All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
How to prepare your feet for long walks without pain and blisters
Medical expert of the article
Last updated: 19.09.2026
The best way to prepare your legs for long walks is not by stretching the day before or buying the "most shock-absorbing" running shoes, but by increasing your usual walking time in advance. You should start with the walking duration you currently comfortably tolerate, and then gradually increase the time, distance, elevation, and other elements of your future route. The NHS recommends that physically inactive people increase their walking distance gradually, and the World Health Organization generally emphasizes the principle of gradually increasing the volume of physical activity. [1]
It's not just the muscles that need to be prepared. Walking for hours puts strain on the skin of the feet, the muscles of the calves and thighs, the Achilles tendon, the plantar fascia, the joints, and the bones. A person may have sufficient cardiovascular endurance for five hours of walking, but end the walk after two hours due to a sore heel or pain in the forefoot.
The main practical principle is not to increase everything at once. If today you typically walk for one hour on a flat surface, don't immediately switch to three hours, mountainous terrain, a new backpack, and new shoes for your next workout. Research on sports injuries does link abrupt changes in training load to some overuse injuries, but the evidence doesn't allow for a universally safe percentage increase in load. Therefore, the popular rule of "no more than 10% per week" cannot be considered a medical law. [2]
What exactly do you need to prepare for a long walk?
A long walk differs from a short one not only in the number of steps. The longer a person is on their feet, the more significant accumulated muscle fatigue, repetitive movements of the ankle and knee joints, shoe pressure on the same areas of the foot, and constant shear stress between the skin, sock, and shoe become.
Therefore, someone who regularly engages in strenuous strength training isn't necessarily automatically prepared for an eight-hour hike. Conversely, someone who walks many kilometers daily may tolerate long walks well, even if their performance in the gym isn't great.
Specificity is crucial here: the best way to prepare for a long walk is to walk regularly. If the upcoming route includes climbs, descents, stairs, or backpacking, some of the training walks should gradually approach these conditions.
The World Health Organization considers walking a complete physical activity and recommends that adults in their daily lives achieve at least 150-300 minutes of moderate aerobic activity per week, while also maintaining muscle strength. These figures are intended for public health purposes and are not intended as a standard for preparing for a specific hike, but they emphasize the value of regular activity over occasional, very long bouts of exercise. [3]
First, determine your starting load
The starting point should not be the distance you would like to cover, but the load that your legs are already able to withstand repeatedly.
For example, if after a typical forty-minute walk you feel only normal fatigue and there's no increase in pain in your feet, knees, or shins the next day, this duration can be used as a starting point. However, if after an hour of walking the next day you experience heel pain or limping, you should begin your training at a lower level.
In medical rehabilitation, this approach is called determining the initial tolerable level of activity: a person chooses the volume that he or she can perform regularly without noticeable exacerbation of symptoms, and then gradually increases it. [4]
It's especially important to assess not only your condition immediately after a walk. Overuse pain sometimes becomes more noticeable in the evening or the following morning. If a new distance is regularly followed by a significant deterioration in your condition the following day, you're increasing your intensity too quickly.
How to gradually increase distance
There's no one-size-fits-all schedule. Someone who walks 8-10 kilometers daily will require completely different training than someone who leads a predominantly sedentary lifestyle.
The NHS recommends that those with low initial activity levels start with a manageable distance and gradually increase it. The American Heart Association recommends the same principle: choose a duration that feels manageable, and then gradually increase the time and distance. [5]
It's often helpful to first increase walking time on a relatively easy surface, and then add speed, elevation, and additional weight. This approach allows you to understand which new factor is causing the overload.
If the new level is tolerated well after a few walks, you can make the next workout slightly longer. If significant pain occurs, several days of recovery are needed, or your gait changes, it's best to return to the previous tolerable level.
Should you follow the 10% rule?
No. The rule that distance can supposedly be safely increased by a maximum of 10% per week is convenient in its simplicity, but the current evidence base does not support it as a universal limit.
A systematic review of studies of runners found only limited evidence linking acute changes in training load with injury. A later review of 36 studies also concluded that the association of injury with specific changes in distance, duration, frequency, or intensity remains inconsistent.[6]
This doesn't mean the load can be increased indefinitely. Rather, safe progression can't be reduced to a single mathematical number.
When preparing for long walks, it's best to consider your previous activity level, age, body weight, chronic illnesses, terrain, footwear, and how your legs respond after each workout.
Is it necessary to walk a distance equal to the future walk in advance?
Not necessarily.
If you're planning a five-hour excursion, there's no need to prepare for several five-hour workouts beforehand. The goal of preparation is to ensure your body can handle the long-term effort and that your footwear and equipment are comfortable.
It is more useful to gradually accumulate experience over several longer walks and at least once test conditions that are as similar as possible to the future ones: the same shoes and socks, similar terrain, the intended backpack.
If your trip involves several long days in a row, it makes sense to try walking two days in a row at a moderate volume beforehand. This isn't a strict clinical recommendation, but a practical guideline for specific training: how well you can handle one long day doesn't necessarily predict how your legs will feel the next morning.
Which muscles are especially important?
For long-distance walking, it is important to work the entire lower limb, not just the calf muscles.
The gluteal muscles help control pelvic position and hip movement. The quadriceps are actively engaged during ascents and especially during controlled descents. The gastrocnemius and soleus muscles are involved in each push-off of the foot. The foot muscles help stabilize the foot during weight transfer.
Therefore, strength training can complement walking. The World Health Organization recommends that adults perform exercises for major muscle groups at least twice a week as part of their overall health. [7]
A recent meta-analysis in older adults also found that strength training increases lower extremity strength and can improve walking distance and usual walking speed. Although these findings were primarily obtained in older adults and are not specifically tailored to hiking, they do support the link between leg strength and functional walking ability. [8]
What exercises are really beneficial?
A complex program isn't required. For most healthy people, exercises covering the basic leg movements are sufficient.
| Target | Example exercise | Why is this necessary? |
|---|---|---|
| Calves and ankles | calf raises | repeats the push-off phase of walking |
| Thigh and buttocks | chair squat or regular squat | strengthens the muscles involved in lifting and standing up |
| One leg work | lunges or split squats | brings the load closer to the single-support phase of the step |
| Ascents | steps to a stable level | useful before a route with stairs and climbs |
| Stability | one-leg stand | trains body position control |
| Muscles of the foot | controlled flexion of the arch of the foot without curling the toes | strengthens the internal muscles of the foot |
Systematic reviews of studies on intrinsic foot muscle exercises show that such programs can indeed increase arch strength and improve some measures of foot function. However, the evidence is insufficient to conclude that arch-specific exercises will prevent pain or injury in every hiker. [9]
Therefore, there's no need to make toe and arch exercises your primary training. Regular walking and overall leg strength remain more important.
Should I stretch my legs before going for a walk?
Long-term static stretching is not a prerequisite for successful walking.
It's best to start the first few minutes of your walk at a leisurely pace, gradually increasing your speed. The American Heart Association recommends this warm-up before walking: start at an easy pace, then gradually increase your speed. [10]
If a person experiences tightness in the calf muscles or ankles, familiar gentle mobility exercises may be comfortable, but stretching should not be viewed as a way to "protect" unprepared legs from repeatedly increasing the distance.
In other words, twenty minutes of stretching won't make up for missing several weeks of gradual walking.
How to Prepare for Climbs and Stairs
A route with climbs can be significantly more difficult than an equal distance on flat ground.
As you climb, the demands on your glutes, calves, and cardiovascular system increase. Therefore, for those preparing for a hilly city walk or hike, it's helpful to gradually introduce stairs and inclines even before the trip.
Avoid adding a large volume of climbing exercises in the same week as a sharp increase in total walking time. It's best to gradually adjust the intensity to determine tolerance.
Pay particular attention to descents. They may seem easier subjectively because your heart rate is lower, but the thigh muscles perform greater eccentric work—that is, they slow down the body's movement under load.
That's why, after the first long mountain route, it's the descent that often causes severe pain in the front of the thigh the next day.
Do you need trekking poles?
On rough terrain, poles can be useful for stability and distributing some of the load, but the claim that they always significantly relieve the knees is too categorical.
A review of studies on trekking poles found that their use may reduce some lower limb stress and improve stability, particularly when carrying a backpack, while slightly increasing upper body and cardiovascular work.[11]
On descents, small biomechanical studies have indeed found a reduction in some of the forces acting on the knee joint when using poles.[12]
However, on a flat surface, the reduction in knee compressive load is not always confirmed. In one laboratory study, even a significant increase in pole effort did not reduce the estimated knee compressive load. [13]
Therefore, it is more reasonable to consider poles primarily as a means of additional stability and assistance on difficult terrain, rather than as guaranteed “knee protection.”
Shoes are more important than they seem
Even well-trained muscles are of little help if the shoe squeezes the toes or constantly moves on the heel.
For long walks, shoes should fit the shape of your foot, have enough room for your toes, and provide secure support. Guy's and St Thomas' NHS Foundation Trust recommends leaving approximately 1 cm of space between your longest toe and the tip of your shoe and choosing a wide enough forefoot. [14]
The American Academy of Orthopaedic Surgeons also emphasizes that toes should not be squeezed together and that shoes should be chosen based on the actual shape of the foot. Laces, Velcro, or other fastenings help keep the shoe in place without squeezing the foot with a last that is too narrow. [15]
It's especially important to check your shoes before a trip. If your heels start to itch after forty minutes, increasing the distance often won't fix the problem.
Do new shoes need to be broken in?
It is useful to distinguish two different concepts here.
Don't buy shoes that are too tight in the hopes that they will stretch. The American Academy of Orthopaedic Surgeons clearly states that properly fitted shoes should fit right away; there's no need to count on a painful break-in period. [16]
But even a well-fitting new pair is wise to test out on short walks first. The NHS advises people prone to blisters to wear new shoes for short periods until they become accustomed to them. [17]
There's no contradiction here. New shoes should fit right away, but they should still be tested before a long hike. A short test can detect seams, toe pressure, or heel slippage before the area is subjected to hours of repeated friction.
Why do blisters appear?
A blister doesn't just occur because the skin rubs against the shoe. The key factor is repeated shear deformation of the skin layers.
A modern review of the mechanisms of blister formation emphasizes the role of repeated tissue shear rather than solely surface friction. [18]
The likelihood of a problem increases when the same area is subjected to thousands of stress cycles. Therefore, shoes that are perfectly comfortable for a twenty-minute walk may begin to rub after a few hours.
Moisture also plays a role. An observational study of 203 participants on the Camino de Santiago long-distance route found that damp socks were associated with a higher risk of blisters, while the natural or synthetic fiber composition itself was not associated with their occurrence.[19]
What socks are best for a long walk?
Scientific data does not yet determine a clear “best material”.
A systematic review of blister prevention methods found few high-quality studies on socks, antiperspirants, and barriers. Therefore, blanket statements like "wool is always better than synthetics" or "double socks are guaranteed to prevent blisters" outweigh the evidence base. [20]
What's more important is that the sock fits well, doesn't wrinkle, and doesn't stay wet for long periods of time.
The NHS recommends that if you are prone to blisters, you should wear suitable sports socks and change them if your feet become very sweaty.[21]
If your socks get wet from rain or sweat during a long walk, having a spare dry pair may be more useful than buying socks made from some "perfect" fiber.
Is it necessary to tape up the areas where it usually rubs in advance?
Sometimes this makes sense, especially if a person already knows exactly what their own problem areas are.
A systematic review of blister prevention found moderate certainty in the evidence for the benefit of paper medical tape as a protective barrier, but overall the quality of studies of preventive methods was limited.[22]
Therefore, taping the known area of friction can be considered as an option, but it is not a substitute for appropriate footwear and moisture control.
It's even more helpful to respond to the early sensation of a "hot spot"—an area of skin that begins to burn or irritate before a full-blown blister forms. Stopping and removing the sock crease, adjusting the laces, or protecting the area reduces the likelihood of further injury.
What to do if a blister has already appeared
A small closed blister is usually best left intact and protected from further friction.
The NHS advises against popping common blisters or removing the skin covering them. A soft bandage or hydrocolloid plaster can be used for protection. [23]
If the cause was specific shoes, it is not advisable to continue long walks in them until they heal.
Particular caution is required if you have diabetes, impaired sensation in your feet, or poor circulation: even minor damage to the skin can be much more serious.
Is it necessary to strengthen the feet separately?
This can be a useful addition, especially for people with severe foot weakness or balance problems, but is not a required pre-travel ritual.
Meta-analyses of studies of intrinsic foot muscle exercises have found improvements in foot strength and some biomechanical measures after specific training programs.[24]
Simple variations include controlled arch lifts without curling your toes, spreading your toes, performing toe raises, and standing on one leg.
However, if a person begins performing a large volume of unusual foot exercises for the first time a week before a trip, this itself can cause muscle soreness. Preparation should begin well in advance and remain moderate.
How to Prepare for Backpacking
If you have to wear a backpack during the route, it makes sense to do at least part of the training with it.
Additional weight increases the mechanical and energetic loads of walking. Studies of walking with loads also show changes in lower limb muscle function. [25]
Don't fill your training backpack with everything you need for your upcoming trip right away. First, make sure the walking duration itself is tolerable, and then gradually increase the intensity.
Check the fit of your backpack carefully. Even if your legs are ready, a pack that's too heavy or awkwardly positioned can limit your walk with shoulder or lower back pain.
What to do if the walks take place on asphalt
A hard, flat surface looks simple, but walking on asphalt for hours creates a very monotonous, repetitive load.
An observational study of participants on the Camino de Santiago found an association between more kilometers on asphalt and a higher likelihood of blisters compared to sections on dirt, grass, and gravel. These observational data do not prove that the asphalt itself directly causes the injury, but they do indicate that surface type may indeed matter. [26]
If your upcoming trip involves a city tour on cobblestones and asphalt, training exclusively on a soft forest trail isn't ideal. While there's no need to specifically seek out the hardest surface, it's beneficial to do some of your long walks in similar conditions.
How to prepare for the heat
In hot climates, a normal distance becomes physiologically more difficult.
The CDC notes that the risk of heat illness is higher for travelers who perform prolonged or intense activity in hot weather, especially if they are coming from cooler climates and have not yet acclimatized.[27]
For longer walks, it's wise to choose cooler hours, take breaks in the shade, and maintain adequate hydration. The CDC also recommends that those planning intense hikes in hot climates acclimate to heat stress beforehand, if possible. [28]
Don't judge your fitness solely by speed. While a person can easily complete a route in three hours at 20°C, at 33°C the same distance may require a different pace and more stops.
Do you need special insoles?
For a healthy person without pain, special individual insoles are usually not necessary just for a tourist trip.
If you already have foot problems or your doctor has prescribed orthoses, training walks should be performed in the same shoe and insole combination that you plan to use on the trip.
The biggest mistake is buying a new orthopedic insole just before a long hike and wearing it for eight hours for the first time. Even a medically approved device can alter pressure distribution and requires a tolerance test.
If the same spot on your foot constantly hurts during regular walks, it's smarter to first figure out the cause than to try to mask it with a random insole.
Is it normal for my legs to hurt after training?
Some mild general muscle fatigue can be expected after an unusually long walk.
However, localized, progressive pain in one area requires more attention. For example, stress fractures occur due to repeated overload of the bone and are especially common in situations where a person suddenly increases physical activity. [29]
Pain that initially appears only when walking, then occurs earlier with each workout, or begins to bother you at rest, is alarming. Continuing to increase your distance despite this pain is not appropriate.
The same applies to severe pain in the Achilles tendon, foot or knee if it changes the way you walk.
Fatigue and pain are not the same thing.
It is useful to distinguish between a normal training response and symptoms that require a reduction in load.
| After the walk | What does it mean more often? | What to do |
|---|---|---|
| General fatigue of both legs | normal reaction to prolonged stress | rest, then continue gradual preparation |
| Moderate muscle soreness after unusual exertion | possible delayed-onset muscle soreness | do not increase the load until recovery |
| Burning skin in one spot | friction begins | stop, check your socks and shoes, protect the area |
| Recurring heel or forefoot pain | tissue overload is possible | reduce the load; if pain persists, assess the cause |
| Point pain in the bone that gets worse with walking | stress injury is possible | stop increasing the load and seek an assessment |
| The pain makes me limp. | the load clearly exceeds tolerance | stop training and find out the reason |
| Hot, red, very swollen foot | injury, inflammation or infection is possible | medical assessment required |
When to stop training and see a doctor
If you experience severe pain, inability to step normally on your foot, or sudden, severe swelling, you should not try to "walk away."
The NHS recommends seeking urgent medical attention if you experience severe foot pain, difficulty walking, a change in the shape of your foot after an injury, hot, painful swelling, or a combination of local symptoms and fever.[30]
A particularly alarming sign is a unilateral, severely swollen, hot, and painful shin. This requires urgent evaluation, as venous thrombosis is a possible cause. If the swelling is accompanied by shortness of breath, chest pain or heaviness, hemoptysis, or fainting, emergency care is required. [31]
A routine medical evaluation is necessary if pain regularly returns with walking, interferes with normal activity, worsens despite reduced activity, or is accompanied by numbness and decreased sensation in the foot. [32]
Special care in diabetes
If you have diabetes, preparing for long walks requires more attention to the skin of your feet, especially if you already have peripheral neuropathy—nerve damage with decreased sensitivity.
The CDC emphasizes that a person with diabetic neuropathy may not notice a small cut, blister, or pressure point. Therefore, it is recommended to inspect your feet daily, wear well-fitting shoes, and seek prompt care if a blister, ulcer, redness, or swelling develops. [33]
For such a person, the strategy “if it doesn’t hurt, you can continue” is unreliable: the absence of pain may be associated precisely with a disturbance of sensitivity.
If you have diabetic neuropathy, a foot ulcer, severe circulatory problems, or have had serious foot problems before, it's best to discuss the amount of walking you should do each day with your doctor or podiatrist in advance.
What to do in the last days before a long walk
The last week is not the time to make up for lack of preparation.
If the route is already close, an extra, extremely long walk a day or two beforehand is more likely to create fatigue, a blister, or muscle soreness than to significantly improve endurance.
It's best to continue your normal activities, let any chafing heal, and make sure your shoes, socks, and backpack are fully checked.
If you're planning a trip, sleep is also a consideration. Overnight flights and sleep deprivation can reduce subjective exercise tolerance, so the first long journey immediately after a sleepless night may be more challenging than expected.
A short practical preparation algorithm
If you're a few weeks away from long walks, first determine your usual tolerable walking duration. Then walk regularly, gradually increasing the time spent standing. Once the duration is well tolerated, add elements to your future route, such as climbs, stairs, harder surfaces, or a backpack.
At the same time, you can perform simple strength exercises for your calves, thighs, and buttocks once or twice a week. Shoes you plan to wear during the trip should be tested on shorter walks; the same applies to socks and insoles.
During your preparation, track not only the distance but also how your legs react in the evening and the following morning. Recurring localized pain is a signal to reduce the load, not proof that your legs are "hardening up."
Before a multi-day route, it's helpful to spend at least a few long periods of time on your feet to check how your feet recover by the next day.
What is often misunderstood
"You need to intentionally harden your feet with blisters." No. A blister is a skin injury, not a beneficial training outcome. Preparation should reduce the likelihood of injury, not create it in advance. [34]
"New shoes should hurt first, then they'll break in." Wrong. Shoes should fit your foot right away. However, it's helpful to test out a new, properly fitted pair gradually on short walks. [35]
"To avoid injury, it's enough to follow the 10% rule." There is no reliable, universal limit that works for every person. Data on specific safe percentage increases in load remains contradictory. [36]
"Expensive, special socks guarantee a blister-free experience." Evidence for specific sock systems is limited. A more consistent recommendation is to avoid prolonged exposure to damp socks and eliminate inappropriate footwear. [37]
"Poles always take the load off the knees." Their effect depends on the terrain and technique. On downhill runs, they can reduce some of the load, but on flat surfaces, the effect on knee compressive forces is not confirmed in all studies. [38]
"If the pain can be tolerated, you should keep walking." Localized, increasing pain may be a sign of an overuse injury. Stress injuries to bones often occur after rapidly increasing an unaccustomed activity. [39]
Key points from experts
David M. Walton, MD, is a clinical associate professor of orthopedic surgery at the University of Michigan and a specialist in foot and ankle diseases. His official profile confirms his specialization in foot and ankle surgery. [40] In the materials of the American Academy of Orthopaedic Surgeons, which he co-authored, the basic principle of shoe selection is formulated very practically: shoes should fit the foot, not force the foot to adapt to a tight last. The Academy recommends not buying ill-fitting shoes with the expectation of prolonged painful "break-in" and leaving adequate room for the toes. [41]
Rebecca Rushton, a podiatrist, specializes in the prevention and treatment of friction blisters of the foot. She is the co-author of a critical review of current blister prevention methods published in the Journal of Athletic Training. [42 ] In this review, Rushton and Douglas Ritchie emphasize that blister formation is primarily associated with repetitive shear deformation of tissues, and the evidence for the effectiveness of many popular preventative measures is significantly weaker than is commonly believed. The practical implication of this approach is to primarily eliminate ill-fitting shoes, pressure, and repetitive shear, rather than relying on cream, powder, or special sock alone. [43]
Frequently Asked Questions
How much time in advance should I start preparing for long walks?
There's no set timeframe. The more the future activity differs from your usual activity, the earlier you should start. If you currently walk little, preparing several weeks in advance is much wiser than trying to dramatically increase your distance in a few days. [44]
Is it possible to prepare by walking alone?
For many healthy people, yes, especially when it comes to city walks. Strength training can further improve the legs' ability to bear weight, but walking remains the most specific workout.
How many kilometers should I walk before my trip?
There's no universal control distance. It's more important to gradually increase your time on foot and test your footwear and equipment in advance in conditions similar to your future route.
Do you need to walk every day?
Not necessarily. Frequency depends on your starting level and recovery. Regularity is more beneficial than infrequent, excessively long workouts.
Should you train with a backpack?
If you're actually going to be wearing it on your trip, yes, you should do at least a few workouts with a similar load, gradually increasing it.
Which is better: sneakers or hiking boots?
It depends on the terrain, climate, backpack weight, and individual foot type. For urban walking, well-fitting sneakers are often sufficient; challenging rocky terrain may require different footwear. Proper fit is far more important than the shoe category itself. [45]
Should I buy shoes one size bigger?
Not necessarily. Sizing varies between manufacturers. It's best to focus on the actual fit: about 1 cm of space in front of the longest toe, sufficient width, and no heel slippage. [46]
Is it okay to walk in brand new sneakers?
It's best to take a few short and medium-length walks in them beforehand. But the shoes shouldn't be too tight initially, with the expectation that they'll stretch out later. [47]
What should you do if your heel starts to rub while you're walking?
It's better to stop right away, check the toe and laces, and protect the irritated area than to wait for a full-blown blister to appear.
Are cotton socks worse than sports socks?
It's impossible to claim that one material universally prevents blisters. In a study of long hikes, sock moisture content was found to be more important than the ratio of natural to synthetic fibers. [48]
Should I use two socks at the same time?
Sometimes this system reduces friction, but the evidence for different sock systems is mixed. If you decide to use two layers, be sure to test them on a training walk first. [49]
Is it beneficial to do calf raises every day?
This is a convenient exercise for the calf muscles, but it won't prepare your legs for hours of walking on its own. It's best combined with regular walks and exercises for the thighs and buttocks.
What to do if your knees hurt after a long walk?
If the pain is moderate and quickly subsides after an unusually intense activity, first reduce the volume and assess the response. Recurring, increasing pain, or pain that alters gait requires an assessment of the cause rather than further increasing the distance.
Can you prepare for a long walk if you have diabetes?
Yes, physical activity is generally beneficial, but if you have diabetic neuropathy or foot problems, it's especially important to inspect your skin and shoes carefully. Any blister, sore, or discoloration on your foot should be taken seriously. [50]
Main
To prepare your legs for long walks, first and foremost, you need to gradually increase your usual walking time. There's no magic stretch, socks, or set percentage that can replace regular adaptation to the load.
Start by increasing the duration on a relatively easy surface, then gradually increase the terrain, speed, and backpack weight. At the same time, it's helpful to strengthen your calves, thighs, and glutes. Shoes should fit well right away, but it's definitely worth testing them on shorter walks before your trip. [51]
Blisters are easier to prevent than to treat: watch the fit of your shoes, avoid wearing damp socks for long periods of time, and respond to the first signs of burning. [52]
The most important limitation is to avoid trying to "distract" localized, increasing pain. Pain that causes limping, inability to put normal weight on the foot, severe swelling, a hot, red foot, or unilateral, painful swelling of the lower leg require discontinuing exercise and seeking medical evaluation. [53]

