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Thread: Walkers: Questions (I think I have plateaued)

  1. #1
    Senior Member Imight's Avatar
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    Walkers: Questions (I think I have plateaued)

    I can't seem to see any improvements anymore. Walking doesnt appear to have gotten easier. The only thing I notice, is I fire muscles a lot better, and have better range of motion, but I am not noticing any gain in strength since early this year (Feb) when I got moved on to crutches. I do notice that I can walk a tad faster, but to me, I am still very sloppy when it comes to walking.

    My question is, for those walking with minimal assistance, how did you transition from mummy walking to almost normal smooth gait walking?

    I understand the following are what makes a complete workout, but I guess I am trying to find which of the 3 really helps at getting back to normal......



    1. Did it just get easier the more you walked?

    or

    2. Did you isolate muscles?

    or

    3. Stretches is what did it?

    4. something else?

    I know someone here stated that using an excercise bike really got her legs going. they loosened up and she noticed a huge gain in agility. Another person uses a treadmill and walks for about an hour before starting the day.

    Ive tried the exercise bike to start off the day when I was at sci-step. It works. Ive also tried treadmill walking, but noticed that my gait changed immediately after I got off. In other words, gait patterns are completely different on the treadmill then on the ground. perhaps because I am holding on to parellel bars? who knows....

    But anyways. I need help. What is everyone using?

  2. #2
    I'm glad for your gains and improvements. It seems you are doing well even though I know you are frustrated.

    I have never gotten beyond a lurching kind of gait using braces and a trough/platform walker. In fact, over the years my gait (if you wish to call it that) has deteriorated significantly to the point a chair just makes sense.

    I've broken too many bones trying to go vertical. I have written about it previously here at CC, but I landed in a nursing home for a month post-op after breaking a lot of bones. That was an ugly little chapter in quaddom.

    My advice?

    -Do what you can safely do upright. Push too far, do something too crazy and you may pay for it for months.

    -Realize when you need a chair to go big distances or when you are exhausted, ill, distracted in a big way. You are not a failure or giving up when your body will not do what you need it to do and you use a chair to get yourself where you want to go. Using a chair beats being stuck in your home 24/7 any day.

    -Listen to your docs and P/Ts. Take their counsel into consideration when deciding what to do and how far to push yourself. My neurologist referred me to gait training at Vanderbilt's Bill Wilkerson Center. What I learned there is that I should not be trying for any sort of gait. I'm a disaster waiting to happen.

    I learned through what I was shown at Vanderbilt that when I'm upright I'm in a perpetual state of falling. It's how I propel myself. I'm falling forward. I was told to use the trough/platform walker if I'm determined to be upright and "walking" on my own. Their advice was to ditch upright other than standing each day.

    Even with the trough walker I have had broken bones and sustained what I consider to be semi-significant injuries. It doesn't work so well for me.

    -Remember that gains seem to come in cycles of some sort. When you get gains initially, these seem to be more rapid, more noticeable. These gains also involve more of the gross motor skills The more you fine tune what you can do, the harder it becomes. When you get to tweaking what you have, it's harder. The longer the journey the narrower the way and that includes physical improvements. At least, this has been my experience.

    -Conserve your energy when and where you can. Plan for what you want and need to do. Yeah, I know this is a major PITA, but if you have big plans tonight, try not to go so full-tilt boogie during the day. You may find your upright time is smoother than if you drag yourself around all day with KAFOs and crutches and try to be at your best that night.

    So this is a bit of a vanity thing (or is it?), but if I know I want to be at my best physically and I have ginormous plans that night, I try to plan my day so I feel my best that night.

    -Do try new things and do push yourself, but just remember to be safe. It's not worth it if you break bones, have surgeries for those breaks and become even more disabled, losing what you had. I have permanent losses from pushing too hard.

    I don't know that any of this has helped. It's just been my experience.

    I'm glad for your gains and improvements. Keep doing what you can and looking for ways to safely do what you want.

    Best to you IMight.




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  3. #3
    Senior Member Imight's Avatar
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    Great reply!

    I agree with pretty much everything you've said. I've only fallen twice, I think thats pretty good considering I use my crutches and or walker around the house (unless I have to carry something). The times I did fall, it was because of something on the ground, like a wire, and the other time it was my shoe. Unfortunately I don't have the same reflexes I did when I was ab, so I couldnt catch myself. Meh no biggie, I consider dirt a delicacy, I only eat it on 'special occasions'.

    - When you get gains initially, these seem to be more rapid, more noticeable. These gains also involve more of the gross motor skills The more you fine tune what you can do, the harder it becomes.
    This is exactly right.

    At the beginning, I was flying. Now, I just notice small things every couple of weeks. Like "Oh, my right hip flexor has gotten easier" but as always its followed by negativity "Now if I can get this hamstring stronger I'll be able to bend my leg better."

    How did you know when you broke a bone?

  4. #4
    - Yes, I walked a lot.
    - Yes, I stretch a lot.

    I think stretching is important - I did it nearly every day before my injury too ! It's something I will keep doing as I get older ..

    After leaving the hospital I went out for walks in the afternoons around the neighborhood. Usually I tried to combine it with some little task (like dropping off a letter in a mailbox). I made an effort to increase the distance gradually, when possible.

    I live in a quiet and safe neighborhood, and there is a good transit system around here. I have a card from the local paratransit for free fare on bus and light rail, so that was helpful in case I felt like I was getting too tired to make it back home.

    The advice about watching your energy / fatigue level rings true to me too .. I had to be especially careful about that, since I was in a halo (the titanium pins in the skull can be driven into the brain in the event of a fall). If I went to outpatient PT that day or the gym, then that would usually be a day when I wouldn't go for a long walk.

    A friend suggested I keep a journal to track progress, so I did that also .. 0.75 miles, 1 mile, 1.2 miles, etc. If I was feeling ill or the weather was bad then I'd note that too.

    I walked with the AFO gait for a while until my PT showed me how to correct that (I'd stopped using the AFO by then). I had to consciously remember to stop hyperextending my knee .. that's taken months. I still sometimes catch myself doing it sometimes .. I sometimes think I walk more normally up / down hills than on flat ground

    It seemed like progress took forever, but in reality little advances would seem to happen every several weeks. Sounds like you are doing pretty well to me

  5. #5
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    You are a year post injury, so it is natural that the returns are slowing down. That said, I did not get a stride to my walk until 18 months post.

    This really helped me get those muscles working. Try setting a line of shoes on the floor about 18 inches apart in front of a full length mirror. Walk, lifting your leg over the shoes, while watching in the mirror. Walk forward and backward.

    I still require a walker. I'm rather slow, but if my leg is not fatigued, my gait is good.

  6. #6
    Quote Originally Posted by Imight
    How did you know when you broke a bone?
    Major swelling, discoloration, autonomic dys, the x-rays the doctors took when I stopped being stubborn and got it checked. Sometimes I could feel pain (depending upon where it was), sometimes not.

    When I broke the multiple bones in my lower left leg/ankle/foot, the bones did not punch through the skin, but there were edges/protrusios under the skin which had not been there previously. Pretty sure sign I'd FUBARd myself.

    Think you might have broken something in recent dirt tasting?

  7. #7
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    I dont know if I would call what I do normal? I sway and walk with AFO's. The more active I am the stronger I am. I sat home for a couple of years having myself a pity party. I could barely make it from the house to the car to go out.

    Now that I am going everyday and going places on the weekend. I am stronger and more stable. I still "eat dirt" occasionally and as recently as last week.

    I still have the left sided weakness that I have always had but the stronger and more active I am, the stronger my right side gets to kind of make up for the weakness of the left side.

    It is not always good to try minimal assistance. I didnt use my cane for several years and walked with just my AFO's. I done some damage to my hip joints and especially the one on the weaker left side. I thought I was doing great until the hip pain started. My doc explained that my left side is always going to be weaker and that the cane helps take the stress off the joint when I sway.

    If I were you, I would pace myself and not make my goal walking normal. As you age, the damage you do to your weaker body parts now will present itself in the future. I am already there. LOL

    I can pretty much walk as far as I want on level ground. It just takes building up your stamina.

    When I get tired or stressed, that is usually when I eat dirt.

    Good luck and keep working at it!!!
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  8. #8
    I didn't even read your post fully, but it doesn't matter because all your posts are virtually the same. Everyone wants reassurance, and you've had far more than most here. Go work hard--as hard as you can--and see what happens. Working as hard as you can is all you can do.

    f
    ight

  9. #9
    Senior Member Imight's Avatar
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    Probably so. I talk a lot about recovery and exercising. A lot of what I've learned, are from posts way back as far as 04'. In 04', I had no idea what SCI was. Hopefully in the future, someone who is 'going' to be injured, will follow my threads/posts (as you have) and hopefully it will help their road to recovery as well.

    I find the replies in this thread very interesting.

    I thought I might have broken a bone because I kept feeling a sharp pain around my left ankle, not quite sure what it was, but its not there anymore, it was only for a couple of days. I can def see how over doing it could do some harm. I now know what to look for. Discoloration, swelling and AD.....

    Seems like everyone is in agreement that, the more you walk, the easier it gets. That's the thing tho, its not getting easier. isolated areas sometimes improve (the ones that need major improvements). Its the 'refining' method that I am curious about.....

  10. #10
    Senior Member Imight's Avatar
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    Quote Originally Posted by SoFla
    You are a year post injury, so it is natural that the returns are slowing down. That said, I did not get a stride to my walk until 18 months post.

    This really helped me get those muscles working. Try setting a line of shoes on the floor about 18 inches apart in front of a full length mirror. Walk, lifting your leg over the shoes, while watching in the mirror. Walk forward and backward.

    I still require a walker. I'm rather slow, but if my leg is not fatigued, my gait is good.
    same here. Im slow on my feet, but my gait is improving. Never tried lifting over shoes, seems a little dangerous lol.

    I got my hip flexors stronger by knee hiking. You know that bar in front of a walker? I would lift my knees high enough to hit it until my legs couldnt get that high anymore....

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