Walking on Eggshells

"There has been debate about barefoot running being good or bad, or shoes being good or bad, and this is the wrong debate. It should be about what the costs and benefits of shoes are and how we can better understand how shoes affect our feet, our health, the way we walk."
"We live in this weird world where calluses are bad, like you have a problem with your shoe, and you go to a podiatrist, and they remove them. But until recently it was abnormal not to have calluses." "We’ve lost touch with our bodies in some respects and this is a good example of that. When we tell our results to barefoot people, they say, 'Tell me something I don’t already know'."
"I'm not saying people shouldn't wear shoes." 
"If your feet can’t sense what’s going on on the ground, maybe you’re more susceptible and more vulnerable [to falls], and shoes may be a part of that. If we can give people’s brains, their reflexes, more information, that might help them."
"I find it unimaginable to be barefoot in middle of Europe in the Ice Age, but then again, all the other animals in Europe during the Ice Age were barefoot—so maybe our cousins, the Neanderthals, were able to handle it just fine."
Daniel E. Lieberman, Edwin M. Lerner II Professor of Biological Science, chair, Department of Human Evolutionary Biology, Harvard University

"We tested the sense of touch, the dynamic sense of what you feel on the ground. We found these stiff calluses don’t prevent any communication between the force of the feeling of what you are stepping on and what makes its way to the nerve cell to be transmitted to your brain."
Nicholas B. Holowka, postdoctoral fellow, Graduate School of Arts and Sciences, lecturer in Human Evolutionary Biology

Credit: Getty Images

 A new study recently published in the journal Nature, posits that when people wear shoes it alters their natural way of walking, a manner of walking that nature designed us for, shoeless. The study builds on earlier research whose findings popularized barefoot running. The study conclusion was that when walking, people move differently when barefoot than they do when their feet are encased in shoes. Moreover the sensitivity of the sole of the foot to the ground differs as well. An unclad foot is directly exposed to the texture of any surface being walked upon, whereas the sole of the shoe interrupts that sensitivity to a degree without entirely erasing it.

What the researchers feel, however, is that the differences in sensitivity, in feeling between the sole of the foot and the surfaces being trod upon may have the potential to affect balance (which presumably is compensated for in the way the body responds to the differences) as well as joint loading. One of Dr. Lieberman's takeaways, is that this could lead to arthritis for some people. The intimation is that it may be advantageous to walking and running with bare feet. One of the surprise findings was the advantage of a bare foot coming directly in contact with the ground, is the gradual build-up of calluses.

Yes, those are the calluses that are seen as an impediment to good foot health, that we take as a signal that something is wrong. When calluses develop, on the other hand, as a result of constant direct contact with the ground by a bare foot, they tend to serve as a protective screen, making the foot while not impervious to harm from stones, roots, sharp objects, better able to absorb the shock that interacting directly with those objects results in, on contact.

Dr. Lieberman has wondered at the function of calluses even while most people consider them unsightly, needing to be removed. After mulling the issue over, that the calluses could conceivably be viewed as an advantageously unacknowledged utilitarian purpose, he decided to launch a study to revolve around that hypothesis. He and a team of collaborators took to comparing how a select subject group in Kenya walked, with and without shoes, then comparing the results with a similar group in Boston.

At the Lieberman lab in Boston when male and female volunteers walked on treadmills barefoot their feet hit the g round in a manner very similar to the unshod walkers in Kenya, but when the volunteers wore average cushioned sneakers, there was a subtle alteration in their walking pattern. Their feet struck the ground slightly more lightly initially, yet the stride impacts lingered longer than when the subjects were barefoot. Impacts of this nature tend to move up, dissipating through legbones, ankles and knee joints.

Custom-built device used to measure tactile sensitivity of foot at different frequencies. Credit: Daniel Lieberman

The shorter, sharper jolts felt when people walk barefoot on the other hand, are likelier to rise through soft muscles and tendons in the body, according to Dr. Lieberman. Suggesting that the way people walk is determined by what is worn on their feet. Shoes have a protective function, and absorb the slight pounding that feet undergo while walking, but at the same time they alter strides and over time have the potential to increase pressure and wear on leg joints.

The particular calluses that arise when walking shoeless on the other hand, shield the foot from discomfort of coming in contact with objects on the ground while barefoot, even while not reducing contact with and the ability to feel the ground's complex texture. Which suggests that people experiencing concerns over balance, and less concerned over how their feet would appear with calluses might benefit from walking about barefoot at times.

Comparing the foot of a shoe wearer vs. the barefoot walker. In Kenya, researchers measured the biomechanics of the barefoot walker.

Photos by Thomas Milani and Daniel Lieberman

Consider The Choice

"There has been a great deal of scientific research about sit-stand desks in the past few years, but we have only scratched the surface of this topic."
"With my background in occupational injury prevention, I wanted to gather what we know so far and figure out the next steps for how can we use these desks to better benefit people in the workplace."
"There are health benefits to using sit-stand desks, such as a small decrease in blood pressure or low back pain relief, but people simply are not yet burning enough calories to lose weight with these devices."
"Though these are mild benefits, certain populations might benefit greatly from even a small change in their health. In order to achieve positive outcomes with sit-stand desks, we need a better understanding of how to properly use them; like any other tool, you have to use it correctly to get the full benefits out of it."
"There are basic ergonomic concepts that seem to be overlooked. Many workers receive sit-stand desks and start using them without direction. I think proper usage will differ from person to person, and as we gather more research, we will be better able to suggest dosage for a variety of workers."
"There is still more to learn about sit-stand desks. The science is catching up so let's use what we've studied in this area to advance the research and answer some of these pressing questions so that people can use sit-stand desks correctly and get the most benefit from them."
Dr. April Chambers, assistant professor of bioengineering, Swanson School of Engineering, University of Pittsburgh

 

"In general, prolonged static postures including both sitting and standing, are associated with poor health and increased injury risk and discomfort."
Study conclusion

Sit-stand desks, once a novelty, have become the mainstream, a response to the crisis headlines that report too much sitting equals serious health risk. Given that office workers tend to spend eight to ten hours daily seated, the new office features sit-stand desks as standard equipment. These desks offer an alternative to all-day sitting; the user can opt to stand while they're working, or alternate between sitting and standing throughout the work day.

Claims by marketers for the manufacturers of these desks are that sit-stand desk use ends up burning more calories since more energy is needed to stand rather than sit; they lead to improved work habits, better blood circulation and posture is maximized with these desks as compared to a traditional desk-and-chair.

Those claims propelled workers to opt for the sit-stand version of the old desk-and-chair. Since then, research to measure the impact of the new office equipment has reached its own inconclusive conclusions. Nothing is ever as simple as it seems.

Recently a multidisciplinary team of American researchers conducted a review of sit-stand desks for their role in improving [or disproving claims] mental and physical health, work performance, discomfort, behaviour and posture. Of the 549 publications the team studied, the outcome was narrowed to the most relevant 53 of which 21 took place in the workplace, 25 in the laboratory, and 7 in the field.

People who use a sit-stand desk for work stand more, between an estimated 30 minutes and three hours, as opposed to those workers who relied upon a traditional desk. On the other hand, health benefits appear to be more tenuous than advertised, between standing versus sitting, since the majority of studies noted no significant alteration in blood pressure, cholesterol levels or other markers linked to cardiovascular health among those who used sit-stand desks.

Exceptions related to several studies making use of subjects who were obese, and they realized small improvements in energy expenditure and glucose levels. Some study subjects reported that they felt less tired at work, and others noted the opposite effect. Swollen feet resulted for some subjects, common among people required by the nature of their work to stand on their feet all day.

Moving from one stationary position to another made little difference in the number of calories burned; about 6 calories more per hour, equivalent over the course of a day to the number of calories in a small slice of bread.

And while some of the subjects felt they were increasingly productive while standing, others found that sitting while working was easier. As for mood improvement whether standing or sitting, it proved to be inconclusive. One positive conclusion emerged from standing where study subjects felt that after 12 weeks their low back pain had eased at work as well as during other daily activities.

Study authors are unanimous on one shared conclusion; the need to get up from a desk regardless of whether it's a conventional one or a sit-stand desk, and to move away and move about. The sedentary effects of office work can be temporarily dispelled by leaving the desk and taking a break for a brief period of exercise, of walking about, and it is those breaks that aid in boosting mood, burning calories, and improving work productivity, and toward overall improved health.

Back to the old standbys of walking where and when one can; taking the stairs rather than elevators, walking down the hall to another office to convey a message otherwise sent by email; leaving the building and indulging in an outdoors walk, just simply moving about rather than remaining tethered to a desk -- any kind of desk.

Credit: Sun Lee

Taking Note of Potential Dog-Walking Risks for Seniors

"Dog walking, which has repeatedly demonstrated social, emotional and physical health benefits, is a popular and frequently recommended activity for many older Americans seeking new ways to stay active."
"This study highlights that while there are undoubtedly pros to dog walking, patients’ risks for falls must be factored into lifestyle recommendations in an effort to minimize such injuries."
Kevin Pirruccio, medical student, Perelman School of Medicine, University of Pennsylvania

"We make all these recommendations about pets, and yet we don't really understand if there are potential negative implications."
"There are things we should be aware of before saying, 'Hey, you should get a dog and take your dog for a walk'."
Jaimo Ahn, associate professor of orthopedic surgery, Penn Medicine

A growing body of research is discovering that pet ownership and health and happiness go together. But this is also a new area of study, without having as yet achieved any robust sample sizes or control. Now a new study, while validating that seniors who bring companion pets into their homes and respond to the dogs' need to exercise -- taking them out for daily walks -- are in the process aiding their own health for the better, it is the very act of walking with a leashed dog that "imparts a significant and rising injury risk in older adults".

Unsurprising, since leashed dogs are known to pull impatiently, are able to walk more speedily than their people; dogs sometimes get underfoot and cause stumbles; and if an older person is walking on uneven ground, it presents no hazard for a four-footed animal, but it might for a human. Dogs can get into an altercation with another dog while on leash. In short, any number of causes for a stumble or a fall can arise when walking a leashed dog in an outdoor environment. Winter walks present even more challenges with icy surfaces underfoot.

The University of Pennsylvania researchers' study found that between 2004 and 2017, bone fractures associated with walking leashed dogs doubled, and then some, among U.S. residents 65 years of age and up, of whom eight in ten who suffered fractures were women. The most commonly injured bones were in the hips, wrists and upper arms. The U.S. Consumer Products Commission which records injuries, reported a nationally representative sample of some 100 emergency rooms nationwide and produced a public data base of dog-walking fractures.

Those fractures increased from 1,572 reported in 2004 to 4,396 in 2017, a reported number of incidents that rose at a significantly higher rate as compared to the overall number of fractures. Baby boomers, pointed out Dr. Ahn, are more active than their counterparts in previous generations, and he believes that health-care providers are increasingly suggesting to their patients that having a dog in their household would give them an incentive to get out and get walking, to improve their overall health, without thinking through to important caveats.

The study, published in JAMA Surgery, focused exclusively on seniors, representing a group that Dr. Ahn felt his team of researchers recognized as most vulnerable to this type of physical injury, for whom broken bones can result in a particularly insidious outcome. The study, emphasized Dr. Ahn, was not meant to discourage seniors from acquiring dogs as pets, nor to get out walking with them. Health care providers, he stated, should ideally discuss risks with patients and older people in particular.

Karen Arnold via Wikicommons

Recreational Pleasure and Health Benefits

"Walking and running provide an ideal test of the health benefits of moderate-intensity walking and vigorous-intensity running because they involve the same muscle groups and the same activities performed at different intensities."
"The more the runners ran and the walkers walked, the better off they were in health benefits. If the amount of energy expended was the same between the two groups, then the health benefits were comparable."
"Walking may be a more sustainable activity for some people when compared to running, however, those who choose running end up exercising twice as much as those that choose walking. This is probably because they can do twice as much in an hour."
"People are always looking for an excuse not to exercise, but now they have a straightforward choice to run or to walk and invest in their future health."
"It takes longer to walk a mile than to run a mile. But if you match them up on the energy expended, they are comparable. If you do the same amount of exercise – if you expend the same number of calories – you get the same benefit."
Paul T. Williams, staff scientist, Lawrence Berkeley National Laboratory, Life Science Division in Berkeley, California

• Running significantly reduced risk for first-time hypertension 4.2 percent and walking reduced risk 7.2 percent.
• Running reduced first-time high cholesterol 4.3 percent and walking 7 percent.
• Running reduced first-time diabetes 12.1 percent compared to 12.3 percent for walking.
• Running reduced coronary heart disease 4.5 percent compared to 9.3 percent for walking.

"Walking at any speed costs some energy, but when you're changing the speed, you're pressing the gas pedal, so to speak."
Ohio State research team

Benefits to walking as a leisure time activity that gets you out and about: breathing fresh air, appreciating an outdoor landscape, bringing you closer to nature, allowing you to relax, your mind to wander and your daily concerns to recede into the background as your mood lifts. Walking is known to help in the reduction of anxiety and depression symptoms; as a mood elevator; being in tune with nature, in a green setting has few parallels. According to some researchers, happiness is boosted when walking becomes a regular feature in one's life.

Women in a study reported having greater energy, were more inclined to be socially active, less likely to surrender to out-of-control emotions, and less hounded by depression once they began routinely walking on a regular basis, amounting to 200 minutes weekly. Researchers from Santa Clara University gathered 176 college students, assigning them a walking schedule, because their study goal was to discover if "a simple walk might lead to more free-flowing thoughts and more creativity".

The walkers, it turned out, were more creative once they returned to their desks, compared to those who didn't participate in the experiment. Creativity flourished while the participants were out walking, regardless of whether they walked in fresh air or used a treadmill instead. The end result was more ideas coming to mind while walking in comparison to those who simply remained at their desks.

Yet another, earlier study undertaken in 2013 took 33,060 runners and 15,045 walkers as participants to determine whether the intensity and energy expended in walking serves to produce similar heart health benefits as running. The Berkeley, California researchers reached the conclusion that "If the amount of energy expended was the same between the two groups, then the health benefits were comparable". Walking reduced risk of hypertension by 7.2 percent as opposed to a 4.2 percent drop in runners.

Runners' risk of high cholesterol was reduced by 4.3 percent, while walkers' risk dropped by 7 percent. As for diabetes risk, it fell by 12.3 percent for walkers and 12.1 percent in runners, while heart disease was reduced by 9.3 percent for walkers and for runners 4.5 percent. So walking most definitely earns its place in the firmament of good health-achieving initiatives, and it can be done anywhere, at any time.

Another bonus comes by way of speeding up the walk for random periods to achieve an even greater health impact. Moving at an average or brisk pace, walkers benefited from a 20 and 24 percent reduced risk in mortality from all causes, in comparison with those who maintained a more leisurely stroll. For adults aged 21 to 40, moderate intensity in walking equates with 100 steps a minute, while 130 steps per minute is considered fast walking.

According to an Ohio State research team, changing speeds during a walking workout can burn up to a 20 percent greater number of calories, in comparison to remaining stuck at a single speed. Monitor walking speed simply by speeding up until you feel a bit breathless, then slow down to allow breathing to return to normal. As simple as all that.