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Walking and Power Walking: How Do They Benefit IC Patients

As the benefits of routine walking and the number of daily steps we take become a focus for good health, IC patients may wonder where they fit in to this exercise approach. After all, exercise in general can be quite challenging for many patients. And for some, even walking short distances can cause bladder, hip, low back and leg pain.

In this column I am going to cover the pros and cons of walking in general, for both people with and without IC, to give the whole picture. First of all, walking like other exercise, promotes mood-lifting hormones that fight pain and depression. Walking also promotes deep breathing, increases circulation, aids digestion and elimination (good for irritable bowel syndrome), helps us sleep better, and gives us a "sense of control" over our bodies. Walking can strengthen our abdominal muscles, our low backs and legs, and build our bones. Moderate walking (30 minutes of walking on most days of the week) helps to pare down the pounds, boosts our "good cholesterol," lowers our blood pressure, and reduces our risk of diabetes. And, the benefits increase when we lengthen the duration of our exercise. A study in the Sept. 10, 2003 Journal of the American Medical Association (JAMA) found that women who did 75-150 minutes of brisk walking a week significantly lowered their risk of breast cancer. While most of us can't even imagine trying to walk 150 minutes a week, we can still benefit from moderate manageable walking, even a few times a week.

Lets look at the different types of walking. We all know what it feels like to take a stroll, a nice leisurely stroll through the park. Yet, with IC, the feeling may just be a memory. As a matter of fact, many of us IC patients walk fast, and for similar reasons. One, we need to get to where we are going so we can find, or get back to a bathroom. Two, the constant awareness and/or pain of IC can create a sense of nervousness, a hyper feeling that causes us to get up and down a lot when it's just too uncomfortable and painful to sit still. And, some of us pace when we are in a flare-up, because the energy of pacing matches the intensity of the pain. It's almost like we are trying to run away from the pain.

I recently decided to take advantage of my pacing. I got a pedometer. I understand that they are now available at McDonald's with a certain purchase. Anyway, I intend to wear my pedometer for one week to figure the average daily count of steps I take. During week two of wearing the pedometer, I'm supposed to, according to U.S. Health and Human Services Secretary Tommy Thompson, add 500 steps per day to my lasts week's total.
Week three and beyond, I'm supposed to add another 500 hundred steps a day until I have reached the 10,000-step goal (about five miles)!

In a recent study on walking, participants benefited from adding just 400 steps a day (about the equivalent of 20 minutes of walking). Of course, this must be kept up to benefit. And although it sounds better than the 10,000-step plan (or the other 2000-step plan), I think that I will need to pare it down to fit my capability. Still, starting with baby steps, I can definitely challenge myself just enough to feel like I'm making a difference, and then I'll feel alright about the times I cannot add steps because of my IC.

The word aerobic means "with oxygen." Aerobic capacity refers to the health of our hearts, blood vessels, and lungs, in other words, our circulatory and respiratory systems that send oxygen to our muscles. The benefits of aerobic activity, such as raising our metabolisms, are great, and even if we have IC if we can walk we can get these benefits. Just fitting a little more brisk walking into our lives can make a difference, even three 15 to 20 minute sessions a week can help. (Brisk walking burns up twice as many calories as regular walking, or strolling.)

One nice thing about brisk walking, which is the same as power walking, is that we can do it in intervals and get good results. For instance, walking more intensely (in faster intermittent spurts) for short durations during our walking workout appears to offer the benefits of continuous exercise in half the time. This may make brisk walking more bearable for us for a couple of reasons. For one thing we don't have to walk as long, and with intervals there is less rigidity and tension in the body. Also, too much brisk walking can be hard on the lower back because there is a lot of rotation and twisting.

According to chiropractic theory repeated twisting may actually irritate the third lumbar nerve, which is a bladder nerve and a nerve that also goes to the hamstring muscles (backs of the thighs). If the third lumbar nerve is compromised by IC, it is probably best to avoid repeated twisting of the low back. However, walking without too much twisting can benefit the third lumbar nerve, and therefore supposedly strengthen the bladder and the hamstring muscles. Like everything with IC, benefits are always individual.

The position of our arms while walking can make a big difference. When we hold our arms with our elbows bent at 90 degree angles, in a tense position, we create more twisting in our lower backs. We also tend to lift our shoulders, causing our necks, jaws and heads to lock-up (even our eyes can become fixed). If we only swing our arms from our shoulders, our torsos lock up. Same thing happens when we take big steps. Instead, we should gently swing our arms from relaxed elbows, while keeping our shoulders and heads relaxed as well. This will promote movement in the whole body, so we can use our muscles more evenly and avoid tension. The idea is to feel comfortable movement, from our feet up through our heads, while we walk, not tension.

Some power walkers hold two to five pound weights in their hands while walking. This helps to get their heart rates up. If IC patients can comfortably do this then I say do it. However, walking while holding weights can keep our arms locked in 90 degree angles, increase twisting in our low backs, and limit the amount of movement through our bodies. Weights, especially for us, can also promote tension in the joints of our shoulders, arms and hands, because most of us don't have good support and strength (for holding the weights) in our pelvic and abdominal muscles. If IC patients want to walk with weights it's a good idea to begin walking with a handful of pennies in each hand. Starting with small amounts of weight in each hand, we are less likely to take on a tension pattern, and more able to recognize tension if we decide to progress to one or two pound weights.

IC patients often stand and walk with their body weight in their heels (see The Pain Pattern of IC in Positive Moves For The New Year, January 2001, and Standing And Walking in Reducing Pain and Strain with Better Ergonomics, February 2001), so it's a good idea to choose walking shoes that do not turn up at the toe. A turned up toe keeps our body weight back in our heels. And, with brisk walking we don't roll through our feet like we do when we walk more slowly.

Lacing our walking shoes for our foot type is also important (refer to our Summer Shoes column, May 2001), as is picking a shoe with a comfortable arch. Too much arch can create tension in our feet, ankles, knees and hips. We need to choose walking shoes that provide comfortable support without imposing too much change in the way we stand.

Not only is it important to pay attention to how we walk, and what type of shoes we wear, it's also vital for us to pay attention to the environments we walk in. Because we breathe in more air when we exercise, most of us know better than to take a walk outside on high ozone and pollution days. And, we know to avoid walking near heavy traffic where there is a lot of car exhaust. But, we also need be aware of indoor pollution if we walk indoors. Breathing in the fumes from chlorine (in swimming pools), and the bleach and ammonia often used for cleaning in gyms, is not healthy, and after all, we are walking to improve our health.

Stretching and limbering our muscles before walking is necessary for our flexibility and joint mobility. Without proper stretching we are at greater risk of walking in a tension pattern, which can lead to injury and/or pain.

To prepare your upper and lower bodies for a "walking workout," refer to the stretches in Short Cuts, in the back of our STRETCH INTO A BETTER SHAPE book. You will find the "Hamstring Stretch" and photos of the other stretches at the end of this column. Please do not try the other stretches without proper instruction. And, always walk around your home a little before stretching to warm your muscles.

Click here for a pdf of our exercise of the month: Hamstring stretch

About The Authors:
Gaye is an author and IC patient & support group leader who has been involved in IC work for years. In 1990 she published "Stretch Into a Better Shape" and produced a stretching and exercise video for IC patients in 1993. She is a specialist in Aston-Patterning movement and muscle re-education.

Andrew has over ten years of clinical and health care management position. He is currently the Administrator of Maison Hospitaliere, located in New Orleans. Andrew holds a Ph.D. in Special Education, a M.A. of Health Adminstration, M.A. of Clinical Psychology.

They welcome your comments and feedback on their articles at: The Sandlers

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