How to Reduce or Prevent Injury When Starting a Walking Program

As the weather starts to get nice, many people start walking programs to stay healthy and active.

Two injuries that occur often with starting a walking program are Achilles tendonitis and plantar fasciitis. Both injuries typically occur from overuse, but there are some signs to look for that can help you prevent them.

Missteps: Common Injuries That Can Occur From Frequent Walking

Achilles tendonitis is an overuse injury to the Achilles tendon, the band of tissue that connects the calf muscle at the back of the lower leg. It can be caused by intense or repetitive strain of the Achilles tendon, such as a rapid increase of activity and increased intensity of activity after not doing much over a period of time. 

Symptoms of Achilles tendonitis usually begin as a mild ache in the back of the lower leg on or above the heel after walking. You might also experience tenderness and stiffness particularly in the morning that usually improves with mild activity.

Factors that place you at a higher risk for Achilles tendonitis include:

• Sex – males get Achilles tendonitis more than females
• Age – the Achilles tendon weakens with age
• Physical problems – naturally flat arch, obesity, and calf tightness
• Training choices – wearing worn-out shoes
• Medical conditions – people with psoriasis or high blood pressure
• Medications – certain antibiotics called fluoroquinolones
• Volume and intensity of walking

Plantar fasciitis is the inflammation of the plantar tendon, which runs the length of the bottom of the foot spanning the area from the base of the toes to the front of the heel. The tendon attaches to both areas through the fascia, a strong fibrous membrane. The purpose of the plantar tendon is to keep the arch from flattening when weight bearing on the foot. It helps to provide shock absorption and cushioning when walking. Plantar fasciitis is inflammation of the plantar fascia caused by any movement of the legs that pull on the plantar tendon. Examples of movements that can cause plantar fasciitis are excessive walking, walking up and down hills, stairs, walking on the toes, or pulling the toes up when the heel comes down. Landing on the heel with the foot pulled up (dorsiflexed) increases stress on the plantar tendon, acting like six times your body weight on the tendon. Other causes of plantar fasciitis include:

• Worn out shoes
• Very high arches or very low arches
• Obesity
• Tight calf muscles
• Walking barefoot on soft sand

Plantar fasciitis can initially feel like a lump in your heel like you have a pebble in your shoe, pain in your heel or arch when you first get up from sitting, or pain in your heel or arch when you first get up in the morning that subsides once you are up and moving around.

One Foot at a Time: Tips for Walking Injury Prevention

To prevent Achilles tendonitis and plantar fasciitis from occurring, make sure that you wear good shoes or sneakers geared towards frequent walking. Make sure that your shoes are not worn out. A specialty walking or running store can help you select appropriate shoes. Start off your walking program with a slow prolonged warm-up. Do not over-stride when walking which can cause increased pressure on the heel. Keep your calf muscles stretched, strengthening the arch by scrunching up a towel with your toes over and over, and perform heel raises to strengthen your calves. 

As you progress in your program and fitness remember to increase distance and intensity slowly and listen to your body. If you have questions about your walking program or think you might have an injury it’s always best to consult a medical professional before continuing.

Pamela A. Ziegenfus, PT is a physical therapist with OrthoCarolina Huntersville.