a lifestyle include: 1) not smoking, 2) a diet that supplies the body’s nutritional needs, and 3) a high grade exercise to improve the body’s metabolism and chemistry. We may add a fourth: an effective relaxation procedure that quiets the adrenergic tone of the body and brings down hypertensive blood pressures. The diseases that can be ameliorated and probably prevented include coronary heart disease, hypertension, diabetes 2, osteoporosis, several cancers, chronic low back pain, mild to moderate mental depression, and a few others.
 

A healthy lifestyle is simple in concept: nutrition, exercise, and relaxation. Of the three components, exercise is, arguably, the most important. But, there are many types of exercise and widely varying opinions of what counts as exercise.
 

Exercises come in five categories: 1) strength training, 2) aerobic, 3) stretching, 4) skill training, and 5) fun. Of the five, only aerobic exercise changes the body’s metabolism, brain chemistry, blood pressure, immune system, and bone structure. It is the only type of exercise that will improve your lipid profile, increase insulin resistance, lower your set point for body weight, and move the fight & flight vs. rest & repair balance to the right. Both resistance training and aerobic training will increase bone density. All of the above effects have been documented in the sports medicine literature.
 

Let’s start with the definition so we can judge which exercises are truly aerobic. Aerobic exercise is a rhythmic, sub-maximal, weight bearing (on your feet) activity that is done far enough, fast enough, and often enough.  Exercise must fully adhere to the definition, or your body & brain will say you’re not serious. Of all sports and exercises, only running and cross country skiing fulfill all the requirements of a high grade aerobic exercise.

 
Even walking is not highly aerobic — it employs the calf muscles for power as you push off the ball of the foot and toe. The calf muscles are not large enough to produce much of an aerobic effect. Nor are they large enough to generate much speed. Yet, walking is weight bearing and uses the same large muscle groups as running and cross country skiing. All we must do is change the technique for it to become “aerobic walking.” The new form will not look contorted but will use a large total muscle mass.
 

Here are the basics for  walking. The leg that is on the ground, the support leg, provides the power of moving forward. The other leg, the recovery or swing leg, moves forward through the air getting ready to become the support leg on the next stride. In ordinary brisk walking the support leg presses down and back on the earth during the last 1/3 of the stride. Aerobic walking gets most of the power from the first 2/3s of the stride, starting at the moment the heel touches the ground. This pulling motion is hamstring and gluteal work. The power is continued through the middle of the stride. At the last part of the stride, you will still push off, even without thinking. The total power will involve a large total muscle mass and create large aerobic change.
 

Even further power can be generated by using the mid-body muscles. As the swing leg moves forward for recovery, lead its motion from the hip. In this way, an alternating 45° angle is formed between the hips at every stride. This hip power enlists lower back and abdominal muscles, adding to the total muscle use.
 

Power generation, however, is only half of the new technique. Smoothness of form is the second half. The transition from stride to stride must be fluid, and overall form must be light footed. With a gentle heel strike at the beginning of the stride and an easy toe-off at the end, you can make your new form extremely smooth and avoid pounding. One stride will flow into the next, and you will be able to increase your strides-per-minute pace. Advancing the hip of the swing leg at each stride will lengthen your stride. Using larger, stronger muscles for power will enable you to maintain a faster speed for the whole workout. The research shows that at a fast pace, aerobic walking will be as aerobic as running.
 

With its smoothness, aerobic walking also creates less stress on the knees and lower back. In fact, the strengthening of the hamstrings will increase knee stability (for stubborn old runners), and exercise of the supporting muscles of the lower back will lower the risk of chronic low back pain. How wonderful — gain without pain.

Posted by Dr. Mort Malkin

Dr. Mort Malkin is an Attending Surgeon Emeritus at The Brooklyn Hospital Center. His most recent book on health and fitness is Aerobic Walking — The Weight Loss Exercise.