Walking Poles for Pain Relief: Benefits of Nordic Pole Walking

Walking-Poles-for-Pain-Relief-Benefits-of-Nordic-Pole-Walking

Nordic Pole Walking is a popular recreational activity using light weight poles when walking for many benefits including pain relief and health gains. Developed in Scandinavian countries, as the name suggests, the benefits of Nordic pole walking have been recognised globally and are used by many for a multitude of reasons.

Benefits of Nordic Pole Walking

In this blog on the benefits of Nordic pole walking, we'll be covering the following main topics:

For each topic, our aim will be to clarify how Nordic pole walking can assist and specific conditions for which they may be valuable. Walking with Nordic poles restores many people's ability to be physically active, due to reductions in pain and improvements in balance and confidence.

Increased physical activity can assist with maintaining or increasing muscle strength, joint mobility, cardiovascular health and fitness, a healthy weight range, confidence, improved mental health and quality-of-life.

So many benefits for getting physically active! Nordic poles might be your opportunity to enjoy some of the many benefits of physical activity.

Walking poles for pain relief - chronic back pain

Research has shown that Nordic pole walking can help reduce back pain.1 Let's look at how walking poles might help and particular back pain conditions that might benefit.

6 ways walking poles may help back pain

1. Walking poles may increase trunk mobility through arm motion

When using walking poles, there is increased use of the arms, which flows into rotation of the trunk. This regular rotation can help alleviate physical pain and stiffness.

2. Walking poles share the load with the upper body

Pushing down on the poles using the upper body means the upper body supports part of the body weight. Reduced weight and therefore lower physical stress is then placed on the spine. This may be another reason Nordic walking poles can help relieve back pain.

When trekking, walking poles can also help share heavy external loads such as a back pack.10

3. Walking poles reduce excess activity in the back muscles

When you have low back pain, the back muscles may work harder as a response to pain (spasm) or due to weakness of the muscles. If the muscles are working harder than normal, without normal relaxation and recovery during movement, this excess muscle activity may contribute to pain and fatigue. Activity of the back muscles has been found to be reduced when walking using Nordic walking poles.2 With the arms taking more load and some rotation of the trunk occurring, back muscles can start to relax and be less rigid when walking. It seems this is another way Nordic poles help with back pain relief.

 

4. Walking poles stimulate the abdominal muscles

Pole walking has been shown to increase the activity throughout the abdominal muscles.4 As you push down with your hands, the abdominal muscles are naturally recruited. This abdominal activity may help to better support your spine during walking, but may also over time result in some strengthening of these muscles for use in everyday activities. Better abdominal support of the spine can help alleviate back pain.

5. Nordic pole walking may assist with balance

Balance has been shown to be negatively affected by chronic back pain, Support from Nordic pole walking may assist in balance when walking. Less apprehension and better balance may facilitate more normal muscle recruitment when walking, thus reducing pain.

 

6. Using walking poles may increase confidence to engage in physical activity

Feeling safer and more secure when pole walking may encourage you to walk more. Walking programmes for those with chronic low back pain have demonstrated decreased pain, improved function and increased physical activity.3

6-Ways-Walking-Poles-May-Help-Back-Pain

Back conditions that may be helped with Nordic pole walking

Back conditions that may be helped with Nordic pole walking include:

  • Disc prolapse (disc bulge) or degenerative disc disease
  • Stenosis
  • Spondylolisthesis
  • Spondylosis
  • Facet joint related injuries

When first starting to walk with poles, start with a similar distance you can manage without poles, and then gradually increase your distance depending on your pain. It takes time to build your strength and endurance, so allow time for your body to adapt. Remember, if you haven't been able to walk for some time, you will no longer be walk-fit. Build slowly over 2-3 months, adjusting distance and terrain depending on your response.

Nordic walking poles for hip pain relief

We have seen in the section above how walking poles can help provide pain relief in those with chronic back pain. Hip and pelvic pain may be coming from your back, in which case Nordic pole walking may help reduce pain due to the beneficial effects on the back. You can read more about back pain felt in the hips and pelvis HERE.

Nordic pole walking has also been shown to help reduce hip pain.1 Let's look at how walking poles might help and particular hip pain conditions that might benefit.

5 ways walking poles may help hip pain

  1. Walking poles share the load with the upper body
  • By sharing the load with the upper body, weight is not only reduced on the back, but also the hips and legs. This may be a key reason Nordic walking poles can help relieve hip pain.
  • For those with hip joint related pain, such as hip osteoarthritis, labral tears, hip dysplasia or femoroacetabular impingement syndrome, walking might become too painful due to the load across the hip joint. Sharing the load can allow many people with hip joint related pain to stay more active and control their weight.
  • Those with gluteal tendinopathy, trochanteric bursitis or Greater Trochanteric Pain Syndrome (GTPS) have been shown to walk in ways that place higher than normal loads across these tissues at the side of the hip.5 Sharing with the arms while using Nordic walking poles can assist with reducing this load, and again help with maintaining some level of activity while the pain settles.

2. Walking with poles may improve control of pelvic and hip position

      • Alterations in the way the pelvis and hip move are commonly reported in research studies of various hip conditions. One of the altered movement patterns that has the potential to be most irritating for those with hip joint related pain and soft tissue related pain at the side of the hip (gluteal tendinopathy, trochanteric bursitis or GTPS), is sideways shifting or tilting of the pelvis.
      • Pelvic side shifting and tilting puts the hip in a more adducted position (knee closer to the midline), which can increase load at the hip joint and the side of the hip. Research on those with gluteal tendinopathy has shown that the higher loads we mentioned above are related to higher degrees of sideways movement of the pelvis and hip adduction.5
      • People with hip joint related pain and gluteal tendinopathy or hip bursitis (GTPS) are usually weaker in the gluteal muscles that control this pelvis position.6 Gluteal weakness may then make it difficult for you to control this pelvic motion, so walking poles can assist to share the load as you rebuild your strength.
5-Ways-Walking-Poles-May-Help-Hip-Pain

3. Pole walking may assist with more efficient hip muscle recruitment patterns

    • People with hip joint related conditions (e.g., hip osteoarthritis and FAIS) and gluteal tendinopathy or hip bursitis (GTPS) have been shown to walk with less efficient hip muscle recruitment patterns,7 particularly the gluteals (buttock muscles) and the Tensor Fascia Lata (TFL) at the side of the hip.
    • These muscles may be working at a higher level or for longer than normal during walking. This may contribute to hip pain and fatigue during walking.
    • Excessive muscle activity may be related to pain (spasm or excessive splinting of the area) and/or muscle weakness. Using Nordic poles can share the load and ease pain and fatigue of walking while your condition settles, and you work on your strength.

4. Walking poles help you keep your body more upright

    • In clinic, we often see that our patients with hip pain are walking with their body leaned forward or with a sideways rocking of the trunk. This may be due to the hip pain, restrictions of hip range of motion, muscle weakness, fear, lack of confidence or even just pure habit.
    • Alterations in trunk position can have quite marked impact on loads that cross the hip, pelvis and lower back. A forward trunk position increases loads on the lower back, pelvis, buttock or back of the hip and hamstring muscles and tendons (back of the thigh and sitting bone region). This may result in irritation of low back pain, upper buttock pain related to the sacroiliac joints or piriformis syndrome (aka deep gluteal syndrome), and lower buttock pain related to proximal hamstring tendinopathy.
    • Sideways rocking of the body is common in those with more advanced hip osteoarthritis as well as people with gluteal tendinopathy, trochanteric bursitis or GTPS.5 Sideways shifting of the body during walking may increase load at the side of the hip5 and increase side-bending forces across the spine. This walking pattern may result in aggravation of low back pain, hip joint related pain and pain over the side of the hip (gluteal tendinopathy, trochanteric bursitis or GTPS).
    • One of the great benefits of Nordic pole walking is better control of body position, which can help reduce irritation of back, pelvic and hip pain.

5. Walking poles may reduce limping and help retain hip range of motion

    • When you have a sore hip related to joint related pain (hip osteoarthritis, labral tears, hip dysplasia or femoroacetabular impingement syndrome), hip flexor pain, or pain at the side of the hip (gluteal tendinopathy, trochanteric bursitis or GTPS) you might begin to limp. Our patients with hip pain find that the further or faster they walk, the more likely they are to begin limping. This is usually to avoid pain at the front or side of the hip.
    • The problem here is that the more you walk with a reduced stride length, you might start to lose range in your hip, and also become weak in muscles that would usually be supporting your hip at the end of each step. Loss of range of motion (flexibility) and weakness then contributes to loss of function or disability.
    • Limping also tends to shift load elsewhere, most commonly to the lower back and/or knee. We commonly see patients who develop secondary problems at the back or knee due to limping to avoid pain at the hip.
    • By sharing the load with the arms at the end of the step, Nordic walking poles can provide pain relief at the hip, but also help maintain range of motion and reduce chances of developing secondary issues at the back or knee.

Hip and pelvic conditions that may be helped with Nordic pole walking

Due to all the reasons we discussed above, Nordic pole walking may assist with many different hip conditions.

Hip and pelvic conditions that may be helped with Nordic pole walking include: 

Hip-and-pelvic-conditions-that-may-be-helped-with-Nordic-poles

Nordic walking poles for knee pain relief

Similarly to back and hip pain, walking poles can help provide knee pain relief.1

This is likely to be in ways that we have discussed throughout the sections above, but we will give a brief summary here.

4 ways walking poles may help knee pain

1. Walking poles share the load with the upper body

Once again, pushing down on the poles using the upper body means the arms support part of the body weight, reducing weightbearing loads crossing the knee. This is a likely way that Nordic walking poles can help relieve pain.

2. Nordic pole walking may assist with balance and stability

Improved balance provided by the poles helps to provide support to the lower limbs. They are particularly useful on more unstable surfaces, where a loss of balance or footing may result in a sudden jerking across the joints and pain irritation.

3. Walking with poles can help control irritating movement patterns

As we mentioned above, people with hip pain, reduced range of motion, or weakness, may start moving in ways that increases load elsewhere, such as at the lower back and knee. Walking poles can assist with improving biomechanics (movement patterns) as you work on improving strength and range of motion.

4. Walking poles keep you active and may help control your weight

Being able to walk with less knee pain, means you can walk more1 helping to maintain good knee function, but also the general health benefits including weight control. Carrying excess weight can affect those with knee osteoarthritis.

Keeping weight within a healthy range is one of the key recommendations for managing knee osteoarthritis. That can be difficult when you can't be active due to your pain. Nordic walking poles can assist you to maintain higher levels of activity. Weight control will always be most effective in conjunction with a balanced diet.

4-Ways-Walking-Poles-May-Help-Knee-Pain

Be aware that knee pain can be referred from the hip. If no-one has been able to find an explanation for your knee pain, then get your hip checked by a healthcare provider who knows hips, such as a Hip Pain Professional.

Knee pain reduced by Nordic walking poles may be related to reduced load at the hip or the lower back, both potential sources of knee pain.

General health benefits of Nordic pole walking

The benefits of pole walking extend beyond just pain relief. Extensive benefits to general health and fitness have been well demonstrated. So, what are these other general health benefits of pole walking?

Nordic pole walking may assist in maintaining or improving muscle strength and health, particularly in the upper body and abdominal muscles. Being able to walk further and more often may also indirectly help to strengthen your legs.

One key general health benefit of pole walking is weight management. Pole walking can be an excellent way to counteract obesity or trim those few extra pounds or kilograms.8 Nordic pole walking has been shown to use up to 22% more calories than normal brisk walking!9

There is a whole heap of other general health benefits of Nordic pole walking. We'll summarise them here.

General health benefits of pole walking may include:

  • improved strength,
  • improved ability to walk further and faster,
  • weight management,
  • improved cardiorespiratory fitness,
  • reduced risk of heart attack,
  • beneficial effects on resting heart rate,
  • beneficial effects on blood pressure,
  • beneficial effects on exercise capacity,
  • beneficial effects on maximal oxygen consumption, and
  • beneficial effects on quality-of-life in patients with various diseases.
general-health-benefits-of-pole-walking

Benefits of pole walking in other conditions that affect mobility

As more and more studies are being completed, we are able to see the wider benefits of Nordic pole walking across many different groups, struggling with many different conditions that directly or indirectly affect mobility.

Nordic pole walking for Parkinson's Disease and other neuromuscular disorders

In people with Parkinson's Disease, beneficial effects of Nordic pole walking have been demonstrated. With regular pole walking, patients have been shown to have improved movement skills, improved functional mobility, and improved ability to walk at faster speeds and longer distances.

These improvements are likely to have contributed to a reduced rate of falls, improvement in functional independence and an improved quality of life that have been reported in people with Parkinson's disease after a Nordic pole walking program.11,12

Nordic pole walking for cancer

Regular physical activity positively affects exercise tolerance and quality-of-life in people living with cancer. After mastectomy surgery for breast cancer, Nordic walking additionally improves shoulder mobility and reduces sensitivity to pain in the upper body. This has been shown to occur without worsening lymphedema.12

Nordic pole walking in chronic obstructive pulmonary disease

A Nordic walking pole program in those with chronic obstructive pulmonary disease (COPD) demonstrated improvements in perceived breathlessness during physical exertion. Further, Nordic walking improved anxiety and depression, and improved quality-of life for people with COPD.12

Nordic pole walking for other health conditions

Benefits have also been shown in those with obesity, coronary artery disease (heart disease), peripheral artery disease (vascular disease) and claudication (pain related to lack of blood supply).12

benefits-of-pole-walking-in-other-conditions-that-affect-mobility

How to know if Nordic poles will benefit you?

There are many reasons to consider trying Nordic pole walking. There is an initial learning phase to coordinate walking with poles, but with practice, most people are able to adapt and get used to this new way of walking, while gaining all the benefits listed above.

We hope that this blog will give you some ideas as to the benefits of pole walking, and if you suffer from pain, why Nordic poles for pain relief can be valuable.

Please note, if you have pain or a health condition, we always recommend you seek the advice of a Health Professional before starting any new exercise routine. Check with your Doctor - general medical practitioner or medical specialist, or physical therapist about using Nordic poles to assist walking.

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Check Out More You Can Read on Hip Pain Relief at HipPainHelp:

Top Tips for Hip Pain Relief Sitting, when Socialising or Travelling

Top Tips on Hip Pain Relief Sleeping

3 Simple Strategies to Reduce Hip Pain with Walking and Running

Authors

This blog was written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists who have over 50 years of combined professional clinical experience, dealing with patients suffering from a wide range of hip and pelvic conditions.

Dr Alison Grimaldi - Hip Pain Professional

Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of Physiotec Physiotherapy, an Australian Sports Physiotherapist and Adjunct Senior Research Fellow at the University of Queensland, author and global educator.

Kirsty McNab hip pain professional and hip physio
Kirsty McNab BSc Hons, MPhty(Sports), is Practice Principal of Physiologix and a highly experienced Sports and Exercise Physiotherapist having worked extensively with elite athletes, the Olympic Winter Institute of Australia, and Tennis Australia.

References

  1. Silverberg DS, Goodman CA, Prejserowicz A (2016) The Effect of Nordic Pole Walking on Chronic Low Back, Hip, and/or Knee Pain on Walking and on Distance Walked - A Prospective Community Study in Ambulatory People Over Age 60. Int J Phys Ther Rehab 2: 122. doi: https://doi.org/10.15344/2455-7498/2016/12
  2. Pellegrini B, Peyré-Tartaruga LA, Zoppirolli C, Bortolan L, Bacchi E, Figard-Fabre H, Schena F. Exploring Muscle Activation during Nordic Walking: A Comparison between Conventional and Uphill Walking. PLoS One. 2015 Sep 29;10(9):e0138906. doi: 10.1371/journal.pone.0138906. PMID: 26418339; PMCID: PMC4587792.
  3. McDonough  SM, Tully  MA,ÂBoyd, et alPedometer-driven walking for chronic low back pain: a feasibility randomized controlled trial. Clin J Pain2013;29:972-81. doi:10.1097/AJP.0b013e31827f9d81 pmid:http://www.ncbi.nlm.nih.gov/pubmed/23446066
  4. Luca Zoffoli, Francesco Lucertini, Ario Federici, Massimiliano Ditroilo, Trunk muscles activation during pole walking vs. walking performed at different speeds and grades, Gait & Posture, Volume 46, 2016, Pages 57-62, https://doi.org/10.1016/j.gaitpost.2016.02.015.
  5. Allison K, Wrigley TV, Vicenzino B, Bennell KL, Grimaldi A, Hodges PW. Kinematics and kinetics during walking in individuals with gluteal tendinopathy. Clinical Biomechanics 2016 Feb; 32:56-63. doi: 10.1016/j.clinbiomech.2016.01.003. Epub 2016 Jan 15.
  6. Allison K, Vicenzino B, Wrigley T, Grimaldi A, Hodges P, Bennell K. (2015) Hip abductor muscle weakness in individuals with gluteal tendinopathy. Medicine & Science in Sports & Exercise. 2016 Mar;48(3):346-52. doi: 10.1249/MSS.0000000000000781.
  7. Allison K, Salomoni SE, Bennell KL, Wrigley TV, Hug F, Vicenzino B, Grimaldi A, Hodges PW. Hip abductor muscle activity during walking in individuals with gluteal tendinopathy. Scandinavian Journal of Medicine & Science in Sports 2018;28(2):686-695.
  8. Tschentscher M, Niederseer D, Niebauer J. Health benefits of Nordic walking: a systematic review. Am J Prev Med. 2013 Jan;44(1):76-84. doi: 10.1016/j.amepre.2012.09.043. PMID: 23253654 Available from:https://pubmed.ncbi.nlm.nih.gov/23253654/ (accessed 9.4.2021)
  9. Muollo V, Rossi AP, Milanese C, Masciocchi E, Taylor M, Zamboni M, Rosa R, Schena F, Pellegrini B. The effects of exercise and diet program in overweight people – Nordic walking versus walking. Clin Interv Aging. 2019;14:1555-1565
    https://doi.org/10.2147/CIA.S217570
  10. Hawke AL, Jensen RL. Are Trekking Poles Helping or Hindering Your Hiking Experience? A Review. Wilderness & Environmental Medicine. 2020 Sep 24.Available from:https://pubmed.ncbi.nlm.nih.gov/32980249/ (accessed 9.4.2021)
  11. Federica Bombieri, Federico Schena, Barbara Pellegrini, Paolo Barone, Michele Tinazzi, Roberto Erro. Walking on four limbs: A systematic review of Nordic Walking in Parkinson disease, Parkinsonism & Related Disorders,Volume 38,2017,Pages 8-12, https://doi.org/10.1016/j.parkreldis.2017.02.004
  12. Tschentscher M, Niederseer D, Niebauer J. Health benefits of Nordic walking: a systematic review. Am J Prev Med. 2013 Jan;44(1):76-84. doi: 10.1016/j.amepre.2012.09.043. PMID: 23253654.
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