6 Walking and Orthotic Support
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Dynamic Chiropractic – March 25, 2002, Vol. 20, Issue 07

Walking and Orthotic Support

By Mark Charrette, DC
People who are concerned about good health are walking a lot more nowadays, and they're doing it to help lower blood pressure, lose weight, look better, and feel better. Many chiropractors are even recommending that their patients begin walking regularly to improve their neuromusculoskeletal health. With so many people participating, it should come as no surprise that many of these regular walkers need orthotic support.

A Popular Activity

Fitness walking is a very popular form of exercise because of its many health benefits and the ease with which it can be accomplished. Research from many fields has proven the value of this form of exercise. Recommendations to "get out and walk" come from any number of health organizations and groups, and as more individuals participate, even more friends and neighbors are joining in. The aging of the "baby boomer" generation is certainly a factor in popularizing the use of walking as a low-stress exercise.

Advantages of Walking

  • It can be continued when on business trips and vacations.
  • Companionship with friends and/or family is possible.
  • It does not require a partner or companion.
  • Equipment is relatively inexpensive.
  • Indoor locations are readily available in poor weather conditions.
  • Little or no commuting is needed.
  • No membership or fees required.
  • No special coordination or learned skills are required.
  • It permits listening to music, radio, or books on tape.
  • Routines are simple and can be easily varied.
  • Scheduling can be individualized and varied.
  • It utilizes large muscle groups for efficient aerobic conditioning.

Health Benefits

Fitness walking is effective in:

  • burning calories efficiently, assisting in weight loss;
  • decreasing blood pressure and resting heart rate;
  • decreasing cholesterol counts and increasing good HDL levels;
  • developing heart and lung capacity;
  • gradually increasing lean muscle mass;
  • helping to reduce all the health risks of obesity;
  • improving balance and neurological coordination;
  • improving elimination of waste and toxic products;
  • improving psychological outlook, reducing stress;
  • increasing oxygenation of all tissues in the body;
  • lowering the risk for many diseases;
  • stimulating strong and dense bones, staving off osteoporosis;
  • strengthening hip and back support muscles; and
  • strengthening the immune system, thereby reducing cold and flu symptoms.

Spinal Conditions and Walking

Walking is a very beneficial, and is recommended exercise for patients with back problems.1

I have found this to be true with my own patients. In most cases, both acute and chronic back conditions improve more rapidly when patients walk at least 20 minutes every day.

Walking at comfortable pace for at least 20 minutes is an achievable level of exercise, even in very busy lives. You can feel the benefits almost immediately, and those benefits continue as the pace is increased. When patients miss work due to a back injury or condition, I have them walk three times a day for at least 20 minutes per session. Most patients are surprised at first by this recommendation; they do not think they can do much walking with sore backs! However, once they start walking, they can feel how it loosens up the back muscles and decreases their pain levels.

Walking is a very useful adjunct to the treatment of most spinal conditions - and patients gain all the benefits and advantages listed above. There is, however, a factor that must be considered. For many patients, a major issue in their spinal condition is inadequate support and faulty alignment from the lower extremities and/or poor shock absorption. These issues must be addressed if your patients are going to enjoy their walking regimens and truly benefit from the activity.

Orthotic Support for Walkers

As fitness walking catches on as a regular exercise routine, there will be walkers who develop back problems, and many will seek chiropractic care. To effectively treat their spinal conditions, most walkers will benefit from custom-made, flexible orthotics - either to decrease the biomechanical stress on the spine caused by arch collapse, foot hyperpronation, or leg length problems, or to help absorb and dissipate the shockwaves transmitted into their spines with each step.2 This is especially true in middle-aged and elderly walkers who have developed degenerative changes in the joints of the lower extremity and of the spine. The gradual aging of the soft tissues results in a progressive stiffening of the natural shock absorbers. This stiffness eventually leads to clinical symptoms, and will be accentuated by a regular walking program.

The answer, however, is not to cut back on the walking, but to address the issue at its source - by providing well-fitted, custom-made, flexible orthotics that decrease biomechanical asymmetry and excess motion, absorb much of the shock, and fit comfortably into the walker's shoes. Orthotic manufacturers who recognize the value of walking in the treatment of spinal conditions have developed specialized lightweight inserts to address these concerns. This is the type of orthotic to consider whenever you are dealing with a patient who already has an established walking program. Such an orthotic is also appropriate when you recommend that a patient begins a walking program to help a spinal condition and improve general well-being, but the patient has an interfering condition (such as arch collapse, degenerative joint changes, or spondylolisthesis).3


The chiropractic patient should be encouraged to engage in a regular fitness and exercise program, and fitness walking should be considered for such a program. While many walkers need only a well-made walking shoe, some patients will need to be fitted with custom orthotics. The orthotics must be designed to be lightweight, shock-absorbing, and comfortable, and yet provide proper biomechanical support and a good fit. These parameters can be achieved through the use of specialized orthotics for walking shoes. The doctor who considers this approach will improve clinical efficacy and outcomes, while being assured of patient satisfaction at the same time.



  1. Bigos S, Bowyer O, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline, Quick Reference Guide Number 14. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, AHCPR Pub. No. 95-0643. December 1994.
  2. Yochum TR, Barry MS. The short leg (revised edition). Practical Research Studies 1994; 4(5).
  3. Yochum TR, Rowe LJ. The Essentials of Skeletal Radiology (2nd ed.). Baltimore: Williams & Wilkins, 1996:363.

Mark Charrette,DC
Las Vegas, Nevada

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