Walking

[ldruce]

Having Problems With WalkAide

I am getting very frustrated. During my test period and setting up when I finally got my own, it was like a miracle. I could walk further and longer, I had more energy, I didn't need the cane 24/7 and certainly not at home. For the last few months everything seems worse when I have it on. It lifts my foot when I test it, but then when I start to walk, my foot and leg start to drag. I have gone back to wearing my AFO. Has anyone else experienced this? I have gone to 3 separate Hanger clinics, and they all said the placement of the electrodes is fine. They all want to put the cuff right under my knee, but when I do that, my foot jerks strongly to the right and I feel I am constantly fighting against that. It feels better when I put it an inch or two below, but then I have the problems mentioned above. I don't know what to do!

[Christina]

Walking

I walk on a treadmill at an incline. I start at an incline of 4 and gradually increase to 12, and then back down. I don't go at a fast pace because my left foot can only keep up at 2.5 mph. But, the incline helps build strength and endurance. And, I can hold on to the sides for balance. I also like the air conditioned environment of the gym. Tonight I walked the neighborhood, and found it much more difficult to lift my foot the farther I went, and the top of my foot hurt from the lifting. I'm not sure why increasing the incline on the treadmill helps, vs. walking outdoors, but then maybe it's the A/C.

[AMFADVENTURES]

Hey all, I recently did a lot of walking in Iceland and Holland, some of it I even combined with biking. I am really, really glad I worked myself as hard as I did in the first few months of this year and I am ever so grateful for the PT I accidentally found and worked with. I think the combination of those two things enabled me to do quite a bit more walking than I thought would be likely.

It wasn't all good, I never went out with the group at night because I was just too beat and I wanted to rest up, never mind I'd probably had more than two beers by that time too. Overall I did pretty well for the first 11 or 12 days but the last few days of the trip I had to take it pretty easy as the legs just weren't working well at all. It will be interesting to see how things are after I've recovered for a week or so.

Glad you're getting outside Veronica, there's no doubt it's not the same as a treadmill or even a smooth surface like a shopping center. Concerning making progress, what I've found is that I rarely get to the point I'd like to but I always find some area of improvement, frequently unexpected - and that never fails to keep me coming back.

I might have found a walking buddy. A fellow MSer from one of my yoga classes. She's faster than I am but that's ok, it'll be incentive and besides, I'm used to struggling to keep up. With a little luck there could even be some hiking in my future.

[Veronica]

Hi all: I've been keeping up the treadmill work, seeing some improvement and small increases in distance. So it was time to get this show on the road, so to speak, and last Saturday I got in a dedicated walk along the river on a paved path that is straight and flat. Can't say that I was surprised, but could only get 1/2 mile in, and that was with four 1 minute rests...I basically sat down on each bench as I got to it...really feeling that I needed to stop each time... annoyed me, to say the least. But I have started the outside training. Herb reminded me that outside walking is an entirely different entity from treadmill walking, and now wants me to switch my training from inside to always outside. We also factored in that I did this at the end of a day that I was active during the day ( I thought I had given my body enough of a rest before this walk, but I realize that I still wasn't at my optimum as first thing in the morning.) Now, regardless of this, and the wind, which was strong at times, I think when I do this again this weekend, in the morning, I will see just about the same results, but sure hope I am wrong. Need to remember that this progress ( yes, I still think there WILL be progress...) is going to be incredibly slow and I have to pay attention to these subtle changes... I So want to improve a bit on the walking....

[Grady]

My Bike Friday arrived about a month ago. We have had a relatively early end to winter around here so I have been able to get out and ride. I still struggle to raise my leg high enough to get over the down tube on the bike but if need be, I can just lay it on its side and get on that way. So far I like it a lot. Wish I would have purchased the BF before I bought the trike. I love the trike but not as much as I love being up at the level with my fellow riders. I have signed up for the local M.S. 150 and the week long M.S. TRAM. Now I need to train since day one of the TRAM is 87 miles.
I was having some back pain following a pilates class. Had an MRI and found out I have spinal stenosis. I had a steriod injection in my spine which seemed to help initially but seems to have worn off. I'm finding the real key for me is to stretch. I am doing that faithfully and am using a yoga strap to really stretch out my legs and hips. Regarding walking, someone mentioned it takes a lot of effort to walk correctly. I find that to be absolutely true for me. Pre-M.S. I'm sure we all took it for granted. Now it is a different story. I had been using one walking stick for most of my walking. I still do for shorter trips and around the office but anything of length, I use 2 and that really seems to help with my posture and back.
I don't participate in the blog often but I love reading about what everyone is doing. My friends and family are amazed by the things I do but I don't hold a candle to what some of you are doing. Lots of inspiration on this blog!! Keep at it and I wish you all the best!

[AMFADVENTURES]

Teena Marie, I asked my PT about the stairs and she is of the opinion it's a great exercise. She says the muscle contraction on the step up should come from the glute. She gave me another stair exercise of going up and down a stair case sideways. Like - lead with the left leg going down then lead with the right leg going back up, switch sides and repeat. Lifting the weak leg up to the next stair seemed to be the toughest part of that one for me.

I'm not getting much walking in Veronica, doing too much other stuff and I know that if I'm fatigued I won't be able to walk far. I will continue to do it when I can though. I also think part of the reason I may not be able to walk too far these days is because I am trying to walk better. It takes a lot more energy to walk correctly when you've been used to compensating in some fashion for so long. I'm also certain the walking poles help me maintain better form particularly on longer walks.

[Veronica]

Hi all: Lots of talk about walking and lots of new members since I last checked in with you all! Happy to see it, for sure....

Walsh: concerning using a cane or walking sticks or crutches.....It took me a long time emotionally to use an aid. Just didn't want to be seen with it. About three years ago, my compensation gait resulted in a really nasty case of sciatica and, separately, a shin split on my stronger leg. Was rough rehabbing, very painful, and resulted in my having to use a cane. In essence I was using my strong leg as the crutch/cane...and this is what caused my issues. After I healed I was aware of just how much more confidence, and endurance I had when I used the cane in comparison with before I did so. Now I use two trekking poles to walk longer distances or inclines in comfort, or else I use a cane for much of my outdoor walking. I do not use the cane at home, or in my office, but usually need something if walking slowly with others nearby. I say all this just to play devil's advocate here. I really want to get off the cane/aids, but for now I walk longer, in better form, and confidently with the aids. And this has helped me get out there more often without injuring my good leg.

My walking routine continues, with peaks and valleys. Haven't been able to get anywhere near the collapse point walk I did in the fall when I started this program. And I think I see what some of my problem is.... in the winter, I really cut back on my cycling/spinning...shouldn't, but honestly, it is what I do. Never had an issue in doing so, but since I am now also working on walking better, I think I need to keep it going year round to get better results with my strides. Larry or Teena Marie, you could explain why this is to me! Also have learned that my stretching between segments needs to also focus on my back/core, as often when I am getting motor fatigue, it is the core muscles that help raise my leg that do not engage ( Oh, those core exercises!!) For my most recent walking routine, I put this into practice on the recovery periods that Herb has me add, and I really felt the difference. Still haven't taken this routine into the great outdoors yet.....very interested to see how I am on a track....

" Beyond mountains there are mountains"..... I like that Larry...... says it all....

[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.

[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!

[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.

[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.

[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

[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 ?

[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

[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.