Walk this way! But how much?
August 30, 2015 1:11 PM   Subscribe

It's finally time for me to get serious about getting healthy. Walking more is a key part of this. But is there a 'too much more'? Snowflakes inside.

Details about me: I am 5'9" and a little north of 400 lbs, and though I'm probably more active than the average 400 lb person, I need to change. Otherwise mostly healthy in other respects; slightly elevated BP controlled well by low dose meds, normal cholesterol and periodic bloodwork, aside from a genetic clotting disorder for which I am on lifelong Coumadin. No signs of diabetes (yet, I know). I have a mostly sedentary desk job.

My plan is to start eating better (which I don't need help with), and walking (which I do). As a baseline I tracked my steps last week during a 'normal' week and clocked in an average of about 3000 steps/day. I know, not great. I need more, but because of my excess weight and lurking knee issues, I want to slowly ramp things up instead of suddenly throwing excess activity at my body with no 'workup'.

My plan is to set a goal of increasing daily steps. My main questions are:
  1. What is a good goal increase, and how often?
  2. Is it a good idea to periodically 'plateau' at some points to let my body adjust more completely before continuing to increase the daily goal?
  3. Anything specific as far as knees / feet I should be aware of that might tell me I'm pushing too hard?
  4. Could loose tennis shoes contribute to foot/knee problems when walking? Mine are slip-them-on-already-tied level of loose. How troublesome is this, physically?
My initial thought was to take that 3000 and add 500 daily steps every two weeks until I get to 10k, and then evaluate my progress and the need to continue to increase. Too conservative? Too aggressive?

Initial goals are to be able to participate in more 5k walks (I can do them now, but need to sit for a few minutes 2-3 times because my ankles and calves get really sore, and I want to keep up with family / everyone else, plus I ache like crazy for 2 days after) and to be fit enough to enjoy all the walking that might come with touring the UK / Ireland next spring. Mid-term, lose 70 lbs in 1 year, long term get close to 200.

Any and all advice welcome. Thank you!
posted by SquidLips to Health & Fitness (19 answers total) 13 users marked this as a favorite
I don't know anything about steps, but if you can look up a Couch to 5k walking plan, that would be a good start.
posted by roomthreeseventeen at 1:13 PM on August 30, 2015 [1 favorite]

Throw all your money at a good pair of shoes. There are stores that will specially fit you for the perfect shoe for you. Since you already have knee issues, you probably need a shoe that will not allow you to roll your feet when you walk. They will help you find that shoe. The right show will help with your knees and ankles. Minor stretching will help with your calves. Just do the cool down or warm up part of any yoga video.

Once you are in the perfect shoe, walk every chance that you get. If you are out of breath or dizzy, you have gone too far and need to rest. Otherwise, park at the back of the parking lot, drink lots of water, and walk on.
posted by myselfasme at 1:17 PM on August 30, 2015 [8 favorites]

If it's within budget, I would invest in a good pair of running shoes that support your feet and offer some shock absorption. Nothing sucks more in getting fitter than having to deal with an injury, and your shoe situation sounds like the worst, especially when you describe knee and ankle pains.

Best of luck with your plan! Don't be afraid to be slow and steady about it - it sounds like you will get a great benefit from increasing little by little and being consistent.
posted by carbide at 1:22 PM on August 30, 2015 [1 favorite]

Honestly, as someone with knee and ankle problems whose family all has knee and ankle problems, I would strongly consider starting using non-weight bearing activities like swimming. I would also look at weightlifting and possibly targeted strength training with a physical therapist, to strengthen the supporting muscles in your knees and ankles.

I would definitely not try to do running or anything like that--you really want to be careful with your knees.
posted by internet fraud detective squad, station number 9 at 1:31 PM on August 30, 2015 [5 favorites]

A typical rule of thumb for increasing mileage is to limit to no more than 10% increases weekly. Given your comorbidities, and the fact that this is a lifestyle change and therefore much more of a marathon than a sprint, I would halve or even quarter that and aim for an increase of 150-300 steps per day each week.

All of that said, no formula in the world will tell you what is the right amount of walking to do each day if you already have a chronic issue in your back or lower extremities, so in order to succeed here you are going to have to really tune into your body and how it is feeling day to day.

Sometimes when we get on a roll with a positive lifestyle change it snowballs and it becomes impossible to listen to the very loud messages our bodies send us to slow down or to visit the doctor. I would urge you to keep that in mind, and as an adjunct to your walking practice, consider adding in some gentle yoga -- not only for its primary health benefits, but also because it will force you to pay attention to your body and train you to judge when you might be pushing too hard. I really like the Yoga With Adriene YouTube channel -- you can practice at home for free and she provides tons of encouragement and appropriate modifications for all levels.
posted by telegraph at 1:43 PM on August 30, 2015 [6 favorites]

My initial thought was to take that 3000 and add 500 daily steps every two weeks until I get to 10k, and then evaluate my progress and the need to continue to increase. Too conservative? Too aggressive?

I think it really depends on you as an individual. The 500 daily steps seems like a good baseline to start with* - you'll know right away if it's too much or too boring / easy. You can make adjustments as you go. Some weeks might vary from other weeks, too: one week adding 500 daily steps might seem ridiculously easy and another week adding 500 might seem like too much. That's okay.

Good luck!

*I am not a walking-for-fitness expert
posted by bunderful at 1:45 PM on August 30, 2015

Loose shoes by themselves shouldn't cause problems, but you're more likely to slip or trip if they don't fit snugly.

You might check out Hoka One One trail running shoes. They have more padding than most other shoes. The jury is still out on whether extra cushioning is better for your knees and ankles, but it's not likely to be worse. The only caveat is if you have a tendency to roll your ankle: in that case, the thicker soles on the Hokas could be a liability.

Walking is a lot lower impact than running, but I think some of the same rules of thumb would be useful:

- Increase total distance by no more than 10% per week. At short distances, you can do more, but you don't want to go much over. Start by adding 2100 steps each week (10% of the 21,000 that you currently average). As your walks get longer, you can increase that value.

- Every 3rd or 4th week, cut back total weekly distance by 20-30%, to allow for recovery. 20% should be fine for walking.

- Vary your workouts, and give them a focus. Instead of aiming to do a little more walking every day, pick one or two days a week on which you'll do a longer walk. If you add 2100 steps next week, for instance (300 per day x 7 days), go 200 steps more on six days, and then 900 steps more on your long walk day (which might be a weekend day). Make one of the other days a "brisk walk" day when you go a little faster than usual (nothing too strenuous, just at the limit of your comfort level). You'll feel more tired after a long walk and a brisk walk than usual, but doing them will produce fitness adaptations more quickly than just increasing every day's walking a bit. The day after those workouts, take it easy—you don't have to take the day off, but do less than usual, and don't rush.

- Pay attention to your body. If you have a persistent ache or pain that isn't getting better, take a couple days off, and see a doctor if it doesn't get better. Any pain that is severe, or that gets worse as you continue to exercise, is a sign to stop immediately.

On preview, ifds,sn9's advice isn't bad: if you have access to a pool, you can mix up your walking by adding some water exercise. It doesn't have to be swimming; walking or jogging in water (with a flotation belt if you need it) is great, low-impact exercise.

I know you said you have the eating part down, but I'll just share a bit of my experience in the past few years: in 2012, I resolved to eat better, and I did. I bicycled nearly 2,000 miles. And I gained 10 pounds. In 2013, I continued to bicycle a lot, but I also counted calories (I used MyFitnessPal). I lost 47 pounds. Eating "better" by itself wasn't enough for me; eating less was the key. In 2015 I lost another 18 pounds, and now I'm maintaining.
posted by brianogilvie at 1:46 PM on August 30, 2015 [2 favorites]

How much more you walk could be dependent on finding fun places to walk. In order to avoid boredom you might want to make a list of places you could go that are a walking distance from your base, either home or some place where you park. Then you can walk to the drugstore on your lunch break as a goal even though you could have just picked up the whatever during your regular weekly grocery run. You might also look for places that are nice to walk, such as the local parks, or malls, or museums or waterfront etc.

Once you have found the places to walk your own health, the heat, your energy level and time available will dictate whether it is two go-arounds the lake, or just to the first green bollard and back, or keep going until it's time to get back to work.

The important thing is that the walking should be feeling good. You want to look forward to it. Don't forget to motivate yourself by taking pictures on your walk, or having grapes to snack on, or borrowing a dog to walk or making it a social time and meeting a friend to walk with you, or wearing some music to listen to and keep the beat steady.

If walking makes you feel ugh then only increase reaaaallly slowly. If a morning walk and a noon walk means that after dinner you are full of vim you are not overdoing it. You do want to feel that you have been walking and be comfortably tired and a tiny bit sore, but not aching all over and nauseated.

Many people do NOT get a boost in energy, apart from getting used to doing their exercise and not finding it difficult while they are doing it so don't be discouraged if you don't start feeling like the actor who just gulped down the entire can in a Red Bull commercial.

Consider also adding some range of motion and slow-motion exercises to your regime. It may be that you are sedentary enough that there would be some pay off from simply doing things like raising your arms above your head. Some of the non-exercising people I have known have limited range of motion because they always do the same kind of things day after day, so discover their tendons and ligaments have shortened and reaching behind themselves or walking sideways instead of forward has started to become difficult or become impossible.
posted by Jane the Brown at 1:48 PM on August 30, 2015

I wouldn't over think it too much. Just walk and increase your distance slightly every now and again. Maybe add some gentle hills to your route on occasion.

The idea of water walking seems good to me too. Hopefully your new diet will have you shedding lots of weight and help with the aches and pains.

Good luck!
posted by backwards guitar at 1:49 PM on August 30, 2015

Is a visit to a physical therapist's office an option? I saw one when I was having pain from walking and discovered that a specific kind of insole was good for me, and that one of my legs is longer than the other. All easily fixed, now no pain.
posted by The corpse in the library at 1:51 PM on August 30, 2015

You might want to read some of the popular articles about the negative health impact of sitting. If your work situation permits this, just standing for a couple of minutes two or three times an hour is suggested to be helpful. I mean do this in addition to all the walking that you plan. (I know it sounds odd, but I listened to a fairly lengthy interview with someone who wrote a recent book on the topic.)
posted by puddledork at 1:54 PM on August 30, 2015 [2 favorites]

Have you considered one of the many 'fitness trackers'? While they have limitations (accuracy is a concern), it can be one way to see some progress and feedback to yourself. If you set your goal at just above what you're seeing at baseline, and then work towards increasing the goal slowly, it gives you a nice sense of progress. My fitbit doesn't care how fast I walk, or where I walk (even if it's just getting up at every chance I get from sitting) and the number at the end of the day is a motivator to take the extra few steps when I can. There is lots written about various fitness trackers, but it might be worth looking at one if funds allow.
posted by Northbysomewhatcrazy at 2:09 PM on August 30, 2015 [1 favorite]

Shoes matter, and socks matter. I didn't get to the point that I could knock out a good distance without blistering my feet until I got some suitable athletic shoes (Keens for hiking in my case) and started wearing wool hiking socks (which are totally worth the cost).
posted by wotsac at 2:10 PM on August 30, 2015

I would consider increasing as you find it's getting easier and not at arbitrary date intervals. So if you add a half mile walk to your current activity and find in a month you get home and feel you could have kept walking, then add some distance. If it takes 6 weeks, then it takes six weeks. Whatever, it's better to be consistent than push too hard and giving up. Listening to your body will always be the right answer.

Also when you are very overweight, you burn so much more than a thin person doing less exercise. So don't discount those current 3000 steps! It's more than a lot of people get at half your size.
posted by cecic at 2:14 PM on August 30, 2015

aside from a genetic clotting disorder for which I am on lifelong Coumadin

I have a genetic disorder. Walking is the only exercise I have been able to successfully stick with for most of my adult life. I used to be about 245 pounds. I don't know my current weight, maybe ~160, but I am lots smaller.

For me, my foot and joint problems have dramatically improved with regular walking. It took time. I continued walking even with pain unless I was really injured and the walking was obviously making things worse. Otherwise, I just kept walking every day, pain or no pain, and things gradually improved. I have much less foot and joint pain these days.

I wear really cheap sandals most of the time. I do look for sandals that I find comfortable, but I don't look for any kind of special walking shoe. These days, I typically walk 2.5 or more hours a day. So I think if you are comfortable and do not have reason to think your shoes are an issue, then wear whatever you feel comfortable in.

Something a lot of people seem unaware of is that lymph or interstitial fluid is basically blood minus the cells. It is kind of part of your circulatory system, but kind of not. Your heart does not move it back to the circulatory system. Muscle action moves it back to the circulatory system. Increased activity will really dramatically increase the rate at which this happens, like 6-8 times as much fluid (maybe even more) will be moved. It's really a big difference.

I looked into this because I was having serious side effects at times from walking. I sometimes had real problems triggered by walking. Increasing your walking will dramatically increase the rate at which your body moves lymph back to the circulatory system. This can help remove old drug residues (like from Coumadin) out of your tissues and push them through your liver and kidneys. This can do good things for your health, but it can also overwhelm your body's systems in the short run.

So given your high weight and your genetic disorder and that you are on medication, I will suggest that if you start getting really weird problems of any kind, then you need to lower the amount of walking you are doing and account for the fact that lymph is being moved and this is having significant consequences. If you get a severe short term reaction, give it a few days and then resume trying. If the reaction is milder, then just slow things down a bit.
posted by Michele in California at 2:15 PM on August 30, 2015 [2 favorites]

Rather than focusing on counting steps, I would focus more on finding pleasant and interesting routes you can walk between benches for resting. Maybe some nice nature walks somewhere? Try to find routes that incorporate something you like to do. Take a camera and a bottle of water. Or listen to music or audio books while you walk. Make walking an important and permanent part of your life apart from staying fit.

But I would also walk to the pool and do a lot of swimming instead if I were you. Get the load off your poor joints. You'll be no good to anyone if you strain yourself and can't walk at all.
posted by pracowity at 2:21 PM on August 30, 2015 [3 favorites]

I'm pretty heavy -- not as heavy as you are, but not as tall either -- and I walk a lot. Occasionally circumstances will collide and I'll end up doing about twice as much walking as usual in a given day, and boy, my ankles and hips and low back really feel it. If you spend a lot of time sitting down, your core muscles will have a lot of adjusting to do to adapt to holding you upright for so much longer. Pilates helped me a lot for this, as did water aerobics.

Your decision to work things up slowly is a really good idea, from my experience. The last thing you want to do is injure yourself through enthusiasm and set yourself back further than you started. My doctor recommended increasing my steps by about 10% per week at a maximum, and scaling my goal back if I discovered I was at a level that I was routinely not meeting, because you don't want to get into the habit and expectation of not making your goal.

Another good tip, particularly if you spend a lot of time sitting down for long stretches, is to find a way to interrupt those long sedentary periods. Apparently there is literally no amount of exercise that doesn't have a positive benefit, however small, and short periods of exercise throughout the day are very nearly as effective as one big chunk. I have a tendency to sit down with my computer and a cup of tea and emerge from a Internet haze four or five hours later, and so I installed a program that forcibly stops me from using the computer for 5 minutes every 45 minutes. If I want to still be internetting, I use that period to get up and pee and get a glass of water and maybe do some very light calisthenics for a couple of minutes; if I want to get up and do other things, it serves as an opportunity to get me out of my groove and go do other things. I'm only about a week into it but it's been pretty effective so far.

Sometimes, particularly in the beginning, you can find yourself being really stiff at at the start of an exercise period. That's normal, or at least it is for me. But in my experience, if you're more than five or ten minutes into your walking and you're still in enough pain that you're wincing or changing how you walk, you may be doing yourself more harm than good and might want to talk to someone about what you can do differently.
posted by KathrynT at 3:13 PM on August 30, 2015 [1 favorite]

Walking is awesome for exercise and it's great that you want to make it a consistent part of your life. Start by getting good shoes. These don't need to be wildly expensive and you will need to replace them every few months. (Heavier body mass will crush the cushioning faster. I'm a heavier than average runner. I replace my shoes about twice as frequently as my lighter friends.) Look for last year's model shoe - they are fine for your purposes and much less expensive. For encouragement I like the app The Walk.

If you have a knee/foot issues and been sedentary for an extended time, then it's important to ramp up slowly and to have an alternative, non-weight bearing exercise when walking is going to aggravate an injury. Here is a chair exercise workout video, but there are plenty of others.
posted by 26.2 at 5:18 PM on August 30, 2015

Hey! I've just started a similar program. I've had serious problems with my weight every time I went through hormonal changes: puberty, pregnancies, and now menopause. And recently I remembered that the other times, walking was the cure.
Walking is great because it is gentle and slow, but also because it strengthens the whole body, and is gentle on joints (I have sports-injuries from all of my slim/sporty eras). My knees are very vulnerable and I have an ankle which recently broke, but no amount of walking can make these hurt or in other ways cause trouble.

My plan is to double my steps over 3 months (now two months in). I'm not going to reach that goal as a mean, but I am on track and I have managed to walk my ideal steps on several occasions with no damage at all. And I can feel the benefits.

From the outset, I sometimes walked those ideal steps, with no problems because walking is so gentle. Obviously, I was very tired at night, and sometimes felt some muscle strain (calves, thighs, feet) the following day. But no pain in joints/bones, which is what you need to avoid.

Since it is summer, I'm wearing Birkenstock sandals most of the time, alternating with Asics (and serious trekking boots in a park with snakes). The point is that walking is a lot less demanding when it comes to footwear than running. I don't think your unlaced shoes are a problem, but I am not an expert. The other day I got three times my goal in one day by dancing barefoot at the office party, but I have the wildest new colleagues who make such things possible (fat old ladies dancing with good looking younger gents).

One of the best aspects of this is that my appetite is regulating itself in a totally different way, so I am not over-eating, and I am not craving snacks at all.
posted by mumimor at 1:50 PM on August 31, 2015

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