As someone who has had back pain and stiffness on walking even 50 meters, due to disc degeneration since my teens (I am now 77 years old), and who has, as a result of this, walked bent over about 30 degrees ever since (a condition I call Posturis Horribilis), I want to share with you my striking experience with walking with special ski-like poles.
I started Pole walking or Nordic walking four months ago. I also had suffered for years from bilateral hip pain on walking, despite having had one hip replaced once and the other twice in the past five years. In addition my right knee has been aching for the last year on walking the same 50 meters. A mess!
Then I went to a meeting on Pole (or Nordic) -walking four months ago, and I was given two modified ski poles (corrected for my height) and instructed in how to walk with them. The instruction was free and took 5 minutes. Then off I went … Immediately I sensed something unexpected. I was waiting for my inevitable pains to kick in in my back, hips and knee – but nothing happened! Nothing! 50 meters, 100 meters, 500 meters, 1000 meters, and here I was standing straight up instead of bent over, walking quickly, and free of pain in my back, hips and knee! And not desperately looking for a place to sit down to relieve the inevitable pain. There was none to relieve.
How could this be? I had never had such relief with Feldenkrais stretching exercises, chiropractic manipulations, physiotherapy exercises, manipulations or massage treatment, water exercises, or Pilates. And my 3 times a week 2-hour workouts at an exercise center for 5 years in Netanya (where I live), including cycling and 23 stretching and muscle strengthening exercises, had never relieved the discomfort. If anything, I was worse than when I had started there 5 years earlier.
As an internist at Ichilov Hospital in Tel Aviv (still working), and Professor of Medicine at Tel Aviv University, and having written over 160 papers on medical subjects, my scientific interest was kindled by this startling experience. I hit the books (medical literature) to find out more about this 'strange' therapy.
I found that there has been an enormous amount of research done on Nordic walking over the last 25 years, but specifically on the subject of back pain there was very little information. By coincidence, the best paper on this subject appeared in a major medical journal only six months ago. This paper by Dr Park and associates, from Chosun University in South Korea, employed walking using Nordic poles for elderly women with chronic back pain. Their results showed that low back pain during walking decreased greatly (about 85%). Why? Because the upper extremities were used together with the lower extremities during the walking using the Nordic poles.
More effort and more calories burned
To quote them: "Nordic walking using the poles was a full-body exercise, and it developed the upper and lower body muscles simultaneously. This exercise strengthened the paraspinal muscles (muscles along the spine) and enabled the participants to maintain a steady position (in the back) for a long period, because the abdominal muscles, pelvic muscles and nervous system were used together. This exercise can improve muscle strength and muscle endurance and consequently could be useful for recovering the normal angle balance of the trunk (straighten the spine) and relieve pain. In this study, the effect of pain reduction in the muscles from these enhancements and the reduction of the weight load reduces the pain as a result of the normalization of the spine (which was) in misalignment displacement."
The reason the weight load on the back, hips and knees fell is that part of the weight is being carried by the poles. For example I weigh 85 kg normally but when I use the poles to partly support me, the weight falls to 55 kg on my scale, since the other 30 kg are being carried by the poles and the arms. This puts less pressure on the spine and lower limbs.
The fact that I was using the upper part of my body, which is not generally used with ordinary walking, leads to several things:
- Pole walking causes one to stand up straight with good posture instead of being bent over, which means that there was no excessive (or asymmetric) working of any of the back muscles, which could cause spasm or pain. All the muscles are contracting equally and strongly.
- You use 90% of all your body's muscles instead of only 60% that occurs with ordinary walking.
- Because of this you burn 46% more calories than in ordinary walking.
- This means that you are likely to lose more weight than in ordinary walking. This has been proven, and is associated with improvement in serum cholesterol levels and in blood sugar levels in diabetics.
- Despite the extra exertion you do not feel more tired or short of breath. This is hard to believe but is true. Exercising the upper part of the body does not seem to cause any more fatigue or shortness of breath than walking normally. I personally cannot understand this striking fact, but it has been shown in a dozen research studies and I feel it. You get a bargain – more effort and more calories burned but with no added fatigue! Go figure!
- The stretching of the muscles in the neck and shoulder with pole walking helps to relieve neck and shoulder pain as well. Another bargain.
- The fact that you are using 4 legs to walk instead of 2 (the 2 poles act as legs) means that you are more stable and less likely to fall. This instability is particularly seen in people with Parkinsonism, and they feel much more stable and walk better if they walk with the poles. And elderly patients without Parkinsonism have also noticed this improved stability. This makes you less likely to fall.
- The group with poor blood flow (circulation) in their legs – intermittent claudication – has also been helped. Because of the lack of circulation, they develop pain in their legs on walking and have to stop walking every few minutes for a minute or two. They have been able to at least double the distance they walk when they use the poles.
- Not only is the pain less, but the poles allow you to take longer and more frequent steps and therefore walk faster.
- The poles improve physical strength and endurance, as all the muscles become more developed. Endurance increases by about 27%. This form of exercise is now used in rehabilitation in people after a heart attack, heart failure, chronic lung disease and different kinds of arthritis.
- Studies have shown that the quality of life improves.
I have interviewed 12 people who also had severe back pain from various causes, such as spinal stenosis, lumbar discs or knee replacement, and who, despite surgery, were still suffering, and who had a great improvement in back pain or knee pain on using the poles. Many of us walk together in Netanya once a week. I would be happy to hear of the experience of others with these problems who have used Nordic Walking.
Nordic walking develops upper and lower body muscles simultaneously
What is surprising is that such a simple and inexpensive treatment (350-450 shekels for 2 adjustable poles) is not being used by more people in Israel. The instruction is usually free and very short (just a few minutes). And if you Google "Nordic Walking" or "Pole Walking" on the Internet, a few minutes of watching and listening to a video or two will give you most of the facts. Millions of Europeans and Americans use these sticks for walking, with or without medical problems. Why not us? And why does the medical establishment not catch onto this? I looked at 12 recent textbooks on back pain in the Ichilov Hospital Medical Library - Orthopedic, Rheumatology, Physical Medicine and Pain text books. None even mention this form of treatment. And I spoke to medical specialists in each of these fields at Ichilov Hospital and none had used them in their patients. Strange and sad.
As for me, it is wonderful to be able to walk in nature without pain and to talk to the birds, bees, butterflies and flowers, and listen to the music of the meadows, the woods and the mountains. These are pleasures I could previously never really appreciate fully because of the pain and stiffness.
As Wordsworth wrote in 1815:
My heart with pleasure fills
And dances with the daffodils
If you want to talk to me about this, I am at 09 866 5715 or 052 515 0375 or at
Donald Silverberg MD, MSc, FRCP (C)