Walking

Walking is a fundamental, low-impact cardiovascular activity that emphasizes sustained aerobic metabolism, lower body endurance, and daily movement capacity. Often underrated, walking serves as an excellent modality for Zone 2 cardio training, active recovery, and building a base of general physical preparedness while placing minimal stress on joints and connective tissue.

Quick Reference

Aspect	Details
Primary Muscles	Glutes (hip extension), Quadriceps (eccentric control), Calves (push-off), Hip flexors (swing phase)
Secondary Muscles	Hamstrings, Core stabilizers, Hip abductors (glute medius), Tibialis anterior
Energy Systems	Primarily aerobic (90-100%), excellent for fat oxidation and Zone 2 training
Common Injuries	Plantar fasciitis, Shin splints (rare), Low back pain (usually from pre-existing conditions)

Muscles Trained

Walking involves a continuous, cyclical gait pattern with lower intensity and impact compared to running. Muscle engagement is sustained and aerobic rather than explosive, making it ideal for building endurance without significant tissue breakdown.

Stance Phase (Heel Strike to Toe-Off)

Glutes (Hip Extension)

Role: Drive hip extension to propel the body forward during mid-stance

Activation Level: Moderate (40-60% of maximal voluntary contraction)

Function Details:

• Gluteus maximus extends the hip during mid-stance through toe-off
• Glute medius and minimus stabilize the pelvis in the frontal plane, preventing hip drop on the stance leg
• Lower intensity than running but more sustained engagement throughout the gait cycle
• Often undertrained in sedentary individuals, leading to compensatory patterns

Training Note: Walking uphill significantly increases glute activation (up to 100% increase), making incline walking an excellent glute-building modality

Quadriceps (Eccentric Control)

Role: Control knee flexion eccentrically during initial contact and loading response

Activation Level: Moderate (30-50% MVC)

Function Details:

• Vastus lateralis, medialis, intermedius, and rectus femoris decelerate knee flexion after heel strike
• Prevent excessive knee collapse during weight acceptance
• Work eccentrically to absorb impact (though forces are much lower than running: 1-1.5x body weight vs 2-3x in running)
• Less intense than running, making walking ideal for quad recovery

Training Note: Downhill walking increases eccentric quad loading, serving as a low-impact way to build eccentric strength

Calves (Push-Off)

Role: Generate plantarflexion during terminal stance and toe-off to propel body forward

Activation Level: Moderate (35-55% MVC)

Function Details:

• Gastrocnemius provides powerful plantarflexion during push-off
• Soleus maintains ankle stability throughout stance phase
• Sustained, rhythmic contractions develop calf endurance
• Less explosive than running but longer duration of continuous engagement

Training Note: Walking on toes or soft surfaces (sand, grass) significantly increases calf activation

Swing Phase (Toe-Off to Heel Strike)

Hip Flexors

Role: Drive the leg forward during swing phase

Activation Level: Moderate (30-50% MVC)

Function Details:

• Iliopsoas and rectus femoris concentrically contract to flex hip and advance the leg
• Tensor fasciae latae assists with hip flexion and stabilization
• Lower intensity than running but continuous engagement across thousands of steps
• Can become tight with excessive walking volume, especially uphill

Training Note: Hip flexors are less prone to overuse in walking compared to running, but sedentary individuals may still experience tightness

Tibialis Anterior (Foot Clearance)

Role: Dorsiflex the ankle to clear the foot during swing phase

Activation Level: Moderate to High (50-70% MVC during swing)

Function Details:

• Lifts the toes to prevent tripping during forward swing
• Eccentrically controls foot descent after heel strike
• Often weak in sedentary populations, leading to foot slap or shuffling gait
• Sustained activation across thousands of repetitions builds endurance

Training Note: Weak tibialis anterior is a common cause of trips and falls, especially in older adults

Hamstrings

Role: Decelerate the lower leg before heel strike, assist with hip extension

Activation Level: Low to Moderate (20-40% MVC)

Function Details:

• Biceps femoris, semitendinosus, and semimembranosus act eccentrically to control leg swing
• Assist glutes with hip extension during stance
• Much lower activation and injury risk compared to running
• Provide support without high-intensity loading

Stabilizers (Throughout Gait Cycle)

Core Musculature

Role: Maintain trunk stability and prevent excessive rotation or lateral flexion

Activation Level: Low to Moderate (20-40% MVC)

Function Details:

• Transverse abdominis and obliques stabilize the spine during gait
• Erector spinae maintain upright posture
• Rectus abdominis prevents excessive lumbar extension
• Continuous low-level activation develops core endurance

Training Note: Walking with load (weighted vest, backpack) significantly increases core demands

Hip Abductors

Role: Stabilize pelvis during single-leg stance, prevent hip drop

Activation Level: Moderate (30-50% MVC during stance)

Function Details:

• Glute medius is the primary hip stabilizer during stance phase
• Prevents Trendelenburg gait (dropping of pelvis on swing leg side)
• Gluteus minimus and TFL provide additional frontal plane control
• Weak hip abductors lead to compensatory lateral trunk lean

Training Note: Walking on uneven terrain or side slopes increases hip abductor demands

Minimal Engagement

Upper Body

Role: Maintain rhythmic arm swing for balance and minimal momentum

Activation Level: Very Low (under 20% MVC)

Function Details:

• Deltoids and arm muscles maintain gentle arm swing
• Trapezius and rhomboids stabilize shoulder girdle
• Minimal contribution to propulsion
• Can fatigue on very long walks (multiple hours)

Training Note: Walking with poles (Nordic walking) significantly increases upper body engagement

Intensity Variations

Normal Walking (3-4 mph)

• Baseline muscle activation patterns described above
• Comfortable, sustainable pace for extended periods

Brisk Walking (4-5 mph)

• 20-30% increase in muscle activation across all lower body muscles
• Greater glute and calf engagement
• Begins to approach power-walking mechanics

Incline Walking

• 50-100% increase in glute and calf activation
• Greater hip flexor demand for knee drive
• Excellent for building lower body strength while maintaining aerobic nature

Decline Walking

• Increased eccentric quadriceps loading
• Greater tibialis anterior activation for controlled foot descent
• Useful for building eccentric strength with low joint stress

Joints Involved

Walking places low, repetitive loads on lower body joints, making it one of the safest forms of exercise for joint health.

Ankle Complex

Movement Pattern:

• Dorsiflexion during stance phase (10-15 degrees) allows tibia to advance over foot
• Plantarflexion during terminal stance and toe-off (15-20 degrees)
• Subtalar joint controls pronation during loading response (4-6 degrees)

Demands:

• Impact forces: 1-1.5x body weight (significantly lower than running's 2-3x)
• Repetitive but low-intensity stress promotes joint health without excessive wear
• Adequate dorsiflexion mobility critical for normal gait mechanics

Common Issues:

• Limited dorsiflexion forces compensations up the kinetic chain
• Excessive pronation can lead to plantar fasciitis and posterior tibial tendon dysfunction
• Generally very well-tolerated even with mild arthritis

Knee Joint

Movement Pattern:

• Slight flexion at heel strike (5-10 degrees) for shock absorption
• Extension during mid-stance (near full extension)
• Flexion during swing phase (60-70 degrees for foot clearance)

Demands:

• Low compressive forces (1-1.5x body weight vs 2-3x in running)
• High repetition but low intensity per cycle
• Generally protective of cartilage health through nutrient circulation
• Thousands of repetitions without significant breakdown

Common Issues:

• Well-tolerated even with mild knee osteoarthritis
• Excessive valgus (inward collapse) indicates weak hip abductors
• Minimal risk of acute injury or overuse compared to running

Hip Joint

Movement Pattern:

• Hip extension during stance (typically 10-15 degrees behind body)
• Hip flexion during swing (20-30 degrees)
• Minimal abduction/adduction and rotation compared to running

Demands:

• Low-intensity, high-repetition movement
• Promotes joint lubrication and cartilage health
• Limited range of motion compared to running or other activities
• Excellent for hip joint health maintenance

Common Issues:

• Prolonged sitting limits hip extension range, reducing stride length
• Tight hip flexors are common and restrict optimal gait mechanics
• Generally very safe even with hip osteoarthritis (often recommended by orthopedists)

Spine

Movement Pattern:

• Maintains relatively neutral alignment
• Minimal rotation with natural arm swing
• Small amounts of lateral flexion with weight transfer

Demands:

• Low-level continuous postural muscle activation
• Promotes spinal mobility and disc health through gentle motion
• Weight-bearing stimulus beneficial for bone density

Common Issues:

• Pre-existing low back pain may be exacerbated by poor posture during walking
• Generally therapeutic for mild back pain when mechanics are sound
• Weak core can lead to excessive lumbar lordosis

Energy Systems

Walking is primarily an aerobic activity, making it exceptional for building aerobic base, improving metabolic health, and promoting fat oxidation.

Aerobic System (Oxidative Metabolism)

Dominance: 90-100% of energy production during typical walking

Characteristics:

• Oxidative metabolism of fats and carbohydrates
• Sustainable for hours with proper hydration
• Excellent for Zone 2 training (conversational pace, 60-70% max heart rate)
• Maximizes fat oxidation relative to carbohydrate use

Substrate Utilization:

• Easy walking (under 3 mph): 70-85% fat oxidation, 15-30% carbohydrate
• Moderate walking (3-4 mph): 60-70% fat, 30-40% carbohydrate
• Brisk walking (over 4 mph): 50-60% fat, 40-50% carbohydrate
• Incline walking shifts toward greater carbohydrate use

Metabolic Benefits:

• Improves mitochondrial density and function
• Enhances fat oxidation capacity
• Increases capillary density in working muscles
• Improves insulin sensitivity and glucose metabolism
• Supports cardiovascular health with minimal stress

Zone 2 Training Benefits:

• Walking is ideal for Zone 2 cardio (can sustain conversation, nasal breathing possible)
• Builds aerobic base without accumulating fatigue
• Promotes recovery between higher-intensity sessions
• Sustainable daily without overtraining risk

Anaerobic Contribution

Minimal Contribution: Under 10% even during brisk or uphill walking

When Engaged:

• Very steep inclines may recruit some glycolytic system
• Power walking at maximum pace (5+ mph) has minor anaerobic component
• Short bursts up stairs or steep hills

Practical Note: If walking feels heavily anaerobic (burning legs, rapid breathing), you've transitioned to jogging/running mechanics

Practical Applications

Fat Loss and Metabolic Health:

• Walking's high fat oxidation makes it excellent for fat loss
• Can be sustained daily without excessive hunger or fatigue
• Preserves muscle mass better than high-intensity cardio alone
• Improves insulin sensitivity and blood sugar regulation

Active Recovery:

• Low intensity allows recovery from intense training
• Promotes blood flow and waste removal without tissue breakdown
• Can be performed daily without interfering with other training

Daily Movement and NEAT:

• Walking contributes to Non-Exercise Activity Thermogenesis (NEAT)
• 8,000-10,000 steps daily associated with significant health benefits
• Builds aerobic base without dedicated "training" time
• Sustainable across lifespan

Endurance Base Building:

• Extended walks (60+ minutes) build aerobic capacity
• Low injury risk allows high weekly volume
• Serves as foundation for higher-intensity activities

Common Imbalances

While walking creates fewer imbalances than most activities due to its natural, low-intensity movement pattern, certain modern lifestyle factors still lead to predictable issues.

Undertrained Glutes

Pattern:

• Prolonged sitting inhibits glute activation
• Glutes fail to adequately extend hip during stance phase
• Quadriceps and hip flexors compensate for weak glutes
• Common even in regular walkers who sit most of the day

Manifestation:

• Shortened stride length (limited hip extension)
• Anterior pelvic tilt and excessive lumbar lordosis
• Low back discomfort during or after long walks
• Difficulty activating glutes during targeted exercises

Assessment:

• Single-leg glute bridge reveals weakness if hips drop or hamstrings cramp
• Trendelenburg test (hip drop during single-leg stance)
• Observation of gait: hip extension occurs primarily through lumbar extension rather than true hip motion

Performance Impact:

• Reduced walking efficiency and power
• Inability to walk briskly or on inclines comfortably
• Increased injury risk when progressing to hiking or running
• Lower back pain from compensatory patterns

Tight Hip Flexors

Pattern:

• Chronic sitting maintains hip flexors in shortened position
• Walking involves repeated hip flexion, reinforcing tightness
• Iliopsoas, rectus femoris, and TFL lose extensibility
• Creates anterior pelvic tilt and limits hip extension during gait

Manifestation:

• Limited stride length (can't extend hip behind body)
• Anterior pelvic tilt compensated by lumbar lordosis
• Low back pain, especially during longer walks
• Difficulty standing upright after prolonged sitting

Assessment:

• Thomas test: thigh lifts off table when opposite knee pulled to chest
• Observation: stride opens primarily in front of body rather than behind
• Tight feeling in front of hip when attempting to extend leg backward

Performance Impact:

• Reduced walking efficiency (shortened stride = more steps for same distance)
• Reciprocal inhibition of glutes (tight hip flexors inhibit glute activation)
• Low back pain from compensatory lumbar extension
• Poor posture both during and after walking

Weak Tibialis Anterior

Pattern:

• Often underdeveloped in sedentary individuals
• Responsible for lifting foot during swing phase
• Weakness leads to foot slap or shuffling gait
• Common in aging populations

Manifestation:

• Audible foot slap when heel strikes
• Shuffling gait pattern with reduced foot clearance
• Trips and stumbles over minor obstacles
• Shin soreness during or after walks (muscle working harder to compensate)

Assessment:

• Inability to walk on heels for extended distance
• Foot drop or slap audible during normal walking
• Difficulty dorsiflexing ankle against resistance

Performance Impact:

• Increased fall risk, especially on uneven terrain
• Inefficient gait mechanics
• Shin splints or anterior shin discomfort
• Reduced confidence walking on trails or uneven surfaces

Weak Core Stabilizers

Pattern:

• Many walkers never engage in dedicated core training
• Core weakness manifests during longer walks or when carrying load
• Excessive rotation, lateral flexion, or anterior pelvic tilt

Manifestation:

• Visible trunk rotation or lateral sway during walking
• Low back fatigue before leg fatigue on long walks
• Difficulty maintaining upright posture
• Pain when walking with backpack or weighted vest

Assessment:

• Inability to maintain plank for 45-60 seconds
• Excessive trunk movement visible during gait analysis
• Low back fatigue disproportionate to walking intensity

Performance Impact:

• Reduced walking efficiency (energy leaks through trunk motion)
• Low back pain during extended walks
• Difficulty progressing to hiking with load
• Poor posture leading to neck and upper back tension

Undertrained Hip Abductors

Pattern:

• Glute medius and other hip abductors stabilize pelvis during single-leg stance
• Weakness common in sedentary individuals
• Walking on flat, even surfaces doesn't adequately challenge these muscles

Manifestation:

• Trendelenburg gait (pelvis drops on swing leg side)
• Lateral trunk lean to compensate for hip weakness
• IT band tightness or discomfort
• Difficulty walking on uneven terrain or side slopes

Assessment:

• Single-leg stance: pelvis drops on swing leg side
• Hip drop visible during normal gait
• Weakness with side-lying leg raises

Performance Impact:

• Inefficient gait mechanics
• Increased risk of IT band syndrome if progressing to running or hiking
• Difficulty with lateral stability on trails
• Compensatory patterns throughout kinetic chain

Complementary Training

While walking is excellent standalone exercise, targeted supplemental training addresses common weaknesses and enhances walking performance and health benefits.

Glute Activation and Strengthening

Pre-Walk Activation:

• Glute bridges: 2x15 - wake up glutes before walks
• Clamshells: 2x12 each side - activate glute medius
• Lateral band walks: 2x10 steps each direction - prime hip abductors
• Fire hydrants: 2x12 each side - activate glute medius and maximus

Strength Training:

• Hip thrusts: 3x12-15, 2-3x per week - maximal glute activation
• Single-leg deadlifts: 3x8-10 each leg - builds glute strength and balance
• Step-ups: 3x10 each leg, 2x per week - mimics walking motion with load
• Bulgarian split squats: 3x8-10 each leg - unilateral glute and quad strength

Benefits:

• Improved stride length and walking efficiency
• Better power for incline walking and hiking
• Reduced low back pain from compensatory patterns
• Foundation for progressing to more intense activities

Hip Flexor Stretching and Mobility

Daily Stretches:

• Kneeling hip flexor stretch: 3x45-60 seconds each side, emphasize posterior pelvic tilt
• Couch stretch: 2x60-90 seconds each side - deep stretch for iliopsoas and rectus femoris
• 90/90 hip stretch: 2x60 seconds each side - addresses internal/external rotation
• Standing quad/hip flexor stretch: 3x30 seconds each side

Dynamic Mobility (Pre-Walk):

• Leg swings (forward/back): 2x12 each leg
• Walking lunges: 10-12 reps - dynamic hip flexor lengthening
• World's greatest stretch: 5-6 reps each side - comprehensive hip mobility

Frequency: Daily stretching, especially important for desk workers

Benefits:

• Increased stride length and hip extension range
• Reduced low back pain and anterior pelvic tilt
• Improved posture during and after walking
• Better glute activation through reduced reciprocal inhibition

Tibialis Anterior Strengthening

Exercises:

• Toe walks: 2-3x30-60 seconds, 3-4x per week
• Toe taps: 3x20-30 reps - rapid dorsiflexion
• Resistance band dorsiflexion: 3x15-20 reps
• Heel walks: 2x30-60 seconds - walk only on heels
• Tibialis raises: 3x12-15 with toes elevated on step

Frequency: 3-4x per week, can be done daily

Benefits:

• Reduced foot slap and improved gait quality
• Decreased fall risk and better foot clearance
• Prevention of shin splints when progressing to faster walking or jogging
• Improved ankle stability on uneven terrain

Core Strengthening

Anti-Extension:

• Planks: 3x45-60 seconds, 3-4x per week
• Dead bugs: 3x10 each side - coordinates core stability with limb movement
• Ab wheel rollouts (advanced): 3x8-10

Anti-Rotation:

• Pallof press: 3x12 each side - resists rotation
• Bird dogs: 3x10 each side - posterior chain and anti-rotation
• Side plank with rotation: 2x8 each side

Anti-Lateral Flexion:

• Side planks: 3x30-45 seconds each side
• Suitcase carries: 3x40-60 seconds each side - functional core under load

Frequency: 3-4x per week, 15-20 minutes

Benefits:

• Improved walking efficiency and reduced energy leaks
• Reduced low back pain during extended walks
• Better trunk stability for hiking with load
• Enhanced posture and spinal health

Single-Leg Balance and Stability

Balance Work:

• Single-leg balance: 3x30-60 seconds each leg, daily
• Single-leg balance with eyes closed: 2x20-30 seconds each leg
• Single-leg balance on unstable surface: 2x30 seconds each leg

Functional Strength:

• Single-leg Romanian deadlifts: 3x8-10 each leg, 2x per week
• Single-leg calf raises: 3x12-15 each leg, 2-3x per week
• Step-downs: 3x10 each leg - eccentric control

Benefits:

• Improved stability on uneven terrain
• Reduced fall risk
• Better gait mechanics and hip stability
• Stronger foundation for hiking or trail walking

Calf Strengthening

Exercises:

• Standing calf raises: 3x15-20, 2-3x per week
• Single-leg calf raises: 3x12-15 each leg - addresses asymmetries
• Seated calf raises: 3x15-20 - targets soleus
• Eccentric calf lowers: 3x10-12 - builds eccentric strength and Achilles resilience

Frequency: 2-3x per week

Benefits:

• Greater push-off power for brisk walking and inclines
• Improved ankle stability and plantarflexion strength
• Prevention of calf cramps during long walks
• Foundation for progression to jogging or running

Injury Patterns

Walking has among the lowest injury rates of any physical activity, but certain issues can arise, particularly with high volume, poor mechanics, or rapid progression.

Plantar Fasciitis

Mechanism:

• Repetitive strain on plantar fascia, particularly at calcaneal attachment
• Microtears and inflammation from accumulated loading
• Often involves tight calves, weak foot intrinsics, and poor arch support

Contributing Factors:

• Sudden increase in walking volume or intensity
• Poor footwear with inadequate arch support
• Tight calves and Achilles tendon
• Weak intrinsic foot muscles
• High arches or flat feet (both alter force distribution)
• Walking on hard surfaces (concrete) exclusively

Symptoms:

• Sharp pain at heel, especially with first steps in morning
• Pain after prolonged sitting (getting up from desk)
• Tenderness at medial calcaneal tubercle
• Pain that improves with initial walking but returns after extended activity

Prevention:

• Gradual volume progression (don't suddenly increase from 3,000 to 10,000 steps daily)
• Regular calf stretching and strengthening
• Intrinsic foot strengthening (toe curls, short foot exercises)
• Proper footwear with adequate arch support
• Variety in walking surfaces (grass, dirt trails, not just concrete)

Treatment:

• Reduce volume temporarily
• Calf stretching (both gastrocnemius and soleus)
• Plantar fascia stretches and massage
• Foot intrinsic strengthening
• Night splints for severe cases
• Proper arch support or orthotics if needed

Shin Splints (Medial Tibial Stress Syndrome)

Mechanism:

• Inflammation of periosteum along medial tibia
• Uncommon in walking but can occur with rapid volume increases
• Results from tibialis posterior and soleus pulling on tibial attachment

Contributing Factors:

• Sudden dramatic increase in walking volume (sedentary to 15,000+ steps daily)
• Walking primarily on hard surfaces (concrete, asphalt)
• Overpronation or improper footwear
• Weak calves and tibialis anterior
• Transitioning too quickly to incline walking

Symptoms:

• Pain along inner edge of shin
• Tenderness to touch along medial tibia
• Pain during walking that may improve with warm-up
• Aching after walking finishes

Prevention:

• Very gradual volume progression
• Mix of walking surfaces (not exclusively hard pavement)
• Calf and tibialis anterior strengthening
• Proper footwear selection based on foot type
• Avoid dramatic jumps in daily step count

Treatment:

• Temporary reduction in volume
• Ice after walks if inflamed
• Calf and tibialis strengthening
• Footwear assessment and correction
• Cross-training with non-impact activities (swimming, cycling)

Low Back Pain

Mechanism:

• Usually results from pre-existing issues rather than walking itself
• Poor posture during walking can exacerbate existing back problems
• Weak core and tight hip flexors contribute to excessive lumbar lordosis

Contributing Factors:

• Pre-existing low back conditions
• Weak core musculature failing to stabilize spine
• Tight hip flexors causing anterior pelvic tilt
• Poor walking posture (excessive forward lean or arch)
• Weak glutes forcing lumbar compensation
• Walking with heavy backpack without adequate core strength

Symptoms:

• Aching or sharp pain in lumbar spine during or after walks
• Pain that worsens with longer walking duration
• Relief when stopping to rest or sit
• Stiffness after walking

Prevention:

• Core strengthening program (planks, anti-rotation work)
• Hip flexor stretching and mobility work
• Glute activation and strengthening
• Posture awareness during walking (neutral spine, avoid excessive arch)
• If carrying load, gradual progression and proper pack fitting

Treatment:

• Address underlying core weakness and hip flexor tightness
• Temporarily reduce walking duration or intensity
• Focus on neutral spine position during walking
• Physical therapy if pain persists
• Avoid excessive anterior pelvic tilt (engage core, slight posterior tilt)

Metatarsalgia (Ball of Foot Pain)

Mechanism:

• Pain in ball of foot from excessive pressure on metatarsal heads
• Can result from improper footwear, foot structure, or gait mechanics

Contributing Factors:

• Shoes with inadequate cushioning or too narrow toe box
• High arches or forefoot structure issues
• Excessive forefoot strike pattern
• Long walks on hard surfaces
• Weak intrinsic foot muscles

Symptoms:

• Pain in ball of foot, especially under 2nd and 3rd metatarsal heads
• Sharp or aching pain during walking
• Feeling of walking on pebbles or marbles
• Pain that worsens with longer walks

Prevention:

• Proper footwear with adequate cushioning and toe box width
• Metatarsal pads to redistribute pressure
• Intrinsic foot strengthening
• Gradual volume progression
• Mix of surfaces (not exclusively hard pavement)

Treatment:

• Footwear assessment and correction
• Metatarsal pads or orthotics
• Ice after walks if inflamed
• Foot strengthening exercises
• Temporary volume reduction

Blisters and Foot Irritation

Mechanism:

• Friction between skin and sock/shoe
• Moisture and heat exacerbate issue

Contributing Factors:

• Poorly fitting shoes (too tight or too loose)
• Worn-out shoes with inadequate cushioning
• Cotton socks that retain moisture
• Long walks without gradual adaptation
• Hot, humid conditions

Symptoms:

• Fluid-filled blisters on toes, heels, or forefoot
• Hot spots and redness during walks
• Painful areas that worsen with continued walking

Prevention:

• Properly fitted walking shoes with adequate room in toe box
• Moisture-wicking synthetic or wool socks (avoid cotton)
• Gradual adaptation to new shoes
• Anti-chafe products (Body Glide, petroleum jelly) on problem areas
• Keep toenails trimmed

Treatment:

• Small blisters: leave intact, cover with blister bandage
• Large painful blisters: drain with sterile needle, leave skin intact, bandage
• Antibacterial ointment if skin is broken
• Address footwear or sock issues
• Allow healing before resuming long walks

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