Forward Motion: The Physiology and Philosophy of Walking and Running

I came across this phrase years ago, and it has stayed with me ever since. Solvitur ambulando – “It is solved by walking.” The core idea is simple: When faced with uncertainty or inertia, purposeful movement – of mind, body, and spirit – creates progress. When in doubt, move.

From a biological standpoint, there may be no activity more intrinsic to our species than self-powered locomotion. Long before planes, trains, and automobiles reshaped human movement, we walked, ran, climbed, and occasionally swam. In much of the world, that is still how daily life unfolds.

Christopher McDougall’s Born to Run brought this into modern awareness by highlighting the Tarahumara people of Mexico, who have long been known for running extraordinary distances well into older age. Their running is not a sport in the modern sense – it is a means of transportation, sustenance, and culture. Similar patterns exist among highland Kenyans, the Maasai, the Khoisan, the Amhara of Ethiopia, the Quechua of the Andes, and numerous indigenous tribes across the Americas. Persistent, daily locomotion is not an exercise program; it is a way of life.

That is not, of course, how most of us live. In the Western world, walking and running are rarely primary forms of transportation. Few commute on foot, and fewer still run to work. Movement, once a necessity, is now elective – fit between digital obligations and professional demands. In this environment, regular movement offers restoration. It repairs not just the body, but also the mind and spirit, making forward motion a vital remedy for modern challenges. For me, they have functioned as a kind of moving meditation – an antidote to a sedentary, virtualized, and often fragmented way of living.

Pandemic Running Renaissance

Running has experienced several renaissances over the past half-century. In the 1970s, cardiologist Dr. George Sheehan’s book “Running & Being” helped catalyze the first major boom. At the time, the public was beginning to understand that cardiovascular and cerebrovascular health were not fixed inheritances, but cultivable outcomes. Running, with its minimal equipment and universal accessibility, spread rapidly.

Marathon participation rose steadily through the 1980s and accelerated dramatically in the 1990s and early 2000s. The arrival of GPS watches and wearable fitness technology added a new layer – quantification. Mileage, pace, heart rate, and sleep could be measured, gamified, and shared. Fitness became data-driven and socially reinforced.

Interest plateaued somewhat in the 2010s. Then came COVID-19. When gyms closed and social spaces contracted, the outdoors reopened. Running surged again – not as competition, but as an escape. It was one of the few remaining outlets for physical and psychological freedom. History suggests a pattern: when society becomes more complex and sedentary, we rediscover the simplicity of forward motion.

The Physiology of Forward Motion

Walking, jogging, and running exist on a continuum – pace and mechanics vary, but the underlying physiology overlaps substantially. Large prospective cohort studies consistently demonstrate approximately 30% reductions in all-cause mortality among habitual walkers and runners compared to sedentary individuals.1 Benefits are dose-dependent, but the most dramatic improvement occurs when going from “none” to “some.” The message is simple: small, consistent doses are power.

Modest daily movement improves:

Insulin sensitivity via increased GLUT-4 translocation independent of insulin
Blood pressure through improved endothelial nitric oxide signaling
Lipid profiles via reductions in triglycerides and increases in HDL
Autonomic balance with enhanced parasympathetic tone
Bone mineral density through mechanical loading
Cognitive resilience via increased cerebral blood flow and neurotrophic factors

Outdoor movement adds another layer. Natural light exposure, particularly in the early morning, anchors the circadian rhythm. As sunrise light shifts from red-dominant wavelengths to the blue spectra, photosensitive retinal ganglion cells signal the suprachiasmatic nucleus to suppress melatonin and promote wakefulness. Evening light performs the inverse. In an environment saturated with artificial illumination, this daily light cue becomes one of the most potent regulators of sleep quality, cognitive clarity, and cardiometabolic health.

While working 24-hour hospital shifts, I prioritize a sunrise walk/jog every day. It recalibrates time in a way no clock can, and goes a long way towards avoiding the negative consequences long stretches in a hospital can have on well-being.

Go From Zero to One

Perhaps the most important principle in exercise science is this: the largest health gains occur when someone moves from inactivity to modest activity. That is the steepest part of the benefit curve. Beyond that, benefits accumulate with dose, but so does risk if progression is careless.

Traditional guidance suggests increasing mileage no more than 10% per week and avoiding more than a 50% increase per month. While these numbers are not absolute laws, they reflect a central concept: connective tissue generally adapts more slowly than aerobic capacity. The wisest strategy is to build a base that feels sustainable indefinitely, and then progress patiently.

Why Running Injuries Happen

The most common walking and running injuries include medial tibial stress syndrome (shin splints), plantar fasciitis, patellofemoral pain syndrome, Achilles tendinopathy, and iliotibial band syndrome. While they are anatomically distinct, they share a common mechanism. Repetitive loading, applied in the presence of muscular imbalance or biomechanical inefficiency, exceeds the connective tissue’s adaptive capacity. The result is maladaptive remodeling (collagen fibers laid down in disorganized patterns) and nociceptive sensitization, whereby peripheral nerve endings become more responsive to mechanical stimuli, resulting in nagging pain and diminishing function.

Importantly, these are not primarily inflammatory conditions in the traditional sense. They are load-management problems. The goal, therefore, is not simply rest or anti-inflammatory therapy, but restoration of balanced loading, which allows adaptive remodeling to occur.

Strength as Insurance

Strength training, as it applies to walking and running, is about building resilience, which will allow for gradually increasing mileage without sustaining injury. The longer one can gradually increase the exercise dose, the longer they can reap the benefits.

Common weaknesses occur in the posterior chain and core; specifically, the gluteus medius (primary abductor), external hip rotators (especially the piriformis), the gluteus maximus (hip extension/rotation), the hamstrings, calves, and abdominal stabilizers. When these muscle groups fail to stabilize the pelvis and control eccentric loading, force is transmitted downstream into the knees, shins, plantar fascia, and Achilles tendons. Several sessions per week of focused strength work can dramatically reduce injury risk. Effective exercises include single-leg squats, Romanian deadlifts, eccentric calf raises, side planks, clamshells, and step-downs, to name a few.

Stuart McGill’s “Big Three” core exercises are simple but highly effective for spine, pelvis and core stability. I promise that if you commit to doing them on most days, especially in the morning, you will experience profound improvements in core stability, posture, and reductions in spine and core strain. The hip and core band by Crossover Symmetry further augments core stability and limits the downstream negative effects on your hips and knees. Kettlebell training, TRX suspension work, and resistance bands are excellent adjuncts. The aim is not hypertrophy – it is stability, proprioception, and load distribution. There’s nothing wrong with hypertrophy, which can certainly be pursued as well, but from an injury prevention standpoint, strengthening the tiny stabilizer muscles is key. In this way, strength training is not an accessory to running – it is structural insurance.

Forward Motion

Ultimately, a habit of walking and/or running is not about mileage totals or wearable metrics. It is about orientation. Choosing to move, even briefly, shifts more than physiology – it alters perspective. Forward motion recalibrates and regulates the body, improving circulation, metabolism, and neuromuscular coordination; additionally, it recalibrates attention. Problems that seem fixed when sitting often loosen with movement. Breathing and stride create rhythm; periods of effort alternate with recovery, and cohesive thought usually follows.

As physicians, we see the cumulative effects of inactivity every day – insulin resistance, deconditioning, joint degeneration, reduced cognitive performance, anxiety, and sleep disruption. We also see the opposite – how small, consistent behavioral changes compound. Transformation is rarely dramatic. More often, it is incremental and sustained. The point is not to become an ultramarathoner. It is to begin and to continue moving. Twenty minutes at sunrise. A short run several times per week. Gradual increases in distance are supported by basic strength work. In a word – consistency. Over time, adaptations are predictable. The body becomes more efficient, the mind becomes steadier, and the noise quiets.

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Forward Motion: The Physiology and Philosophy of Walking and Running – Blog Author: RPG Physician – Dr. Scott Hilton

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