During a time when people are working from home and distancing in the midst of another New England winter, many are looking for a way to stay more active. A simple way to do this is by beginning a walking program. Walking regularly is easy to start, provides a change of scenery, and has many other benefits. However, if you haven’t been active lately, it’s important to start gradually and to seek advice as needed. If you have concerns more specific than those addressed in this article or are trying to begin walking after an injury, we can provide further advice by appointment.

Benefits of Regular Walking and Aerobic Activity

• Improved risk factors for cardiovascular disease including reduction in blood pressure, weight, and Body Mass Index, 
• Lower risk of functional limitation in those with knee osteoarthritis
• Strengthen bones and muscles, provide consistent mobility to joints 
• Psychological benefits including reduced rate of depression

How much and how fast should I walk?

• American College of Sports Medicine guidelines on aerobic activity suggest people 18 – 65 years old should participate in 30 minutes of moderate intensity physical activity 5 days/week OR 20 minutes of vigorous intensity activity 3 days/week, or a combination of the two
• See below for definitions of moderate and vigorous activity levels

How to Start a Walking Program

The nice thing about walking is that there is a low barrier to entry, meaning it doesn’t require any special skills or any equipment other than a pair of shoes. It may be a daunting task to commit to the full ACSM recommendations for physical activity right away, especially if you have not been moving much at all. This guide will help you build up slowly over time until you are either meeting or exceeding the recommendations.

• Begin with 3-5 days/week, walking at a light pace for 15 – 20 minutes
• Begin increasing the time and frequency of your walks until you are doing roughly 30 mins/day, 5 times/week. 
• Start to increase intensity of your walks, working in short intervals of fast walking in order to increase your heart rate(see how to measure pulse rate below)
• Use your change in heart rate to monitor your intensity level

Sample Beginner 6 Week Walking Program

Week	# days/week	# minutes/day
1	3–5	15–20
2	4–5	20–25
3	4–6	25–30
4	5–6	25–35
5	5–6	30–40
6	5–6	35–45

This walking program is designed with the goal of working up to a moderate intensity for the majority of each session.

CDC definitions for moderate and vigorous activity

• Moderate: 64% – 76% of maximum heart rate 
• Vigorous: 77% – 93% max HR 
• Estimated Max Heart Rate = 220 – Age
  • This is variable depending on other factors such as age, medications, and cardiovascular medical history
• Read more on how to calculate your target heart rate for moderate and vigorous intensity activity

How to measure pulse rate manually

• Most smart watches and fitness trackers will monitor heart rate during activity. However, monitoring your pulse manually is fairly simple
• Hold index and middle finger over carotid (area on neck just outside of the windpipe) or radial artery (pulse felt on the front outside of your wrist toward the thumb) until you feel a beat

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• Count beats for 30 seconds and multiply by 2 or count beats for 60 seconds for most accurate result
• During walking, briefly pause walk in order to accurately measure and monitor pulse rate
• As you build your aerobic capacity, your cardiovascular system will begin to work more efficiently, meaning your heart rate at rest and during activity at a similar intensity should decrease

If you develop a problem that prevents you from doing these activities and requires further attention, please reach out to us to schedule an appointment for an evaluation so we can help you get back to doing what you want to do!

Disclaimer

The information in this article is intended for informational and educational purposes only and should not be taken to be the provision or practice of Physical Therapy services. It is not intended to delay or substitute diagnosis or care from a Physical Therapist or other healthcare professional.

Resources

1. Centers for Disease Control and Prevention. (2011). Target heart rate and estimated maximum heart rate. Atlanta, Georgia: Centers for Disease Control and Prevention.
2. Hanson, S., & Jones, A. (2015). Is there evidence that walking groups have health benefits? A systematic review and meta-analysis. British journal of sports medicine, 49(11), 710-715.
3. Kimata, C., Willcox, B., & Rodriguez, B. L. (2018). Effects of walking on coronary heart disease in elderly men with diabetes. Geriatrics, 3(2), 21.
4. Murtagh, E. M., Nichols, L., Mohammed, M. A., Holder, R., Nevill, A. M., & Murphy, M. H. (2015). The effect of walking on risk factors for cardiovascular disease: an updated systematic review and meta-analysis of randomised control trials. Preventive medicine, 72, 34-43.
5. White, D. K., Tudor‐Locke, C., Zhang, Y., Fielding, R., LaValley, M., Felson, D. T., … & Neogi, T. (2014). Daily walking and the risk of incident functional limitation in knee osteoarthritis: an observational study. Arthritis care & research, 66(9), 1328-1336.