Can we talk a bit about physical therapy and/or exercises intended to improve gait and build strength in the legs? Since my last flare, I have some very mild gait/balance issues that my neuro probably wouldn't assess as requiring physical therapy. But I would like to be proactive and begin building a repertoire of exercises which will help me improve my gait and leg strength now (rather than wait to see if things get worse later).
I know several of our members are attending PT and some have pieced together some routines on their own that have helped. I would love to hear about some of the specific stretches/exercises they feel have been beneficial. If anyone has any good websites or videos to share, that would be great as well. I'm hoping this topic will be useful to many of us.
For balance, my PT has me sit in a corner on an exercise ball. He sits in front of me to catch me, then I roll the ball out, put my feet together, hands on knees and close my eyes. we also do a similar thing standing on a piece of foam. Just make sure someone is with you!! I can give you other exercises for leg weakness if you want them.
If you think you would benefit from PT, then I would push the neuro. I never thought I was bad enough for PT, but here I am, once a week, driving the PT guy nuts!!
My routine? I get out of bed every morning and stretch my calves (gastrocnemeus and soleus), quads and hamstrings. Then I stretch my triceps and forearms, and do seated twists to loosen my back If you're into Yoga (as I am), there are many asanas (poses) that stretch all muscle groups. If you're not into Yoga, this page is a good place to start:
physicaltherapy dot about *******
Follow links on left side of page under Keep Your Balance.
There are some good ideas here. Do push your neuro, though - there's nothing like one-on-one therapy!
What a good idea this is, i too would love to add some more strengthening exercises to my kit bag, i do seem to be loosing my legs more quickly and what i've been doing no long seems to be helping.
wii - exercise games, yoga, zoomba (balance isn't good enough for it, you?)
Resistance bands - stretchy elastic thingy thing - you maybe working your legs but your arms are getting a work out too.
Bench top stretching - I do semi yoga, i cant do most things anymore because i need various forms of support or i go over. To make sure i stay stretched out, i got my self into the habbit of using those few minutes whilst the kettle was boiling. Strange but for me true, 'holding' onto the kitchen bench gives me the most support, i stand at the middle. I stretch my calves walking backwards, upper body leaning forward (note i'm still holding onto the bench lol) heels on the ground. If you need your entire upper body can be supported by the bench if your chest is kept close, arms flat. When i want to include my arms i do the above but my chest is as far away from the bench as my arm length can go, my arm strength is holding me up.
I do knees together semi squatts, verticle to the bench, arm length away but 1 hand holding for support, and sometimes it helps to pull my self back up again, i fold and stand, repeat. I hold onto the bench with 2 hands doing normal sizzor squatts, knees wide apart, standing straight then slowly lower your trunk until its level with your bent knees, hold then straighten, repeat. Holding the squatt position, holding onto the bench, jump.
I can't hold my legs up anymore, so i use the bench to support my foot, stand facing the bench, put your foot on the bench, lean forward trying to get your face to your knee, change sides. Facing 90deg to the bench, put your foot up and slightly bend your supporting knee, stand and repeat, then change sides. Facing the bench, body close or touching, put your foot onto the bench, bend your supporting leg, stand, repeat, change sides.
Core strength- lay flat (i use the bed) keeping legs straight, lift them until they are suspeded approx a foot high, hold, rest, repeat. Annnd my mind just went blank lol! something about legs flat and pulling up into a sitting position.
I use to climb double steps, jog up 5 flights of stairs with out noticing but now i can't use a 2 inch stepper platform with out going over lol can you get them with hand rails? lol Almost every exercise i do, requires some form of solid support, something i can hold onto, even if its just a wall behind my back. Um ROFL when i tried using my exercise ball, my brain went on a holiday, fall much ouch lol OH oh if you drop with closing your eyes like I do, do the exercise but if your suppose to close your eyes, dont! I hope i gave you some ideas.
I do alot of quad and hip flexor strengthening exercises.
The number of reps and sets are what I am up to now. Of course do what is comfortable.
lay flat one knee bent and lift opposite leg - 3 sets of ten then switch
Stand on a 2 inch box and lift knee up like I am marching do 2 sets of ten on each side
Wall squats - take an exercise ball up against a wall and roll down into a squatting position and roll back up. My pt has a band tied around my knees so I have to push them out while rolling up and down - I would only do these with someone around especially in the beginning.
Lay on table and bend lower leg in at 45 degree angle roll forward on hip and do leg lifts with top leg 30 of them
I have found that doing planks also helps because a strong core helps to support legs.
One other thing they have me do is stand on foam with my legs together and close my eyes. stand there for 30 seconds 5 times. this too is good with another person - This has helped my balance tremendously.\
I hope this helps - This is a sample of what I do every time at pt. My PT sessions are around 2 hours long. In addition I do other exercises and then walk on treadmill, walk the facility frontwards, back wards, sidewards, and then walk over hurdles. Yes it is exhausting but it has helped so much.
The best part is when they stretch me I have really bad spatiscity. But when I started my legs was at like a 30 or 45 degree angle now it is 90 degrees straight up so it is working.
I walk both inside on a treadmill and outside. When I am on the treadmill I work on my balance. I keep my core/abs tightened, I don't hold on to the rails, and I carry hand weights. This forces me to focus on my balance and gait.
If either one gets weird when I'm walking outside it's no big deal. I just take an extra step to correct. But if either one gets weird when I'm on the treadmill I could end up looking like George Jetson walking Astro!
I have added a series of 5 arm exercises with the hand weights while walking. Some of these are done one arm at a time. This really forces me to focus on my balance, as my center of gravity shifts.
Amended: I am on the treadmill for 45 minutes. I do it every other day. I want this to be sustainable so I don't try and extend the time or level of exertion. If I try to do too much, I'll get hurt/frustrated and quit all together.
Since each of us has different issues with different muscles a PT is important to access your needs. I wish the rest of the country has what we have which are the first specially certified MS PT graduates. The program started at UNC and some of the graduates work at Duke and the other private Neurology practice. The NMSS hopes to take this pilot program to Universities around the country. They do this neat thing where they put you in a harness suspended from wires to work on balance. They also have a video for PTs about MS. When they come talk to our groups they stress there is no one size fits all routine since for each of us different nerves and muscles are involved. I do yoga, pilates, walk, and ride dressage. My gait gets worse with fatigue. My husband told the doctor that is what he notices. I stiffen up in periods when I can't exercise or with stress.
I asked around and found an excellent PT who specializes in evaluation and therapy for people who have physical needs stemming from a neurological origin. She spotted subtle problems my MS doc never mentioned and identified my strengths as well. She pulled the two together so I could improve immediately where needed and work to prevent problems from developing otherwise.
A good size co-pay and travel constraints keep me from working with a PT on a regular basis. This therapist was willing to spend lots of time on both upper and lower body evaluation (OT usually handles the upper body stuff) and then taught me a variety of useful stretching activities and balance training techniques that I could use on my own.
Working with her taught me to stay more aware of how I'm moving my body and how it is responding (or not). I don't think I have fallen once since I last worked with her!
She also employs corners as safe zones for balance training. AND she is the only therapist besides Dr. Karpatkin who I have heard employ the inverse rep:set ratio rule. Simply put, when exercising or stretching....
instead of doing 3 sets of 10 repetitions with a rest after each set ...
try doing 10 sets of 3 repetitions with a rest after each set ....
or maybe 5 sets of 6 repetitions with a rest after each set.
This really helps improve flexibility and strength when rapid fatigue is an issue.
I have an article somewhere that talks about the importance of normal gait and how the fear of falling changes gait (for the worse, of course). I know it is important because there are some places that have what is called "gait clinics" with a sole purpose to exam the mechanics of a person's walk. I remember one factor is if the knee reaches behind a parallel line draw from hip to floor at the end of a stride. It ends up being where the forward propulsion comes from. I think without that movement a person only walks with the strength of the lower leg or by swinging alternate sides of the pelvis forward.
As with everything, it is far more complicated than we ever imagined when we did it all so easily!
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.