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Walking Issue
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Walking Issue

I went for a 4 mile walk outside and I have a question.

When I walk on the treadmill I walk a little better than 2 miles without a problem. When I walk outside, at about 2 miles I start having trouble with my left foot. It starts to almost crash down. I can pick it up OK put putting it down starts to approach being completely out of my control. My legs feel fine. I don't sense any extreme muscle fatigue. Is this "drop foot"? Is it heat related?

Any insight would be greatly appreciated.

Kyle
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987762_tn?1331031553
Interesting question, is the difference between 2mile treadmill and 2mile outside, possible due to changes in gradiant. I'm thinking it maybe 2miles but with the up and down surface your walking on being even minimally different, would make those outside miles harder miles to walk.

Not exactly sure its foot drop, thats commonly described as literally the foot dropping so they are kicking the ground and need to lift their foot higher. With my puppet walking style that I strut (lol) my left side sort of plods like its getting heavier and heavier every step I take. The right leg though, just seems to automatically lift higher than normal because i'm tripping. I bounce though so i doubt either fit 'foot drop' but the right is the closer fit.

When its happening I've tried to force out a normal walk and I can get 1 or 2 steps out before i loose it, its a concious effect to make it normal(ish) and lol it doesn't last long. Hmmm have you checked out the health pages i'm sure there is one on this, though it could be in the muscle tone and spasticy one or even the one on fatigue, worth having a looking at them.

Cheers.........JJ

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572651_tn?1333939396
Just my very unscientific observation here - when we walk on the treadmill it becomes an automatic motion. left, right, left, right at a  set pace and rhythm.  When we walk outside we can't set a rhythm because we have to constantly adjust to the surroundings.  Change in grade, cracks in the side walk, all sort of sensory stimuli also coming at us.  I think all of that gives us a stronger workout than just left, right on the treadmill.

If you are walking and the heat is bothering you, foot drop could also play a factor in this one.  Muscular fatigue is very real, especially when our body has to work so hard to keep us upright.

I hope something in my rambling made sense.

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1936411_tn?1333835449
Hi Kyle. How was you trip (or are you still roaming)? Hope it's fun.

I think I remember that you described similar issues ("foot crashing/slamming down") a few months ago, so this is a recurring problem, correct? Has a Physical Therapist seen it happening?

I feel like leg movements are so complex that the only way to figure out which muscles are affected is to show the problem to a PT. Then, he or she might be able to give you some specific strategies or exercises to reduce the problem. Maybe you can walk to your next doc appointment to recreate it?

Outside of PT, it seems to be mostly a guessing game when it comes to leg/foot movements. It sounds like what you're experiencing might be foot drop, but it's so hard to say. Walking outside is definitely more taxing than treadmill walking...

Best wishes,
Jane
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1045086_tn?1332130022
My guess is muscle fatigue - which isn't really a problem with the muscle but the inability of nerves to repeatedly fire signals to get the muscle moving.

I don't really have foot drop.  The MSologist always gets me to lift both feet and I can do it (even against some resistance) for the time or two he requests to test foot drop.  He determines I have no foot drop.  I always remind him I can do almost anything - for a minute!

The PT tested much differently when she did her evaluation for balance and spasticity.  She documented a lag that appears one the right with repeated attempts.  A dancer who watched me also noted that the big toe side of my foot comes up faster than the little-piggy-that-runs-all-the-way-home side (also on the right).

It seems this is why I tend to stumble more the further I walk.  I took a few face plant falls in the past when I tried to add speed to distance when walking.  My brain lost track of its concentration.  Now I have to be careful to think about walking when I walk.  You know, she can't walk and chew gum at the same time?  That's me.

So I guess I'm singing backup for all the ladies in front of me.  It all makes sense and PTs are the gait specialists.  A good one will ferret out the true cause of many a problem.  Seek one who specializes in neuro diseases and disorders if you can.

BTW, any chance you hold your balance when on the treadmill?  Or have something like an elliptical that coordinates arm and leg movement?  It takes a great deal of energy to maintain balance upright without assistance.  That is why a cane can be so energy conserving even though it isn't used (and isn't designed to be used) for anything but minimal weight bearing.  

Just thinking you might find you outdoor walking improves if you carry a walking stick for touch down balance and minimal gradient assist.  It's always good to know other PwMS are working on ways to stay mobile and active.

Good luck on your big walk.  Is it later this month?
Mary
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All I can say is ditto to what the others have said. I know that if I do any kind of lengthy walking without my cane I am dragging my rt foot a lot and get very worn out. This is especially true when at night and I'm no longer getting visual clues from my surroundings.

Dennis
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1831849_tn?1383231992
I thank you all for your feedback. There is some commonality in with everyone.

One thing I'm going to try is keeping cooler when outside. I know that even on flat walks, outside requires more exertion. I just bought an evaporative neck wrap and a hat with an evaporative insert.

I make a point of not holding on when I'm on the tmill. I've even started carrying 3 lb weights in each hand. But unven surfaces and avoiding people make outside harder work.

I had a baseline eval by a PT several monhs ago. I will bring him up to speed this week. I'm pretty sure it's neuro related cuz my leg never feels 'tired'. Also, as I cool down it seems to improve...

Kyle
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1831849_tn?1383231992
This morning I did 45 minutes/2.35 miles on the treadmill. I carried 3LB hand weights and did random arm exercises. I got a fairly good sweat working. The ambient temperature was fairly cool. At no time did my foot flailing surface.

So, I'm back to trying to isolate the outdoor trigger. The terrain is not quite as smooth as the treadmill, but it doesn't seem to be significantly different. The level of exertion is inherrently higher outside, but the increase seem marginal. One major difference is the sun and higher ambient temperature outside. So to start the process of elimination I'm going to use cooling measures on my next outside trek...

Kyle

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1936411_tn?1333835449
I'll be looking forward to hearing how the cooling stuff works for you, Kyle. I've contemplated getting a vest myself. Keep us posted :)

- Jane
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