Conway McLean, DPM, Journal columnist

Heart problems are considered serious business, as well they should be. You can lose half of your intestines and do okay, but you can’t function without your heart working properly.

As a general rule, a malfunctioning heart is not conducive to a healthy life. But the cardiovascular system is a complex one and is prone to all manner of problems. Unfortunately, many of them are the result of our own actions, or, alternatively, our inaction.

One out of twenty Americans suffers from some form of heart disease, of which there are naturally several types. Heart disease can manifest in other ways besides the infamous heart attack, leading to sudden death without appropriate measures. A stroke is commonly a byproduct of cardiovascular disease, but so is recurrent chest pain. Fainting can be due to heart and blood vessel dysfunction as well.

Heart disease, more accurately termed ‘cardiovascular disease’ (CVD), takes the lives of about 18 million people per year. Technically, CVD is a group of disorders of the heart and blood vessels. A heart attack is, more precisely, a myocardial infarction, which is often the result of coronary artery disease (narrowing of the vessels supplying the muscles composing the heart).

A disease of such significance predictably has been the subject of numerous studies and extensive research, with attempts continuing to determine the best approach for care. We have numerous medications for heart and artery diseases (since we have many medications for everything) and a host of surgical procedures are performed in the treatment of CVD.

Both of these therapeutic approaches to cardiovascular disease have and will continue to save millions. But there is a prescription without the potential for complications that accompany these two. It is a “medicine” so powerful it is of benefit in the treatment of hundreds of conditions while also aiding mood and helping to reduce weight. As the astute reader may have surmised, we are referring to the exercise prescription.

How often does the typical cardiologist’s visit include a recommendation for exercise? It’s a frequent occurrence since the heart is a muscle, arteries have muscle in their walls, and as we all know, muscles need to be exercised to be strong. Muscle tissue gets weak if not worked, so the next question is how best to do that? The most common suggestions for exercise by heart doctors is biking, walking, or swimming.

Which of these is most likely to be pursued by most Americans? The latter option is the most difficult and least utilized. Most of us don’t have easy access to a pool and if you do, it too often requires devoting significant time to the workout. The first is also more difficult and certainly more dangerous. Too small a percentage of US citizens have ready and available bike lanes and good trails. And many aren’t particularly comfortable bicycling amongst the millions of fast-moving automobiles on our streets.

Walking is the way to go for most Americans looking to get some exercise, favored since it gets you outside, breathing (hopefully) fresh air, seeing the sites. And it is relatively safe. A healthy walk can be invigorating, depending on your settings. But how can you go for a stimulating stroll if you have pain from your feet or legs as so many people do? Foot pain is experienced by a higher number than you might think, about 30 percent of us, while about 25 percent of American adults mention having knee pain.

Make no mistake, pain gets in the way of our movement, activity, and exercise. Many respond to pain by stopping their walk, or by not going at all. Another tactic is to move differently, or “tensing up,” but changing your gait style will usually result in some other structure becoming symptomatic eventually. And powering through the pain for your workout is a recipe for tissue damage, tendon rupture, or some similarly debilitating event.

As is predictable, it is of great benefit to have foot pain treated, with a physician specializing in that part of the body being likely the most productive. So many chronic, painful concerns arise because of the repetitive “micro-trauma” of poor biomechanical function, a subject of special focus for some foot and ankle physicians. Even pain from the knees may be a byproduct of faulty body mechanics. Also common is a symptomatic ankle from some old injury or sprain, a condition which can often be resolved without surgery.

The focus of much of podiatric therapies and research is to get people on their feet, walking well, safely and comfortably. Something as simple as resolving a painful callused lesion on a toe, the infamous ‘corn,’ can lead to a faster pace or a longer walk. An inflamed tendon from a lowered arch won’t complain if properly stabilized by some type of arch support (more aptly termed a body support since anything under the foot is providing a foundation for the whole body). Another example of an everyday biomechanical issue, resolved without surgery or downtime. And this approach entails no surgery or lifetime pharmaceutical prescription. Simply put on your shoes! (As long as your foot orthotics are in them.)

A consensus has been reached: walking is a promising strategy for yielding cardiovascular health benefits for many patient populations. Included in this list are those with diabetes, the obese, the elderly, and the many Americans who are less likely to perform vigorous physical activities. The importance of walking in improving cardiovascular health is supported by both observational research as well as interventional studies. Walking is good medicine.

Most residents of technologically advanced cultures are not active enough, with all the modern conveniences at our beck and call. But inactivity is bad for the heart, it’s a muscle and needs to be worked. We’ll see less heart disease, better circulation, and be generally healthier as a nation if we move more. If you have foot or leg pain on a regular basis, have it treated so you can walk pain-free. Then pull on your walking shoes, go outside, and get moving.

EDITORS NOTE: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.