Walking IS Exercise: Why All Movement Matters

As an orthopedic surgeon, I often see patients who struggle with “exercise.” Why don’t they see the benefits of walking, I often wondered.  At the same time, they suffer from common diseases caused by or worsened by a lack of physical activity. The human body is a complex set of interrelated processes. That is to say that one system affects all of our other systems.  Very few issues within the human body exist in isolation.  We need to step back and look at the body from a more holistic perspective. For example, in people with various metabolic diseases such as fatty liver and diabetes, the incidence of osteoarthritis, as well as the progression of osteoarthritis, is much higher.  A significant portion of adult joint or tendon pain is often due to the effects of our poor overall health and lack of movement, as opposed to a mechanical issue in our joints. Granted, it is hard for most people to grasp that last fact, but the human body is one of the only machines that breaks by being still.  

I’ve noticed that most people recognize the need to “exercise”; however, they also believe that to be fit, they must engage in intense, strenuous activities that they may not enjoy or feel capable of maintaining. Perhaps this is the stigma that people associate with the term exercise, or perhaps this is due to much of the nonsense we see on various social channels.  These same people understand the need to exercise, but the thought of sweat, pain, and exhaustion turns them off.   This often leads to a sedentary lifestyle, significantly negatively impacting overall health. However, one of the simplest and most accessible forms of exercise—walking—often goes underappreciated. Despite the rants of many loud social know-it-alls with no training,  walking is indeed exercise. It confers significant benefits for all-cause mortality (ACM), fitness, and overall health. This is perhaps the best reason why, given its profound benefits, I often write an exercise (walking) prescription as a physician. I have had many patients who believed that their workout didn’t count if they weren’t drenched in sweat, their workout didn’t count. After incorporating daily walks, they felt better physically, lost weight,, and found a newfound joy in their routine. Sometimes, it’s the simplest activities that bring the most profound changes.

As I tried to stress in my book, Longevity Simplified, living a longer and healthier life isn’t very complicated.  But that’s not what you would think by doom scrolling through Instagram.  A solid longevity plan includes movement, lifting something heavy on occasion, sleep, home-cooked meals, controlling your blood pressure and LDL cholesterol levels, minimal alcohol, socializing, and having a sense of purpose.  A quick glance through Instagram will make you think that the magic occurs via cold plunges, sauna, supplements, delaying your morning coffee, and being in the sun.  Movement is perhaps the most important variable regarding living a more robust life.  There are no medications, supplements, or procedures that can match the impact of movement on our ability to live longer. Longevity will never be found in a supplement bottle. But… simple, actionable advice can’t be sold to you on Instagram, and it rarely elicits a viral reaction from your followers.  I would posit that many of the videos you see about exercise on various social channels turn most people off to exercise because they know that they cannot perform them.  

Evolutionary pressures are powerful. Ignoring these profound signals is to misunderstand human nature. Humans were engineered to move. Our basic physiology and health demands that we move.  For hundreds of thousands of years, we needed to move long distances to hunt, construct shelter, and find a mate. Humans, however, were also engineered to rest and avoid unnecessary activity to preserve our energy in times of famine.  This has produced a dramatic evolutionary mismatch.   In modern times, a mere blink of an eye in the context of human evolution, food has become omnipresent.   Combine that with the forces that lead to us being sedentary, and the current epidemic of non-communicable diseases shortening our lifespan becomes readily apparent. 

The concept of the need to exercise is new in this evolutionary landscape. It goes against the movement patterns that have governed our existence for a long time.  

Movement is crucial for maintaining health and well-being. Regular physical activity helps control weight, reduces the risk of chronic diseases such as heart disease, dementia, type 2 diabetes, and certain cancers, and improves mental health and mood. It can also enhance sleep quality and increase life expectancy. Given its profound benefits, I often write an exercise prescription as a physician. But how much exercise is enough, and does it have to be intense?

Walking is an often-overlooked form of physical activity that can provide significant health benefits. It’s accessible, doesn’t require special equipment, and can easily be incorporated into daily routines. Moreover, walking is suitable for people of all ages and fitness levels. 

In many fitness circles, however, walking is frowned upon or downright castigated as a means of achieving fitness.  Nothing could be further from the truth.  So many studies have proven that walking is a reliable and immediately actionable means of achieving a high fitness level.    Walking confers significant ACM benefits. Furthermore, the amount you need to walk daily isn’t as high as you think.  Remember the phrase:  just move, move often, occasionally with a quicker pace or some hills. 

My walking prescriptions in the office are straightforward: Walk 2-3 times a day for 20-30 minutes. On the weekends, try to do one longer walk. As little as 6-8000 steps per day yields impressive results. The associated decrease in rates of heart disease, dementia, type 2 diabetes, and more drops upwards of 15-30%.  

Two common issues in my office are that people do not recognize that their fitness levels are declining and their baseline fitness levels are poor.  Aging-related loss of fitness occurs slowly over time.  Far too many believe this is a problem specific to the elderly. It’s not. Are you short of breath on stairs? Can you do 20+ chair squats in 30 seconds? 20 pushups? The effects of aging begin to accrue in our 40s.  You may not begin to notice them until far later.  Our youngest are no longer as active as they had been in decades gone by.  This has significant implications for their future.  Fitness is much like a retirement account. The more muscle mass, the higher our VO2 max and aerobic fitness level that we bring into our later decades, the more we have to withdraw.  If these children reach their 40s with a poor level of fitness and strength, the downstream consequences of aging will reveal themselves far sooner and more dramatically in this demographic.  

Walking is a powerful, accessible, and effective exercise with numerous health benefits. Despite its simplicity, walking can significantly reduce the risk of chronic diseases, improve mental health, and increase longevity. Walking provides an excellent alternative for those who find traditional forms of exercise daunting or unappealing. Many of my patients who have adopted my walking prescription have gone on to lose significant weight; more importantly, they found that walking was the gateway to other healthier lifestyle choices that they ultimately adopted.  

Remember, fitness is in the eye of the beholder. If you can walk 6-8k steps daily, including hills, you are “fit” by many standards. By incorporating more walking into your routine, you can improve your health and well-being without the need for intense or strenuous activities. All movement matters, so take that first step today and invest in your health.