Walking

[teena marie]

Hi all,

I now wear my ice vest walking out of work and it's made a big difference. It's a challenge heading outside to my car in frigid temps but it's worth it in terms of the gains.

Based on Herb's recommendations, I'd like to incorporate rests to increase my endurance. Outside, there's no where to sit plus there is the challenge of standing up again if there's nothing to hang on to. So tomorrow after my swim, I'm going to try walking up and down my hall with a chair positioned at each end and see how it goes.

Take care all,

Teena Marie

[Veronica]

Teena Marie, You are a testament to the "Do What I Have to Do" theory of living well with MS! Chilly on the inside, chilly on the outside, but moving! Good for you with that ice vest ...

And I look forward to hearing of your gains on the walking with your new approach. I know it will help...

I've gotten the treadmill routine entrenched back into my life. Still recovering some that I lost from the Goof Off period in December. But it is coming back. We originally had my Feb goal as 1.75 miles for the collapse point walk. I wish Feb had a few more days in it! It's gonna be interesting to see how close I can get to that by Feb 28... a definite challenge! One thing that I found interesting last night when I was on it.....I was able to up my top speed at the end of the walk to 2.6 which for me is like running at top speed. I have to hold on to the side of the machine instead of using the cross training poles, but I was able to keep these legs of mine moving for about a minute. Almost out of control, but I didn't even feel like I was in danger of tripping....Felt good.....And I envisioned our high school track star that Dave highlighted with her video recently....Kayla, you helped me out!!

[Veronica]

Ok, so two nights after I posted last, I came down with one heck of a cold. First cold in maybe 6 years. And like Larry, it cranked up all sorts of pseudo-exacerbations. Walking was really wonky, and my right hand was weaker than it ever has been. I called my neurologist to just make sure this was what was going on, and he confirmed it, promised me that once the fever broke, and the cold subsided, I would go back to where I was. Had me get on an antibiotic just in case there was a bacterial infection causing the sore throat. So, I did what he wanted, the cold slowly left me, and after 10 days of little to no work on walking, I started on the treadmill again, and was aghast at how much I had lost. Boy, I have had a few false starts these past few months! Herb cranked back my routine, back to very small increments....embarassingly small increments, but needed as I still am a bit winded when exerting myself. SO, here I go again.....tonight just did 10 mins....in increments! But I lasted a bit better than my walk two days ago when I did 8 minutes. I am taking all this in stride ( pun intended!) and know that I can get this back up to where I was at the end of November ( oh, that seems so long ago!) Has reminded me that progress isn't always in a straight line....as long as it is progress I have to not be concerned with the curves in the trail.....

[teena marie]

Hi all,

I've been working with a new physio and it's helping on many levels including my walking. Two of the exercises that have particularly helped is sit to stand not using anything to hang on to and a weight shifting exercise. For sit to stand, he sits in front of me and keeps my left knee from turning in. By getting my weight over my knees I can really use the power of my quads to push up. It's really increased the strength especially in my left hip.

The weight shifting exercise is shifting to the left, lifting the right foot onto a book shift to the right for a few seconds back to the left and take the foot off the book, all using minimal support from my hands. Repeat the other side. With my walking visualization, I've incorporated this weight shifting with my arm swinging.

We also walk. Instead of my sticks, I hang on to his fingers ever so gently and get the neurons to remember what it's like to be upright with no support from sticks. The only thing is I'm not incorporating arm swinging.

I'm encouraged.

I still use my ice vest walking out from work and thankfully it's not as cold outside so that makes life easier. I'm faster. My timed walk is down to 5.5 minutes from 10-15 minutes last year.

I haven't had the chance to incorporate Herb's strategy for increasing endurance. That's on the future agenda.

Take care all,

Teena Marie

[AMFADVENTURES]

Impressive news on your walking TM. Although I cut back for a while, I haven't neglected mine either. Went out for 40 minutes yesterday morning to what Veronica calls the collapse point, then went to yoga. I was happy with the 40 minutes because I had done an hour and a half of intense intervals on the bike the day before so wasn't particularly fresh. Furthermore, I expected to be wiped out for the rest of the day but found by early afternoon I was getting restless and needed to get out and do something even if it was just going to the store and fixing dinner.

It's a great idea to get your PT to walk with you, I need to do that. I did notice the last time that some compensation mechanisms are trying to work their way back into my gait. I plan to start substituting walking for some of the easy cycling days now but I can tell I'll need to monitor my gait carefully. I'm hoping Herbs successive short period method might help with that but like you, I'm not really doing it that way yet.

Larry

[Veronica]

Nice Teena Marie! Must be making you very happy with these accomplishments....made me happy to read about them! I am so glad that you've got a PT that is knowledgable, and caring, and is working with you so well..Makes all the difference..

Larry, I crave doing a 40 min collapse point walk OUTSIDE.....never mind doing it after cycling/spinning intensely the day before.

My walking routine continues, with still small increments of walking spaced with 2-3 mins of recovery/stretching. Herb had me dial back the speed abit...I think I was focusing too much on wanting to accomplish a distance, and wasn't paying enough attention to my form, or need to stretch. And it fatigued me, and frustrated me. So I knocked off my nonsense, and am 100% following his instructions. Nowhere near the 1.75 mile mark that we first strived for achieving end of Feb, but what the heck...Endurance is continuing to build!

An interesting development: Earlier this week, I was doing a presentation with a friend at an elementary school on adaptive sports, and we were using some of the adaptive ski equipment to show the students. I had parked at the handicapped spot, but the entrance that we needed to use was on the other side of the school, so my friend drove around, got me and the gear loaded in his car, and we went to the other side and started to unload everything. I realized that I had left my cane back in my car, and we really didn't have time to go back and get it. While I needed to lean on my friend's arm to go up a couple steps without rails, the rest of the day at the school, I was quite comfortable walking without the cane. Long corridors and no wall bouncing, or right leg dragging behind abit. And as we talked to the kindergardeners who were all seated around us, I was able to get up at times to "corral" some of the little ones back into the circle, and not feel that I would fall over onto any of them. (Now wouldn't that have been a sight???) Felt good....

[teena marie]

Oh my God, Veronica that must have felt amazing. The stuff dreams are made of. Gives me the shivers.

Larry, what compensations are you noticing in your gait?

[AMFADVENTURES]

TM, a new compensation in my walking is the roundhouse swing. The weak leg comes around in an exaggerated arc to plant in front for the next step instead of the knee lifting and kicking out. It didn't do that before. Something to do with strengthening the hip flexors maybe? Neuromuscular retraining isn't easy.

[Suebee]

Hi AM adventures and all. Is the compensation method ok to use. After a significant ms attack, This was the main method I used to get my legs to swing forward and my PT would get on my case. She made me focus on using muscles to keep legs to not swing forward. Now, when I'm particularly fatigued I notice I do it.

Suebee

[Suebee]

I was wondering if you all use private PT or through insurance? If through insurance, is it because you had a new symptom or flare that needed to be addressed ? I have RR aggressive MS. I had 6 mos of in home PT OT etc then about 2 years PT outside home, but it addressed becoming functional. Without a "new " symptom and because I'm stronger, I was told I can't get Pt through insurance. My neuros just tell me to do what I can and when I find I'm too tired, back off. Not much direction! I am the strongest I've been in 10 years and in past 2 years started taking classes and took a few weeks of personal training to make plan. I discovered on my own that intervals worked for me and was excited but I need direction on setting up a routine to be best I can be. My balance is no good and exercises need to talks into account. I don't use cane anymore. Yay. Does Herb have website article on stretching ?

[teena marie]

Larry, I know what you're describing. Circumduction. I have the same and, in my case, it's partly related to foot drop as well as weaker hip flexor and hyperextension of the leg. I use a musmate http://www.musmate.co.uk/ to help pull the leg through so that I'm not swinging it out to the side. It also helps with the foot drop. I'm also finding that with my improved weight shift there is more room to bring my leg forward. Strengthening my quads is helping with the leg straightening. Are you still doing stair climbing? What does your physio say about it? Do you notice a difference if you use bilateral support with trekking poles?

Subee, I'm in Canada so I think the insurance question is different. However, it's private.

Take care all,

Teena Marie

[AMFADVENTURES]

Hi AM adventures and all. Is the compensation method ok to use. After a significant ms attack, This was the main method I used to get my legs to swing forward and my PT would get on my case. She made me focus on using muscles to keep legs to not swing forward. Now, when I'm particularly fatigued I notice I do it. Suebee

Suebee, The biggest problem with physical compensation for weakness is the irreversible damage it can cause to other joints, knee, hip, back even ankles. If or before that starts to happen it's best to seek out some form of orthotic or aid to help correct the problem. There are lots of different forms of orthotic devices designed to help with different weaknesses mentioned in these forums.

Strengthening those weaknesses through physical therapy is of course the best alternative but, if you can even do it, it's a long hard road and personally I've never had a PT through insurance who ever really helped me much. Recently I found a personal trainer and physical therapist who is helping me tremendously. Although it is a private pay situation it's not any more expensive than my co-pay was for the PT's through insurance.

TM, circumduction sounds right, resulting from everything you mentioned. By concentrating and walking relatively slowly I can frequently overcome it for anywhere between 20 and 40 minutes before fatigue sets in. I was using two poles for a while but fell back to one because it seems to allow me to concentrate on the process of walking better. I am actually thinking of walking and carrying my poles with me until the fatigue sets in then using one or both to get back to wherever I started from.

Being able to walk very far at all seems to have a lot to do with alignment. Body straight, hips square, weight centered, concentrate on pushing off with the toes, lifting the knee and striking with the heel, hope the side to side balance doesn't get too far out of line.

I did 2 walks last week, the first one went well, 40 minutes, just barely to collapse point at the end. The second one I aborted after 20 minutes, nothing was working well. I suspect it had a lot to do with leg presses the previous day.

"Beyond mountains there are mountains" from an old Haitian proverb. It means you complete one challenge only to start the next one. Very appropriate for PWMS.

[walshjp]

Hello all... I am new to the site and this forum. I have progressive MS and have found walking is becoming increasingly difficult for me and the time that I can walk before fatigue/spasticity make it nearly impossible for me to continue has shortened considerably.

I used to be able to walk about 40 minutes before foot drop and fatigue made things difficult. Now, at about 20 minutes, I start stumbling about and find it hard to pick up my feet.

Any tips for how to get back to longer walks?

PS, I have been working out at a gym 2-3 times a week, doing a lot of single leg presses, step ups, jump rope, etc., for balance and strengthening... and I ride the stationary bike. It just seems that walking is the thing that nails me.

I do not yet use walking sticks or crutches and am holding out as long as possible.

[Suebee]

AM & TM thanks for comments. Glad you've found professionals to guide you. I wish it was easier to find a private Personal trainer that really gets MS. I'm continuing on my trial and error interval training for 5 K. I took your advice AM and did stationary bike when didn't feel up to "run". I think I can do this! It means a lot to me to know you all are out there in cyber space meeting similar challenges but not giving in.
Walsh- I found walking is best done by me earlier in day and out of sun. A cool shower after workout also seems to prevent wanting a nap after workout. Calcium magnesium zinc combo tablets give me some relief from spasticity. Glad you joined group!

[bknyfinest1]

We're working towards the same goal, walshjp !! My neuro told me the best way to increase endurance is to do more walking. I discussed this with my new PT who agreed and added some functional advice to go along with it. Stretching (especially the calf muscle) is key. Along with incremental increases in distance. For example if you walk one block for three days the next three days should be 1.5 blocks. Of course you have to do as much as you are comfortable with since everyone's MS is so different.

I also found TONS of info just from going through this thread.