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?
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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....
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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
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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
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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.....
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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!!
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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
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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!!
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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....
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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!
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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
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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!
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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,
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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
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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.
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