Walking Rome: How to Avoid Injuries on Cobblestones

walking rome and its cobblestones

Walking Rome from end to end is an excellent method for travelers and expatriates alike to get to know a new city.

Start early in the morning before the city rush-hour begins and you’ll have the city all to yourself.  

Or take an evening walk during the twilight “magic hour” and indulge your senses with the beautiful vistas this new city has to offer.  

Magic hour along the Tiber River in Rome is especially stunning.

An active lifestyle is usually a plus for your health, but there can be downsides.

The last thing you’d want in an unfamiliar city is to get injured while walking, but unfortunately, it can happen (check this nice blog post for 10 common don’ts in Rome).

We will take you through the causes of injuries and the methods of prevention with the help of WTA (Women’s Tennis Association) accredited physiotherapist, Dr. Federica Scalabrino

Here are five common injuries that you should look out for.

Plantar Fasciitis

Do you feel a painful sensation at the base of your heel?

If you are feeling a sharp, tight, painful sensation at the base of the heel that can range anywhere from annoying to excruciating, you might be experiencing Plantar Fasciitis.

What causes plantar fasciitis?

Walking Rome in a day might not be a good idea! The common causes for these symptoms are overtraining, overuse, and improper or worn-out footwear. All or one of the above can cause pain in your heel. However, the main problem lies in tight and weakened muscles in the foot. If your feet are weak, the heel takes on an excessive load and can’t handle the strain of a long walk in Rome.

How can you treat  or avoid plantar fasciitis?

Orthoses (custom fitted insoles) and stable shoes oftentimes serve as a quick fix. However, if you are looking for a long term solution, diligent stretching combined with strengthening the muscles in and around the feet will address the root of the problem and help prevent a recurrence.

Achilles tendinopathies

Are you experiencing pain at the back of your lower leg?

It might be Achilles Tendinopathy.

Walkers who suffer from Achilles tendinitis will often complain of swelling and pain close to the heel, which is oftentimes sharp and can be incapacitating. Achilles tendinopathy manifests itself as pain at the back of the lower leg, just the above the heel at the Achilles tendon, which is the thick band of tissue that attaches the calf muscles to the heel bone.

Why are you experiencing this shooting pain?

The major causes of this inflammation can be tight calves and unsupportive footwear which can overburden the Achilles tendon over time. So, perhaps it was not an arrow that took the great Greek hero Achilles down after all. It could have been his shoes.

How can you treat it and prevent it from affecting your mobility?

Physical therapy (including Laser Therapy, Ultrasound and Tecar Therapy), resting, ice, and stretching will all help right away by relieving symptoms, so that you can complete your long planned Rome walk. Aids such as orthotics, heel lifts, and highly structured shoes are other possible short-term solutions.

For the long term, especially if you are a runner, it’s worth your while to pay close attention to stretching and strengthening your lower legs. Ask the physical therapist to help you learn the right exercises, then you’ll be able to walk Rome and the Vatican in a single day.

ITB Syndrome

When you walk downhill, do you feel a stabbing pain on the side of your knee?

Let’s hope not! ITB Syndrome has been compared to the feeling of somebody stabbing you on the side of your knee when you run or walk, especially when going downhill. Your Iliotibial band (ITB) is a tendon that connects your knee to your hip. That is why is called ITB Syndrome.

Why might this be happening to you?

Many things can be the cause of the ITB Syndrome. The most common is running or walking down hilly streets frequently and on the same side of the street. Does this sound like part of walking Rome around its seven hills? Both the frequency and choosing the same side of the street put a lot of stress on one side of the knee and cause friction between the IT band and the femur causing inflammation.

Prevention and solutions

Massaging the quadriceps and hamstring muscles around the area, and using a foam roller on the affected area will help loosen things up, while a regimen of icing and working regularly with a physiotherapist will aid a fast recovery. Avoid aggressive downhill running, and if you always walk on the same side of the road, switch directions every so often. Finally, strengthen your hips, quads and hamstrings and glutes. See a professional for a good program of stretching and strengthening.

Runner’s knee

Feel a constant ache underneath your kneecap when you run on cobblestones?

You are likely  experiencing runner’s knee or Patellofemoral pain syndrome. The main symptom is  pain just below the kneecap that usually worsens as the intensity of exercise increases.

What may cause it?

The most common causes vary between uneven running surfaces and poor choice of footwear,  to weak quads and hips. Unaddressed biomechanical flaws can also contribute to this common injury. So pay close attention when running in the streets in Rome which are known for being uneven!

What can you do to make it go away?

Long term solutions are switching up the surfaces you run on (have you tried running in Rome’s parks?), strengthening your knees, and making sure you’re running properly and in good footwear that is not worn out. Other preventatives include practicing simple form fixes such as shortening your stride and striking. Strengthening the knee and reducing the inflammation are the keys to a healthy knee. Also, Laser therapy, Tecar Therapy, massage and manual therapy can be very helpful during the early stage of the symptoms.

Shin splints

Are you experiencing pain in your shin area while walking Rome?

Shin splints can refer to a number of different dysfunctions which involve pain in the shin area. At their worst, shin splints can turn into a stress fracture along the tibia, and in less severe cases, the muscles in the shin area may be tender and inflamed. Characteristically, the pain from shin splints lessens a few miles into your run.

What is causing it?

The combination of inexperience with regular running on hard surfaces and worn-out or improper footwear creates a recipe for disaster. Tight muscles don’t help matters either. The less mobile the muscles surrounding your shin are, the more stress there is on the entire area.

Is there a quick fix? How can you prevent it?

Rest, ice, anti-inflammatories and physical therapy will help reduce the tenderness and inflammation. Walking on soft surfaces such as trails or grass, will help reduce the impact on your lower legs, and paying close attention to the mileage on your walking shoes will ensure that you’re not driving on flat tires! Walking Rome’s cobblestone streets is fascinating, but why not take a stroll into Villa Borghese’s park to rest your muscles?

Federica Scalabrino, MS, PT

Physiotherapist Dr. Federica Scalabrino – Physical therapist accredited by the Women’s Tennis Association (W.T.A) and the International Tennis Federation (I.T.F.)