Walking is More than a Gateway Exercise



Walking is one of the best forms of exercise. I used to be resistant to this view. I considered walking as an on-ramp which led to moderate and high-intensity exercise.


Walking is less threatening than most forms of exercise and requires no equipment, but alone, I felt it was insufficient. Without moderate and high-intensity resistance training or aerobic activity — such as running or cycling — walking would never be enough. Walking was a starting point that would eventually be discarded as inferior.

That was my mindset before I took a deep dive into the research.

As a physical therapist and researcher, I owe to my patients to stay up-to-date in the research. That includes challenging my biases. While I believe moderate and high-intensity exercise should be encouraged in many situations, it is easy to forget about the power of walking. Let’s look at how walking compares to other forms of exercise.


Walking Vs. Exercise

A recent research study assessed compared walking to other forms of physical exercise. It pooled 5 trials to look at a bigger pool of data — known as a systematic review with a meta-analysis.

The researchers wanted to determine how walking and other forms of exercise influence pain, disability, quality of life, and fear-avoidance beliefs and behaviors in individuals with chronic low back pain. In this case, chronic refers to low back pain lasting longer than three months.

Three of the studies analyzed the effect of walking versus exercise, while two evaluated the effect of the combined walking and exercise versus exercise alone.

The results of this review show that walking is not inferior, but equally effective as intensive exercise across the board. It doesn’t matter if you define success as reducing pain and disability or improving quality of life, both walking and exercise help. Furthermore, similar results were achieved at short-, mid-, and long-term follow-up (greater than 6 months).

Do these results mean walking can replace all other forms of exercise? No, they do not.

The research specifically looked at the impact of walking and other forms of exercise on pain, disability, fear-avoidance, and quality of life. The studies did not look at muscle growth, strength, power, or endurance. For those adaptations, moderate and high-intensity exercises are needed. But that doesn’t mean walking is useless.

It is important to remember pain and disability are complex. Research does not support that we need to be strong and powerful to be pain-free.

All exercise and activity should have a goal and be specific to you, but all exercise does not need to be high intensity. If your goal is strengthening then high intensity is needed, but strengthening is not always the goal, nor does it need to be.


Walking For Physical Health


Walking induces positive changes in our metabolism — such as lowering blood sugar levels — which benefits individuals with diabetes or cardiovascular disease. Walking alone will not control blood sugar, but it can be a valuable addition to a healthy diet without the need for a fancy gym.

Given the current COVID-19 pandemic and gym closures across the county, walking becomes even more valuable.

If you want to build endurance and improve bone health, walking is a great place to start. Resistance training and moderate to vigorous-intensity aerobic training have greater effects, but that doesn’t take away from the benefits of walking. A key aspect is whether you complete the exercise or not.

Research shows high levels of satisfaction and high adherence rates are partly responsible for the success of walking programs. Walking is less intimidating and exhausting yet still challenges the body enough to create adaptation, provided you are walking longer than duration from your front door to your car. Studies show programs ranging from 30 minutes a day to 7.5 miles per week are effective

I am only getting started. The benefits of walking extend beyond the physical realm.


Walking For Mental Health

Another study reviewed the current research pool to determine how walking affects mental health. The study pooled data from five systematic reviews and 50 individual research trials.

The researchers discovered walking is used to treat depression, anxiety, self-esteem, psychological stress, psychological well-being, resilience, and social isolation and loneliness. Among the listed conditions, walking has the most support for treating depression. While walking does appear to help with mental health, the data is inconsistent. Specifically, the optimal dosage is unknown. Dosing includes duration, frequency, and intensity (speed, surface, and incline) of the walking.

Is a walk in the park the same as walking on a treadmill at a consistent incline? What about a daily walk in the neighborhood compared to a weekly hike in the forest? It comes down to the individual.

You need to determine what your goals are. Find a walking routine that is enjoyable to you. There are many options available. Some people prefer changing the location while others like consistency. Research shows walking in nature can have greater psychological benefits than walking in a city environment.

Consider who you are walking with as well. Do you prefer to walk alone to simply be with your thoughts or do you want a companion? A companion could be a dog — allowing you to still focus on your own thoughts — or a friend or group of people. What would lead to more enjoyment and help you stick with a routine?

Walking is a great form of exercise that yields many benefits. Like all other forms of exercise, the prescription should be individualized.


How Many Steps Do You Need to Walk?

It is likely you have heard of the 10,000 steps a day recommendation. Is that threshold necessary? Once again, it depends.

There is nothing magical about 10,000 steps, it just happens to be an easy to remember and round number that is frequently researched. A recent study looked at the relationship between daily steps and mortality.

At 2000 steps per day, mortality rates are roughly 22 per 1000 adults per year. This figure steadily declines to roughly 6 per 1000 adults at 10,000 steps and 5 per 1000 adults at 12,000 steps per day. There is virtually no change at 16,000 steps. You still achieve benefits from walking more steps, but there are diminishing returns when assessing mortality rates. Granted, this is a single study.

The type of walking matters as well. A 10,000 step stroll around the neighborhood is different from a 7,000 step hike in a park with many hills. Upping your pace to a brisk walk may be more beneficial than worry about reaching the 10,000 step threshold. A study assessing the threshold necessary for significant improvements in outcomes for people with fibromyalgia set a goal of at least 5,000 steps. Another study gave the following classifications:

Keep in mind, these recommendations only look at walking. There are many other forms of physical activity that don’t classify as a formal exercise.

At the end of the day, find a strategy that works well for you. Walking is a powerful tool that can help you with physical and mental fitness. Walking should not be the only strategy for physical fitness, but it should not be discarded either.


How Walking Fits into My Treatment Plans

Walking is now a go-to intervention for most of my patients, regardless of their fitness level. It serves as more than a warm-up.

I encourage all of my patients to walk more. This could be an unstructured family walk after dinner or a predetermined 30-minute route. It doesn’t matter. The patient will benefit.

I too have increased my walking frequency. I find walking is a great opportunity to reflect, step away from electronics (except for the occasional audiobook), and remain active on days I rest from high-intensity exercise. I feel better on the days I walk compared to the days I am inactive.

If you have been resistant to walking as a serious form of exercise, I encourage you to reconsider. The research is clear. Walking is an effective form of exercise for physical and mental health.