yogabook / functional exercises / uphill walk

Therapeutic walking uphill

Effects

Preparation

Special preparations are not required, as most working ranges are around anatomically zero. In the case of contracted hip flexors, see the details.

Follow-up

Diagnostics

Instructions

1. Find a longer stretch of path that leads uphill with a not too gentle gradient. A smooth path is not absolutely necessary, but it makes it easier to concentrate on the essentials and reduces the risk of supination trauma.
2. Place one foot (slightly offset) in front of the other and walk the planned distance with a medium to long stride and strong steps, whereby you should feel a strong push-off with your foot towards the end of the standing leg phase.

Details

1. The push-off towards the end of the standing leg phase should come from the hip extensors so that they tilt the pelvis backwards at the top slightly around its transverse axis. The degree of dorsiflexion achieved in the foot at the end of the standing leg phase naturally depends largely on the stride length, but the plantar flexors, i.e. the triceps surae, should not be consciously used for propulsion during this phase, as any use would be likely to reduce the proportion of propulsion provided by the hip extensors and thus reduce the moment at which the pelvis tilts backwards at the top. As also described for stair climbing, the movement of the leg at the end of the standing leg phase, when it is accelerated forward for the next step by the force of the hip flexors, tilts the pelvis slightly forward at the top due to the mass inertia, so that in the sequence of steps, called gait, an oscillation of the pelvis about its transverse axis occurs. This must be absorbed as well as possible by the autochthonous back muscles in cooperation with other trunk muscles such as the rectus abdominis and the oblique abdominal muscles so that the pelvis provides the legs with as stable an abutment as possible and as little of the energy used as possible is lost in the reactive movements of the trunk.
2. In addition to the effect on the muscles directly involved in stabilizing the pelvis for its support function, this complex movement process has an effect on other muscles in the lower trunk, hip region and legs, which counteracts the tendency to tension that often arises secondarily as hypertonus resulting from pain avoidance.
3. If the hip flexors are contracted, which regularly increases the tendency to lumbar complaints, as the resulting hollow back leads to hypertonicity of the muscles, the pelvis will tilt backwards less than desired at the end of the standing leg phase. It is possible that the pelvis will remain permanently tilted forwards, which reduces the effect of the exercise and is not very suitable for reducing the hypertonicity of the muscles affected by the hollow back. In these cases, a short program to stretch the hip flexors can be performed as preparation.
4. Depending on the design and level of training, this can already approach basic cardiopulmonary training. This can be calculated using the usual methods for calculating the training zones depending on the maximum heart rate, i.e. age and other factors if applicable.
5. The effect of walking uphill can be increased if the stride frequency or stride length is increased. In the same way, the pelvis can be deliberately tilted a little excessively forwards or backwards with a certain number of steps, but care must be taken to ensure that the tilting process is not strictly synchronized with the movement of a particular leg so that no one-sided effect occurs. The tilting must therefore be synchronized to an odd number of steps, for example in such a way that the pelvis tilts forward every 3 steps and backward every 4 steps (or vice versa), so that the odd number results in a regular change of side in the dominance of the odd number. It helps to count this in your head.
   In cases of a herniated disc that tends to react adversely to flexion of the lumbar spine or a facet syndrome, spinal canal stenosis or spondylolisthesis that react adversely to extension of the spine, the tilting movement must be omitted or may only include the painless possible range. It is therefore important to differentiate between the pain phenomena typical of these disorders (neuroradicular or pseudoradicular pain) and the muscular complaints of lumbago.
6. It is not only in the case of shortened hip flexors that there can be a tendency to constantly tilt the pelvis more forwards at the top, i.e. to keep the hip joints in greater flexion than necessary. A lack of strength, particularly in the hip extensors, can also lead to this tendency. Another important reason is pain avoidance: it may be that lumbago-associated pain does not occur in further lumbar spine lordosis, but if the pelvis is only slightly tilted forward or consciously held upright, with the affected muscles regularly exceeding a certain geometry or a certain sarcomere length. If this is the case, it is advisable to approach this effect cautiously and try to utilize its effect, assuming that the resulting stretching stimuli on these muscles will cumulatively bring about an improvement in the symptoms.
7. Therapeutic walking uphill, like climbing stairs, is well suited for muscular disorders such as lumbago, but also for less acute lumbar pain phenomena.
8. In cases where therapeutic walking uphill is used to treat lumbago, it is essential to ensure that any sweaty skin is dried and kept warm at the end of training so that cooling of the underlying muscles does not lead to a worsening of the condition. In addition, a few stretches should be undertaken at certain intervals for the previously strained muscles.
9. If you want to continue walking uphill after reaching the end of the route, you need to return to the start of the section. This can often be done by taking the same route in the opposite direction or by taking a less steep descent. Depending on the condition of your back, the second option may be the easier method to avoid pain in the lumbar region. After all, descending on a downhill section of the trail is subject to moderate impacts if you walk downhill as usual and not particularly gently. On the other hand, the usual descent can always be used to check the condition of the lumbar region.
10. Disorders of the knee joints, hip joints or even a pronounced PHT can be a contraindication for this exercise. In the case of PHT, a certain stride length or a certain amount of force can often not be exceeded. A level must be maintained at which the pain typical of PHT is not triggered. If there is a disorder of the knee joints, a differentiation must be made according to the type of disorder; a disorder of the quadriceps including its tendon quadriceps insertional tendinopathy) prohibits a fast downhill stride more than an uphill one. The same applies to retropatellar cartilage disorders (chondropathia patellae / PFPS). Meniscus lesions will also make going downhill particularly painful.