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  • Writer's pictureDave Balzer

Lymphatics, Sleep, & Back Pain - 3 (lesser known) reasons to walk more!

If I could put one statement on a billboard it would be:

"Go for a WALK"

A daily walking program can improve overall physical and mental health at the individual level, but it can also positively impact familial, community, and societal well-being. It is very well known that walking helps build a foundation for ideal cardiovascular function. For some, this fact is enough to start a daily walking routine, but for many it's just not enough informational inertia to get them off the couch or away from the screen to go outside for a walk.

Alright, this is where I usually lose most people... as soon as I mention a walking program their eyes glaze over. It sounds like too much work to some people, and to others a complete waste of time. So, what's so great about walking? Why am I taking the time to write about this topic? We evolved from a quadruped locomotion species to a more efficient, bipedal gait for a reason. Evolutionary nature doesn't make too many mistakes, so let's dive in...

Big Sur, California - Spring 2021

Throughout my clinical career as a physical therapist I've been lucky to work alongside many outstanding student physical therapists completing their clinical rotations. They would often ask clinicians what were their favorite exercises. The magic panacea movement!?! I asked the question, too. Early in my career I often made up some answers like a reverse lunge, deadlift, or turkish get-up... truly thinking they were the elixir movement to a resilient body. Over the past few years, I've developed a more thoughtful (mature?) answer and it often surprises and/or frustrates students... WALKING! Trust me, prioritizing strength training is needed to live an optimal life, but failing to walk as much as we should can leave us falling short of our peak physical and emotional health.

So, this is why I'd like to share a few lesser known reasons from my laundry list of benefits to daily walking.

(Lesser known) Reason #1: Lymphatics

Everyone is pretty familiar with our circulatory system which carries blood throughout our body, but the less familiar lymphatic system plays a crucial role in health. The lymphatic system is the highway sewer system of our body, carrying cellular waste products to be disposed of accordingly. Ever wonder where all the inflammation magically disappears to? Yup, it's the lymphathic system.

What's amazing about the lymphatic system is that it's buried in our muscular system and relies on muscle movement to stimulate its handy garbage work. Without movement there is no functioning sewer system, which can lead to backups and congestion (example: gnarly cankles after a long plane ride). Decongesting the human body is vital -- garbage in / garbage out. If there's one thing that makes me cringe it's the thought of a nasty, clogged up drain! Anyways, evolution was pretty dang smart by embedding these sewer lines in our movement system -- pairing it with something we do (or used to do) very often... MOVE!

So what does this have to do with walking? Can't I just do my intense strength training movements to stimulate this sewer system? Yes, but... NO. The lymphatic system really enjoys doing its house cleaning in a calm, steady state environment. Overstimulation can lead to one of two options: the garbage men seeking shelter as there may be more important things to worry about than getting rid of a little inflammation OR the garbage men make mistakes, miss things, or dispose of the garbage incorrectly. Insert walking... a (miracle?) full body muscular movement that doesn't require a ton of energy output if done periodically throughout the day. Frequent bouts of walking, paired with periods of rest, assists our lymphatic system in running smoothly... therefore, creating an optimal environment for immune function.

Give the body the opportunity to function as it was designed... move well, move often!

(Lesser known) Reason #2: SLEEP

Increasing the amount you walk daily unlocks a massive amount of hidden physiological benefits. Sleep is one of those underrated hidden benefits. More walking improves sleep by increasing the build up of "sleep pressure" over the course of the day. But, what is sleep pressure? It sounds simple, but it's a complex physiological process that requires input from many bodily systems to guide our body into a sleepy state as the day progresses. Many factors play a role in the process, but the build-up of sleep pressure mainly relies on a molecule called adenosine. This "sleepy time" molecule rides a consistent 24 hour wave called a circadian cycle with levels being highest around bedtime and lowest in the morning after waking. As adenosine builds throughout the day, so does our urge to sleep (adenosine acts to inhibit neural activity). The challenging part is we want these peaks and valleys to come at consistent time periods.

Coffee Break Fun Fact: the main mechanism in how caffeine increases our alertness is by blocking adenosine receptors -- basically creating a roadblock so adenosine cannot build up and bring on sleepiness.

So, how can we efficiently and effectively guide adenosine in the right direction on a daily regular basis? First, a bout of higher intensity strength training triggers the sleep pressure system. It sounds counterintuitive, but a tolerable training session will give us an energy and alertness boost, while simultaneously triggering an adenosine release. For some people, this single bout of exercise is not sufficient enough in stimulating sleep pressure. This is where walking comes into play. If we are sedentary, sitting at our desk for 8 hours following our morning training session, then our mind and body starts to adapt. It doesn't see a need to build up adenosine for sleep, or it builds up too much at the wrong time, as you are already "resting" by sitting all day -- aka "sleep pressure dysregulation". Plus, in our hyperconnected, stimulus driven world there are many dopamine disruptors to this physiological process. Excess screen time and increased near-point convergence vision (staring at computer all day) leads to peaks and valleys in adenosine and other neurochemicals like dopamine, further dysregulating sleep pressure.

Back to the miracle movement... walking!

Our bodies are made to move and want to move. Therefore, periods of light activity like walking post-meals 10-15 minutes or a 30 minute walk after work is a great way to get extra movement in throughout the day to assist with optimal sleep. Going outside for a morning walk (even just 5-10 minutes) within 60-90 minutes of sunrise is an awesome way to set our circadian clocks. This adenosine sleep pressure build-up starts first thing in the morning with sunlight being the main trigger for our sleep pressure clock. (check out a recent blog for details on this topic)

Just to further drive this point home... think about infants and their sleep schedule. I don't have kids, but for the parents out there you know how important it is for the kiddos to have a bedtime routine and a good night of sleep. Why not prioritize your own sleep by getting some more steps throughout the day. We all know what you gain with a good night sleep... You wake up more alert and ready to take on the day, and it is so much easier to go do that workout or take the time to meal prep -- further compounding healthy lifestyle behavior change. So get those steps in to help optimize your sleep!

(Lesser known) Reason #3: BACK PAIN

It's estimated that 80% of American adults will experience back pain at some point in their life. Back pain is a scary topic for many people. There is so much uncertainty in what causes non-specific low back pain, but one thing is certain that ALL pain has a biopsychosocial component -- meaning there are physical/biological factors, psychological (thought/perception based) factors, and social/environmental factors. All of these components must be addressed to resolve low back pain.

There is much discussion on the best treatments for back pain -- injections, surgery, pain meds, acupuncture, physical therapy, massage, yoga, strength training, mindfulness practices, and so much more. Each treatment serves a purpose, but the most powerful treatment tool (that may also be the least talked about) is a regimented walking program. Graded exposure to a walking program has been compared in research to injections, pain meds, and surgery over and over again, and produced the same result every time -- walking is just as effective, if not more effective in treating and resolving low back pain. So why is this news not plastered all over the news? Well a solid walking program recommendation doesn't make Big Pharma or Big Medicine much money.

What's great about a walking program is that it addresses all aspects of the biopsychosocial side of pain. It gets the body physically moving, promotes mindfulness and stress reduction, and often puts us in a healing social environment if walking outdoors with friends, family, your favorite four-legged companion. (speaking of dogs... here's my walking buddy -- Woody)

How is this information pertinent to an individual without chronic or acute back pain? A solid walking program is not just for foundational cardiovascular function... this recommendation serves you in building up resilience and mitigating risk for nagging injuries like low back pain. It's playing the long game... the benefits of a walking program may not be felt immediately, but if consistent you'll reap the benefits over the next few years and decades. Yes, back pain may still occur... like I mentioned before, 80% of adults will experience back pain in life, so it's common and "normal" to some degree. But how your body responds and recovers from this experience can be abnormal if you do not have established lifestyle routines like a regimented walking program.

So, next time you are out on your daily walk, take a moment to give yourself some credit. Yes, you are building an excellent cardiovascular base, but think about these lesser known benefits to walking... You are taking action in improving your internal sewer system (lymphatics), assisting your body in creating a better sleep environment, and reducing your risk for common injuries like back pain... all while promoting a healthier, more resilient body.

If anyone can help me out with the "Go for a WALK" billboard... let me know!



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