Introduction to the Walking Code
IntroductionWalking is a Serious Problem
Is a walk in the park really as easy as, well, a walk in the park? The answer to this question may be vital, not only to your own health, but to the health of our society as a whole. The phrase "a walk in the park" is supposed to refer to something that is super easy, as in "that test on how to screw in a lightbulb was a walk in the park." The existence of this particular idiom implies that walking is an especially easy activity. I would argue that this couldn't be further from the truth.
If we get our recommended 10 thousand steps a day, that would add up to 3.65 million steps a year. Each step is a physical impact on the ground affecting our feet, ankles, knees, hips, and lower back. If the quality and force of those impacts are dysfunctional, that would represent an extraordinary vulnerability to premature wear and tear on our bodies, particularly the structures I listed above. Imagine the effect on your car tires of just a minor misalignment of the wheels. In no time at all, the edges of the affected tires begin to wear down, eventually requiring replacement. Our bodies are no different, except that replacing worn body parts is not nearly as easy as getting new tires. (See Figures 1 and 2)
When our lower bodies are subjected to abnormal forces for long periods of time, just like the car tire, they wear out. This manifests itself as bunions and hammertoes, falling arches, plantar fasciitis, knee arthritis, hip arthritis, and low back pain, just to give a short and incomplete list. Doctors often ascribe many of these maladies to preexisting conditions like being born with flat feet, or to other issues like improper footwear, being overweight, or the consequence of injury or just poor genetics. However, many people develop these conditions with no discernible predisposing cause. Why is this? I believe the cause is the everyday dysfunctional way many of us, unknowingly, use our bodies. Ultimately this causes the abnormal stresses that wear out our joints and injure our tendons and ligaments. The one activity that we do more than any other that makes us vulnerable to this damage is walking.
Just go to the nearest mall and sit for a while and people watch. In no time you will see a wide variety of walking styles. Some people, often in flip flops, will be walking with their feet turned out at an angle. (See Figure 3) Other people will be lunging forward with each step, smacking their heels against the ground as they go. Still others will wobble side to side, pushing their weight from one leg to the other like a penguin. Some people will be leaning forward, some leaning back, some bouncing up and down, and some looking at their toes. Some women will be walking in platform shoes and appear as though they are undertaking their first attempt to walk on stilts. There are so many ways of walking incorrectly, and unfortunately our society as a whole has failed to recognize what a significant health hazard this is.
Figure 3.
If you watch animals walk, you will not see the wide variations in gait that are so prevalent in humans, Animals seem to have a remarkable consistency in their walking patterns. This may owe to the fact that animals do not have the brain power that we humans do, the brain power that allows us to consciously mess up something that should be instinctual. Animals are born programmed to walk in a certain way, and so they do. Humans are also born to walk a certain way, and we do, at least initially. Children around the globe, regardless of culture and nationality, go through a very consistent process of learning to crawl, sit, then stand, and then walk. If you take your toddler to the pediatrician, the doctor has a list of expected developmental goals which should be reached by a certain age. Walking is one of those expected developmental goals, and is predictably developed between 9 and 15 months of age. It does not require any instruction. Just like it is with animals, it is a preprogrammed learning process.
Regrettably, somewhere along the way, many people stray off the path of normal walking, and the reasons may be various. Regardless of the reason, once a dysfunctional way of walking is established and committed to body memory, it generally will stay that way unless the dysfunction is consciously recognized and then retrained. The problem is, in my experience as a physician, most people who are suffering pain related to improper walking have no idea of the connection between their pain and their style of walking, so recognition and retraining never occur.
Go back to figure 3 on the previous page and look at the man on the right with his feet turned out. This man clearly has no idea that he is doing something that is going to eventually result in pain, and when his pain starts, he will have no idea that it is caused by his walking. The doctor examining him on a table in the office will also have no clue as to what the cause is because the doctor won't examine the way he walks. The fact that people can injure themselves by walking incorrectly is not on the radar of most physicians.
One of the most important functions of the body is standing and walking upright. Our core muscles, our spine, our pelvis, our legs, and our feet, are all formed to make walking efficient and to minimize wear on the body. Many people live well into their 8th and 9th decades and preserve good joint function and can maintain an active lifestyle, evidence of how well the body is designed. But others begin to wear out much sooner, often in their 5th and 6th decades. If I had a dollar for every patient that told me "don't get old Dr. Martin," I would be significantly closer to retirement. This is especially disheartening when these patients are only 5 to 10 years older than I am. But my spirit is lifted each time I see an 80 year old come in wearing shorts, fresh off the tennis court.
What is the difference between the one group and the other, between the aged 50 year old and the spry and youthful octogenarian? Of course there are times where old injuries or chronic illnesses take their toll and can be blamed for the difference, but often patients with early degeneration of the body have no discernible cause. Some unrecognized force is attacking them out of proportion to those people who manage to age painlessly. That force is the invisible but ever present force of gravity. When we function optimally, standing with correct posture and walking with correct technique, the effects of gravity are minimized and may be trivial over the course of a normal life span. On the other hand, poor body mechanics amplify the negative effects of gravity, prematurely aging the body, resulting often in pain and disability.
In a study published in the journal Mayo Clinic Proceedings in January 2013, back pain and other joint and osteoarthritic conditions accounted for over 50 percent of all visits to a family practice doctor. Joint pain and osteoarthritis accounted for 33.6 percent of visits while back pain accounted for 23.9 percent of visits. When added together, these conditions accounted for more than half of all visits, more than heart disease, high blood pressure, diabetes, and upper respiratory infections. The cost to our medical system, the cost in lost work, and the cost in pain and suffering is dramatic.
We long ago recognized the slowly erosive effects that both high blood pressure and high blood sugar have on the body. Decades after they develop, they lead to strokes, heart attacks, and many other debilitating medical complications. High blood pressure is called the silent killer because it doesn't cause any symptoms until the damage is already done, a devastating stroke possibly being the first symptom. Poor walking technique may have a similar erosive effect on the body, the difference being that the effect is on the joints and connective tissues, not the blood vessels and heart. The first symptoms may not show up until there is already significant wearing out of the joints, and then it may be too late. Episodic pain in the joints and feet that are often passed off as being caused by temporary "overuse" may really be warning signs of repetitive injury caused by poor body mechanics. If ignored, the problems can often become permanent as joints and connective tissue become irreparably damaged.
If we as a society do not begin to recognize the significant connection between the way we move our bodies and the eventual development of pain and disability, the epidemic of chronic pain will continue to get worse. We must come to grips with the fact that walking, more specifically poor walking technique, is actually a serious problem. But like any other problem, there are solutions. With the proper knowledge and tools, anyone can correct problems in the way they walk, and in so doing prevent future premature wear and tear on the body. Like getting screened for high blood pressure and diabetes, the first step is recognizing the problem, and recognizing it early is essential. There does become a time as people get much older that retraining body mechnics becomes very difficult. Damage to the joints can also cross a point of no return where it becomes difficult or impossible to achieve a normal posture or gait.
The Walking Code is a system for understanding how to walk more effectively, using the core in a precise way that keeps the joints properly aligned and minimizes the effects of gravity. This system is derived from an analysis of Tai Chi theory and it is applied to basic functions like normal walking. In this book I will first share with you my background and how I developed the Walking Code. I will describe some specific dysfunctional styles of walking that can cause severe damage to the body over time. I will then explain the mechanics of the core and how we can use the core properly to correct any deficiencies in our walking technique. The system can be applied to basic strolling, power walking, walking up and down hills, up and down staris, running, and more. The Walking Code is a blueprint for how to use the core to function the way the body was designed to function. Using this system, you will be able to learn to walk with fluidity, walk with consciousness, and ultimately walk without pain.