Walking requires muscle strength, flexibility of hips and cardiovascular endurance. Taking what we know from sports rehabilitation, all three of these components are required for efficient community ambulation. One example of community ambulation is the ability to park your car and walk to the grocery store, shop and return to the car without any needed assistance.
A task oriented physical therapy intervention would direct us to focus on walking to encourage further walking. However, in physical therapy nothing is ever that simple. A patient may have had a surgery that required convalescence. It just takes on average two weeks of limited activity to cause muscle atrophy and weakness. The older you are, the faster the atrophy happens.
It will take anywhere from 4 to 6 weeks to regain muscle strength and endurance after a period of convalescence or lack of activity. Consistency is the key. You must perform an activity that raises your resting heart rate for 20 to 30 minutes per day to gain stamina and endurance. Stationary cycling, swimming, or treadmill walking are excellent forms of cardiovascular conditioning.
Favorite Ankle strengthening Exercise:
Heel Raises on a Raised Step
Start with your heels lowered off the step, feeling a gentle stretch. Then raise your heels into a high heeled position. Push your body straight up. Try not to use momentum. Do 6-10 reps, 2-3 sets.
Resistance exercises are also very important to achieve the muscular strength for walking. Ankle plantarflexion strength allows toe off during the gait cycle as well as forward momentum. Studies have indicated that the slower the gait, the bigger the chance of falls. The ability to dorsiflex the ankle (bringing toes up) allows for clearance of the foot. The chances of catching your toe and stumbling decreases with proper foot clearance.
A Beginner Hip Extension Exercise:
Glute Bridge
Start with lying on your back with knees bent and feet flat. Engage your buttocks while raising your hips up. Relax the buttocks as you come back to starting position. Do 6-10 reps, 2-3 sets. Hip mobility for walking is gained with increasing hip extension. Without normal ROM of hip extension, the stride length will decrease and can contribute to a shortened or shuffled gait. The ability to extend the hips requires gluteal, hamstring and adductor strength.
Global Single Leg Strengtheners:
Forward/Backward Lunge
The forward lunge is a dynamic movement that targets the quads while the reverse lunge is a more stationary movement targeting the hamstrings and glute max. Do 5 reps each side, 2-3 sets.
Isolated Single Leg Hip Strengthener:
Standing Hip Abduction/Extension
You can also increase hip mobility and strength in standing by tapping your foot to the side (abduction) or behind (extension). Placing a resistance band around your ankles is a great way to increase the intensity.
Do 6-12 reps, 2-3 sets.
