Walking

[Veronica]

I like this thread! So today I saw my PT...been seeing him now once a month since I have really committed to getting this walking to a more comfortable and better level. My last collapse point walk just gave me an additional 2 minutes, and added just about 1/10 of a mile, but as Herb said, I am now walking non-stop for 25 minutes and when we started this, I was so uncomfortable walking more than a city block or two.... So, progress!! He made my eyes cross when he suggested I think about the 5K Walk MS event in the spring, and he said he would do it with me. It is very unbelievable to me that I could walk 5K at this point, but he has turned me into a believer with the biking, so what the heck. It's a goal..... At this point, he wants me to do a collapse point walk once a WEEK, and an internal walk routine once a week....My interval walk is now at 9 mins walking, rest, 7 mins walk, rest, 6 mins walk,rest, 6 mins walk, rest, 6 mins walk. Rests are still 4 minutes each. We also talked about and worked on my length of strides. He had me take much smaller steps, move faster, and swing my arms. At first I was pumping them, and bending the elbow. He corrected me and had me just swing them from the shoulder in a more loose, fluid manner. When I did the walk that way, his eyes lite up and said "YES! That looks so normal!!" I told him I felt like a robot, and he chuckled saying that others have said the same thing, when in fact, THAT is the way one walks when there is no compromising issues.... All this is just fascinating to me....and so encouraging..... Will I do Walk MS? Oh I don't know, but just to have hope for enjoying walking again is such a gift to me... I'll keep you in the loop!!

[AMFADVENTURES]

Glad to hear that a PT actually can teach an MSer to walk again, quite encouraging actually, thanks for that.

I've been doing stairs regularly for a couple of months now and I think I can say two things about it:
1) I certainly am more confident on stairs, both up and down and although I prefer to have a hand rail, I'm also more confident even in the absence of one.

2) Doing the stairs has changed my gait, whether for better or worse I'm not sure. For some reason the knee lifting required for stair climbing doesn't seem to have transferred to walking but I feel like the leg strength gained from the stairs has.

Like Bobbo I can always do more and do it easier and better when I'm fresh but unlike TM and Bobbo, I don't fare that well in the middle of the night. It seems to take a while to get my muscles working very well.

[AMFADVENTURES]

Got a chance to test out my walking the other day at a large venue bike swap fair. Using a cane, there is no doubt I can and am walking better. Even the leg lift is better WHEN I REALLY CONCENTRATE on it. I am also walking slightly faster and it all lasted for a little over an hour. I still hit the "wall" at about the one hour mark but I walked better for more of that hour than I have in the past. The only change I've made in my normal routine lately has been climbing up and down a flight of stairs every day.

One thing has me baffled though, I can hit a wall cycling, recover in anywhere from 30 seconds to 20 minutes and keep on going. With walking however, once I hit the wall, there isn't much recovery until the next day. Beats me what's going on there????????

[teena marie]

Larry, I hear you 100%. All I can think of is that walking is weight bearing.

Veronica, a 5k walk sounds like an amazing goal and you of all people can achieve this.

Arm swinging is an important part of the pendulum action of walking, the left right action. When I'm doing my walking visualization I actually swing my arms and move my hips and shoulders. I'm planning to work on this action in the pool.

Take care all,

Teena Marie

[Veronica]

I agree with Teena Marie, Larry, that the difference is that biking isn't the weight bearing that walking is.

Focusing on how people without physical issues walk has become a slight obsession with me...particularly the arm swing, as I have learned that mine had become either very artificial or bordered on none existent. I have it back again, but not naturally....yet.....! Gonna try the visualizations.....guess it is like muscle memory on another level.

This past Sunday I was going to do my weekly Collapse Point Walk on the treadmill, didn't feel like endurance was my friend that day, but started it anyway. Got only to 11 minutes before I really needed to stop. I didn't want to log that in as the weekly CPW, so I just decided to rest a few minutes and do it again.....lasted 9 minutes the second time, did another quick 4 min rest and then was able to walk on for total of 32 mins.... was on 1.9 the entire time, which is my fastest consistent speed yet, and I really worked the last two minutes as I was closing in on one mile... This was a milestone for me...even if it wasn't a continuous CPW, it still was a mile on the mill. I really just did a variation of my PT's interval training, and am checking with him to make sure there is no reason why I can't do it this way from now on.... Just linking CPWs together until I run out of time or abililty. Tomorrow will be my next time on the mill and if all conditions are GO, I will try the pure collapse point walk and see if I can beat my last time of 28 minutes. This is getting to be like a game for me! Gonna talk to Herb about when can I add some incline to the treadmill training as I know that this is such an artificial walk right now. It is definitely translating into a better and more comfortable walk for me, but the quality of my walk outside is nowhere near as good as it is on the mill due to all the natural factors there.

[Veronica]

Hi all:
HUGE milestone for me on Monday. Got back on the treadmill to do the Collapse Point Walk and walked nonstop for 35 minutes covering 1.052 miles.....Be it on a treadmill or on the ground I have not walked non stop for 35 minutes in years.....and I really cannot remember the last time I walked a nonstop mile. I am using a treadmill that has the cross training feature so I can pump my arms as I go and I think this is very important to help me get the natural swing of the arms back. I have alot of work to do on my form when walking "in the real world" but I am so happy for having broken the 1 mile marker.... Herb had set a target of 1.6 miles for the collapse point walk for me in six months from when we started this, so I think I am well on target. Six months would be February....

[teena marie]

Hi all,

Veronica,such fantastic news. Arm swinging is key, in my opinion. I practise a few exaggerated steps in the pool,really thinking about a big X connecting shoulders and hips,right and left. My left hip and shoulder don't swing with ease. I think there's some spasticity there. I love the term collapse point walk.I've experienced it of late walking out of work in my severely overheated building!

For me, walking is all about the pelvis being able to move smoothly. Incidentally,I've introduced Kegel exercises to improve some bladder control. It's helping access some deep core muscles that attach to the pelvis. This in turn helps with lifting the legs.

It's also about keeping the core cool. Yesterday, I brought my ice vest to work and put it on 30 minutes before leaving. What a huge help and what a difference.

Take care all,

Teena Marie

[AMFADVENTURES]

That's really cool Veronica and it's encouraging. I'm sure you and TM are right about the weight bearing aspect of walking, there is undoubtedly more neuromuscular activity involved which leads to faster fatigue and probably slower recovery, particularly among all of those stabilizing muscles which are required for balance. But your ability to reach new heights certainly shows that there is hope through training.

I've done a couple of walks myself recently. The first one was a half hour on a relatively flat gravel trail. I like the gravel because if I happen to drag my foot a little, it's less likely to trip me up. At the end I added about 15 minutes of walking across a deep grassy area. It forced me to pay attention to lifting my foot no matter how awkwardly, but it definitely ended up being a collapse point walk. Spasticity is a big problem that I can only partially overcome with a huge effort.

A couple of days later I did a 30 minute walk at as fast of a pace as I could. I used a single pole but, except for a handful of slightly off balance moments, hardly needed it. I was pretty trashed afterward but seemed to recover by the end of the day.

On my walks, I find keeping my upper body well centered over my hips key to a more normal gait. I'm also concentrating on heel strike and keeping it on a relatively narrow walking line. It's a lot to concentrate on but it seems to help my gait, hopefully endurance will follow at some point.

[teena marie]

Sounds like you're on the right track, Larry. I agee,it's a lot to concentrate on. But, I believe by breaking it down into parts, we will keep discovering the nuances of our body.

A few thoughts.
The effect of gravity has a huge influence on endurance and walking.
Being able to successfully transfer weight from side to side requires pelvic stability.

To help with my exploration and understanding, I google search muscles used in walking, effect of gravity on the nervous system, effect of gravity on walking, etc.

I continue with sporadic walking visualizations. I also try to move hips and shoulders to music, such as my favorite Jimmy Cliff song You can get it if you really want.

Keep up the amazing explorations.

Teena Marie

[AMFADVENTURES]

Hey TM, yes, there is no doubt that concentrating on movement and the nuances involved is helping. The next trick will be turning it into a more automatic response which might just be a "practice makes perfect" scenario. Time will tell.

I've also been looking into the process of movement from a neuromuscular physiology point of view. So far I've found out that it's an incredibly complicated system of conscious and unconscious neural impulses and feedback loops driven by equally complicated neural input from our senses. Throw some missing myelin, dead neurons and weak muscles in there and it's absolutely amazing that we're able to do the things we can and even more encouraging that we frequently seem to be able to improve on them. It's all way over my head but, with some luck, maybe a little insight will eventually come of it.

It's a shame there's not more research on PWMS going on in this area. Seems like we should be past the point of 'this or that exercise actually helps PWMS' and on to more of the detailed what and why of it, and how to make it even more effective. - just a thought

Take care,

[Veronica]

Hi all: Ok, first an update on the Walking Saga: I saw Herb last week and we discussed my collapse point walk of a mile, and then my having done "linked" collapse point walks. Conclusion: the linked walks really are NOT what I should do, as I fatigue out earlier, and ultimately don't "go the distance"....It is just what he has always said to me: Do intermittent exercises, with rests before I feel the need ....keeps the fatigue in check and ultimately gets me to go farther. It is what he had me do to get back to biking....it works.....so I am listening to him.....

What he changed: Now I do what he calls an Interval Collapse point walk. This is 4-5 minute walks with equal recovery, and repeated to collapse point ( and again, that doesn't mean fall down collapse...just to a point where I cannot stay in good form) I am to do this weekly, in addition to the intermittent training of walking in segments of 9,7,6,6,6 minutes with 4 minute rests between. I spoke to him about walking "in the real world" vs. the treadmill, and he said that while he wants me to do walks outside on a relatively flat surface when weather permits, I gain alot from the treadmill in terms of setting my "form".....muscle memory stuff..... Concerning increasing the grade on the treadmill to better simulate outside walking, I am to add just .5%-1% grade for 30 seconds at the end of each intermittent walk section. Some may see this as incredibly complicated, but it really isn't and I so see the improvement. Not just on the mill, but throughout my day when walking....it takes fatigue just a little bit longer to show up... I did my first Interval Collapse Point walk on Sunday ( 5 mins walking/5 mins resting) and got in 40 minutes and a bit longer than a mile distance. And I wasn't totally wiped out after. While I have experienced this progress in terms of the biking, it is still very shocking to me to see that I am progressing as I am with walking.

Larry, concerning your thought about more effective exercise programs for PWMS.... the research is going on, and it over and over again shows that to be optimally effective, an exercise regimen for us needs to be very individualize focusing on each of our individual deficits and weaknesses... and it needs to take into account the fatigue factors and thus be of an intermittent nature....

I'll get off my soapbox now...

Be well everyone!

[teena marie]

Hi all,

Veronica, it is so wonderful you have such a great physiotherapist. The video posted by Dave was great. I dream of working with someone like that. Could you ask him which stretches he recommends for the calf muscles?

Many thanks,

Teena Marie

[allanmiller735]

Stairs and rollator

First I want to say how much I enjoy this blog. It's a very positive environment.

I've started using two canes, but I find I'm uncoordinated. I get confused. I really prefer one cane. I feel more organized. But with one cane it's hard not to lean forward or to one side. I've got three different styles of hiking poles. They all work well. A bit better than two canes.

They best by far is a rollator (4 wheeled walker). I bought a Volaris Smart Patrol Rollator with ten inch wheels. The frame flexes on rougher ground. Designed in Sweden. Worth the money.

I also bought a Volaris Smart Rollator which is the same but with eight inch wheels. More suitable for indoor and outdoor and general use. If you only buy one you don't need the Patrol.

On the first day with the Volaris Smart Patrol Rollator I went 1.8 km. On the day m 2.2 km. I was astonished at how using a rollator improved my balance, stamina, and confidence.

With regard to stairs, backwards like a ladder is best. If you fall you'll fall forwards towards the steps. Easy to recover. And your toes are on the steps, not your heels.

Best wishes to all!

[ActiveMSers]

Thanks for the stair advice, Allan. And that all-terrain rollator looks sweet. Have you tried forearm crutches? They are far more stable than two canes and best trekking poles for support....

[Veronica]

Hi all: I've gotten myself back into a treamill routine again and see that I actually lost a bit of ground(so to speak) with my goofing off during December. I am confident that it'll come back to where I left off if I apply myself... really surprised me that I got winded after about 15 minutes! Have gotten it back up to about 18 minutes in collapse point walk....a far cry from where I was back in the fall....about 35 mins or so... I have learned my lesson!! What's the expression? "Use it or lose it?" Ain't gonna happen here....... and just for a laugh, when I first got back on doing a concentrated time on the treadmill, my cat came into the room, kept looking at me and yowling as if he really wanted to tell me something, then JUMPED onto the tread and promptly flew off the back.... Don't know WHAT he was thinking!!