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My PT Assessment & Drop Foot Question
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My PT Assessment & Drop Foot Question

I picked up my 1st PT session assessment today.
It lists out my primary problems as some balance, standing, & postural issues, neurological issues, as well as walking/gait issues.

His impressions are - primary weakness in the adductor muscles, tightness in leg, back, & core muscles, which are in spasm. Right upper extremity strength & coordination issues greater than the left, as well as bilateral lower extremity coordination & strength issues.

It says that they suggest 6 MONTHS of physical therapy. I thought that was quite a long time.

Onto the foot drop question. I've never had foot drop before, so I'm not sure if this is what I have. My right foot has been feeling really heavy and like it's pulling downward towards the front.  However, I can move my foot up & down. It feels like I need to have something underneathe it to push it up into the flat position, otherwise it kind of hurts when it's hanging down. And it feels strange around my ankle. My right hip has been killing me - esp. at night. I'm assuming because I'm walking a little different. I always seem to walk with an abnormal gait, but a lot of times I've been noticing I'm walking with my right foot point out a little, with my leg turned outward. Does this sound like drop foot or something else?

Thanks everyone!
Kelly
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352007_tn?1372861481
Definitely sounds like you are having some weakness in your muscles to be causing your foot to point forward.  

Yes, when your gait changes, you are using muscles that will eventually compensate for the ones you're suppose to be using.  Just as I had a wide gait (ataxic gait), I would be using muscles that were not meant for the walking, hence my left hip would have spasms as well as my quads, calf and arch of foot.  It was quite painful.  When PT corrected me in how I was suppose to be I could feel the strain on my muscles.  I have not walked normally for quite some time.  

It sounds like drop foot to me Kelly and it is not surprising you're turning your leg outward or externally rotating to compensate for not dragging your foes along the floor or stubbing it.  That is why some MS'ers will have a "steppage" gait because they will use their thigh muscles to raise your foot a bit higher to avoid that.

Sounds like your PT is on the ball and honestly, I'd take PT as long as they would give it to me (if I were you).  I loved my PT.  I stopped going because of the burning issue in the entire month of October with my left arm and left leg.  I'll be restarting again soon as **** starts settling down.

But there are things you can do for drop foot, especially exercises as your Physical therapist will incorporate strengthening exercises of your leg muscles and will keep your range of motion within tolerable limits and perhaps may even go beyond that to ensure no contractures.  There are other modalities (ie: splints) PT can initiate too depending on the severity, but I think right now your PT will concentrate on strengthening.  

With much love and kisses

Lisa
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352007_tn?1372861481
Definitely sounds like you are having some weakness in your muscles to be causing your foot to point forward.  

Yes, when your gait changes, you are using muscles that will eventually compensate for the ones you're suppose to be using.  Just as I had a wide gait (ataxic gait), I would be using muscles that were not meant for the walking, hence my left hip would have spasms as well as my quads, calf and arch of foot.  It was quite painful.  When PT corrected me in how I was suppose to be I could feel the strain on my muscles.  I have not walked normally for quite some time.  

It sounds like drop foot to me Kelly and it is not surprising you're turning your leg outward or externally rotating to compensate for not dragging your foes along the floor or stubbing it.  That is why some MS'ers will have a "steppage" gait because they will use their thigh muscles to raise your foot a bit higher to avoid that.

Sounds like your PT is on the ball and honestly, I'd take PT as long as they would give it to me (if I were you).  I loved my PT.  I stopped going because of the burning issue in the entire month of October with my left arm and left leg.  I'll be restarting again soon as **** starts settling down.

But there are things you can do for drop foot, especially exercises as your Physical therapist will incorporate strengthening exercises of your leg muscles and will keep your range of motion within tolerable limits and perhaps may even go beyond that to ensure no contractures.  There are other modalities (ie: splints) PT can initiate too depending on the severity, but I think right now your PT will concentrate on strengthening.  

With much love and kisses

Lisa
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Thanks Lisa!  :-)
I'm supposed to start PT again soon, too. Once my surgeon/doctor clears me to start going again.  I think his focus for me right now is stetching (which could relate to range of motion like you had said) and strengthening my muscles.  
I'm happy to have the opportunity to have physical therapy.  

love & hugs,
Kelly  
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Omg...no need to thank me one bit Kelly sheesh!  I just reread what I wrote and what a sloppy version of explaining things.  Where is twopack when you need her? LOL!

I'm excited that you will be starting PT soon and hopefully your surgeon/doctor will clear you sooner than later.  

I have to say, when my PT stretches me, it hurts.  She says my hamstrings are tight, my hip muscles are tight, everything is freaking tight.  I get spasms or my muscles will have a ball in it and you can palpate it. When she massages it out...it feels real good (not). LOL.

I can't wait for you to start this so you can get yourself on track.  

love and hugs to you my friend

Lisa
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    I don't think we have met but, my name is Misty nice to meet you.  I just had to drop a line to you because, I have extremely bad foot drop that they say will never get any better. So, I know how you feel.   Although I don't know about my gait because I'm not about to walk.  But, I can say.  My foot is blue and very numb.  And its just kinda hangs there.   I can't feel my foot but,  my ankle is in a lot of pain because I'm unable to move that foot at all.  

    Your not alone.   I had physical therpy and they basically told me nothing more we can do.    And then I heard that your ins.  will not allow visits unless you are progessing along.  I don't really understand that and think its a bunch of crap.   I stated I just wanted to stay in therpy and keep working on the muscles I did have.  They said that they were unable to do that.

  Anyways , I hope this is making sense to you because I'm rambling on.  But, when I seen your story I thought I can relate to that.

     Take care,  always stay positive.   It's very nice to meet you.
         Misty
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    I must do my correction.  I'm not able to walk.  These stupid fingers I should read before sending,  very sorry. Misty.
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1225331_tn?1333369369
Hi Misty, Welcome to the MS forum. Thanks for posting on my question.
How long have you had MS and what type do you have?

That really s u cks about them not letting you continue with the physical therapy. How much time did they let you try it before they said it wasn't really working - 1 month or 2 months or what?  I hope they don't say that to me.  Are you conitnuing to do the things that they taught you in PT?  Hopefully they taught you quite a bit that you're able to continue on your own.

Take care,
Kelly
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   I'm not dx yet going through the process.   I did 5 months of pt before the said they weren't able to do anything else for me.   Along with 2 months of home therpy.    Because I'm unable to walk anymore I'm pretty much bed bound and in my wheelchair.    I'm not able to be in my wheelchair a lot because the pain as got so bad.

    I try and keep moving the muscles that I have but it can be a daily chore.   I did teach me a lot but I was also on a walker then.   I have basically gone down hill fast.     But I'm trying to remain positive and I will continue to fight.

    I hope all goes well with you.    I hope they are able to recover your foot before it gets too bad.

            Take care
              Misty
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   Oh.  I'm also in the process of doing Aqua therpy.  I'm just hoping my doctor ok it.

    Misty
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1225331_tn?1333369369
Misty, wow, all that time in PT and you still don't have a definitive diagnosis?  I hope they figure out your diagnosis soon!

Good luck to you,
Kelly
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Hi Kelly,
OMG,I feel like all of these posts could have been written by me! I have had RRMS for many years now, but after a recent long relapse I developed dropped foot which made walking much more difficult and laborious. I have been going to PT for 4 years now and the stretching, strengthening & balancing exercises have helped me a lot! But now with the dropped foot I feel like the walking has gotten much worse. I just got fitted for a walk aide. I have been using it for 2 days now and it appears to be helping me a lot. My gait is still awkward but I am able to walk much longer without tiring. I am truly hoping it will continue to improve. I wish you the very best of luck
Xxxxx Deb :)
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Thanks so much for thinking of Jordan when you have so much going on yourself.  Jordan (he's 12 yr old) and has slight foot drop on the right.  They gave us 3 months of therapy and told us it was permanent damage.  We still have no firm diagnosis.  Started out with Dx of ADEM but a year later they say it was not ADEM and maybe MS.  I'd keep doing the therapy also.  Sounds like you have good dr's and good pt.  I wish you the very best!  Let me know how you are going.  Thanks again.
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Deb, the foot thing doesn't happen all the time - it seems worse on some days compared to other days.  I'm not for sure if that's something to be expected or not.  I'm glad to hear that the PT has helped you a lot - then there is hope for me.  I've only been diagnosed with MS for about a year or so. I've had constant, progressive symptoms since they started about 2 1/2 yrs ago.

ku111, thank you, but you don't need to thank me for my concerns for your son, Jordan. I know it has to be difficult for you & him.  I can see where the ADEM has to be ruled out, since he's still having symptoms - it hasn't been monophasic & he's progressing. Same with me - they initially diagnosed me with transverse myelitis (TM).  And like ADEM, TM is supposed to hit fast and apex within a month or so and then either stay the same or slowly go away.  Now, I have a diagnosis of MS, instead.

Take care,
Kelly

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