Walking is a universally available and inexpensive physical activity that promotes health and well-being. Patients with severe osteoarthritis, peripheral artery disease, and symptomatic spinal stenosis may require alternative forms of physical activity. Before prescribing a walking program, injury and fall risk should be assessed. Patients beginning a walking program may develop musculoskeletal overuse symptoms despite proper preparticipation screening measures that address existing pain and obvious mobility and strength deficits. When the patient develops walking-induced pain, the nurse practitioner should use simple evaluation tools and principles of management to facilitate return to a safe level and mode of physical activity.