Exercising with painful knees

Dear Dr Gardner:

I enjoyed your article about walking for exercise. I enjoy walking but I walk for exercise once per week. I also go bicycling twice per week and swim once per week. My plan is to increase my walking for exercise with the goal of doing it daily preferably in the early morning before the sun comes up. It is great for fresh air and just for well-being.

I really enjoy power walking but sometimes I get carried away because I love going very fast to get my heart pounding and later on my knees hurt. I had damaged them by jogging on pavement without proper running shoes about a year ago. Now, I have to take glucosamine and chondroitin daily for joint support. I can't walk slowly because it doesn't feel like I am getting any benefit from walking.

Dear Reader:

Thanks for your interesting and informative letter. Commendations are in order for your excellent exercising programme. The combination of walking, bicycling, and swimming is an excellent example of an exercise programme with variety. Variety is necessary to keep you interested and motivated.

The value of walking and swimming has been highlighted in previous articles but not bicycling. Cycling is a non-weight-bearing activity. It is an excellent exercise for people with lower back or lower body injuries or muscle weakness. Cycling is very helpful in the development of cardio-respiratory fitness, muscle strength and leg endurance. The stationary bicycle (ergometer) has made cycling even more attractive.

Power walking

Power walking is a novel way to make walking more challenging and beneficial. A good way to make power walking more helpful is to increase the weight you carry. Your knees are prone to overuse syndrome or tendinitis. This may be due to the excess tension required of the muscles that help to abduct your hip when your weight is on one leg.

This is compounded when you walk fast because of the added impact your foot makes when it hits the ground. Try to avoid hard surfaces such as paved areas, the natural terrain or grass are less hostile to your feet. Good footwear is a valuable investment to help prevent the injuries and discomfort that you have been experiencing. A good pair of shoes that fits comfortably is essential. It should not lean to either side when placed on a flat surface. The shoe should bend at the ball of your foot, not in the middle. A solid outsole and good durable midsole or shock absorbing feature are necessities. This should help to reduce and eliminate your need for any medication.

Jog and walk

You can also place more emphasis on the swimming and cycling component of your prescription until your knees are more tolerant to power walking. Swimming and cycling are less stressful on your legs so you tend to do those activities more vigorously. This is partly responsible for slow walking being less enjoyable for you.

You can make the walking component of your exercise regime more challenging by doing a combination of walking and jogging - walk two times the distance you jog; walk the same distance you jog; jog twice the distance you walk; jog three times the distance you walk; jog four times the distance you walk. If the distance is difficult to decipher use time instead.

Dr Kenneth Gardner is an exercise physiologist at Holiday Hills Research Center; email: yourhealth@gleanerjm.com.