CHAPTER 6. REGULAR EXERCISE 163 Technique The clinician need not be a technical expert in the sports or activities suitable for regular exercise. There are many good books written for the layman on the subject(see"Resources"for some examples). If exercise counseling becomes a regular part of the practice, the clinician may benefit from periodic visits to local bookshops and/or the popular web-based booksellers for an update on available book The technique for pace walking(Fig. 6.1), the recommended starting sport, is very simple. Sample instructions for the patient are provided in the sidebar(Box) How to Pace Walk: Walk fast with a purposeful stride of medium length. With each step, land on your heel, then roll forward along the outside(lateral aspect) Try to keep your feet pointed straigh h ahead, walking along an imaginary white line. This will help your balance and rhythm, and will allow you to ncrease your specia. Your back should be comfortably straight, but not rigidly so. Your shoulders should be dropped ane elaxed, your head up. Swing your arms forward and back, strongly, with your elbows comfortably bent. (The elbow bend prevents the accumulation of fluid in the hands, which will happen if you swing your arms strongly while keeping them straight. )At the end of the back swing, you should feel a tug in your shoulder On the fore swing, your hand should come up no further than mid-chest level To stay in balance and maintain a smooth forward motion from the hips down, concentrate on the back swing, not the fore swing For most people, it is the strong arm swing that makes pace walking aerobic. If a person has been completely sedentary for some time, just walking quickly without the strong arm swing will most likely raise the heart rate into the aerobic range. When the exerciser has been working out more regularly though, walking fast alone will not be sufficient to raise the heart rate into the aerobic range. That is why if walking is to be used as the aerobic exercise on an ongoing basis(and many regular exercisers do so use it), a second major muscle group must be brought into play (i.e., swinging the arms strongly as In pace walking, equipment As with technique, details on equipment can be found in various sport specific books. Common to most regular exercise sports or activities is the need for properly fitting shoes in order to achieve success and avoid injury Proper fit means that the shoe should conform to the shape of the exerciser's foot by touching the foot in as many places as possible, except over the toes The shoe should be fexible under the ball of the foot and it should have a firm vertical"heel counter"at the back end of the shoe to keep the heel down