Wednesday, December 8, 2010

Proprioception and gait abnormality

This year my physical stamina took a hit. A succession of minor injuries meant I couldn't exercise until I healed. Healing was taking forever, with one damn thing after another. My physio finally pointed out that "only some of the problem seems to be bio-mechanical... the rest seems to be...the other thing...".  The other thing being possible/probably MS.  (Unless that was code for conversion disorder?)

The physio is charming, caring and kindly, but I gained the distinct impression that treating someone who can't be completely cured is a bit of a 'downer'. Suspecting that was the physio's attitude was a bit of a downer for me, too.

So I researched neurological physiotherapy. For a physio who routinely treats those with moderate to advanced MS, Parkinson's and Aquired Brain Injury, I'm a good news story. It's also reassuring to be treated by someone who believes they can help.

My proprioception isn't what it could be, and my gait is abnormal. A quick google suggests that CNS lesions and Parkinsons are the front-runners if it's not a mechanical issue (hip, knee or ankle damage) or a genetic disorder. Well, duh. There is an element of mechanical issue, the 'usual' joint deterioration of a middle-aged person, and some learned 'guarding'.

If you watch me walk, you probably won't see a problem, but my neurophysio can see it.

In plain English, brain lesions interfere with the pathways that determine some of the ways muscles work. Part of this can be caused by compensation strategies - your muscles stiffen up to literally keep you upright - which interfere with the normal proprioception.

The good news is that brain plasticity means we have the potential to be retrained in more beneficial ways. As long as we act early enough.

My exercises seem incredibly simple and 'easy'. Because they are working very specific muscles, and my brain, they are quite tiring - even the neurophysio finds them tiring - but if they increase my body awareness (proprioception) and the muscle strength of the weakened muscles, they will be well worth doing.

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