Balance & Gait Problems: A Real Puzzler

Posted by Ray Kemble @ray666, Apr 6, 2022

Hello, all!

I'm a 77-year-old retired male. Although I'm generally healthy, I have balance and gait problems. They snuck up on me sneakily, starting (I'm guessing) about ten years ago. They've been manageable until recently (the past 1-2 years); if I were just careful, I'd be okay. Lately, I suspect they're getting worse. (I've fallen twice in the past few months.) My doctor has been puzzled because I have no dizziness (no pain either); everything from my waist up seems A-okay; the lower half of me seems to be the problem. And the lower half of me does have some "issues." My right knee is prosthetic, and my left is arthritic. My orthopedist tells me my 12-year-old prosthetic is in good shape, and my arthritic knee, though occasionally painful, can still be managed with injections. I have seriously flat feet (pronated), for which I have been wearing orthotics for nearly 30 years. The last time I saw my podiatrist, I asked if my bad might be contributing to my balance and gait problems; he thought no, that I still have good circulation and nerve response. At my wit's end, I met with a neurosurgeon, thinking my difficulties might be all "in my head." Two MRIs––brain and cervical spine––showed only "borderline" cervical myelopathy, which the surgeon thought wasn't operable; nor did he think it was the cause of my get-around difficulties. So, I'm at a loss as to where to turn next. Tuesday, I'll be meeting with my primary doctor to go over all of this. I suspect I'll be giving her a real puzzler. I thought I'd post here on the off-chance that others have had similar difficulties figuring out what was causing their balance and gait problems.

Ray (@ray666)

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Ray Kemble | @ray666 | May 20, 2022

In reply to @hopeful33250 "Hello, @ray666 and @fourof5zs as well as all of the others who have added to this..." + (show)

@hopeful33250

Hello, @ray666 and @fourof5zs as well as all of the others who have added to this conversation. I have found this very interesting because I too have had falls where my left leg will give out on me and I'll find myself on the ground (always a surprise). Fortunately, I'm quite short so I don't fall too far. So far, no broken bones just injured pride and feeling that I really should be able to walk better. Like you, @ray666, I've become much more aware of where and how I'm walking.

I had an EMG done recently that did show a slowing in the nerves of the left leg and a temperature change between the left and right leg showing the left side colder than the right.

I've also had MRIs of the lumbar spine which has been quite a mess for a long time. I also have a definite problem with the sacral joint that @fourof5zs mentioned. I'm now seeing an orthopedic specialist.

All of this to say, it sounds as if many of us are in the same boat. I do exercise my core to keep it as strong as possible. I have other exercises from previous PT experiences that I work with on a regular basis as well.

Many years ago, when my gait problem began I felt like I walked with a stagger (to the right) I saw numerous neurologists. I was tentatively diagnosed with Parkinson's (PD). Since PD does not have a direct testing method, lots of other diagnoses were ruled out. Finally, after many years of staggering and falls a neurologist suggested a PD diagnosis. She told me that in situations like mine, trying a PD med (like Sinemet) is a way to find out if PD is the issue. Once I began Sinemet, the connection between my lower extremities and my brain became much stronger.

Now, however, many years later this left-sided weakness is causing falls again. It makes me feel like I'm starting at square one, however, I understand that I'm now dealing with another aspect of the aging dilemma that we are all experiencing.

@ray666 has an EMG been done for you yet?

Jump to this post

Hello!

This is in reply to Teresa (@hopeful33250) and everyone else who has posted in reply to my thread. I've been remiss in not keeping up with your messages.

A brief update, however: This past Wednesday I met for the first time with a physical rehabilitation and back pain specialist (I believe he's called a physiatrist). We had what I thought was a very encouraging meeting (well over an hour, which in itself was amazing).

His exam showed a number of places on my body where my nerves appear to not be working 100%, my feet especially. He's ordered lab work and a lumbar MRI; also an EMG, which I'll be getting but not until 8/1. After that, we'll meet again. I'm encouraged.

Ray (@ray666)

Teresa, Volunteer Mentor | @hopeful33250 | May 20, 2022

In reply to @ray666 "Hello! This is in reply to Teresa (@hopeful33250) and everyone else who has posted in reply..." + (show)

Hello @ray666

I'm pleased to hear about your appointment with the physiatrist. I agree that they are an important part of the medical team. It sounds like you've found one that is going to work with you and get to the cause of your problems. I've also seen one for the leg problem and falling.

I'll look forward to hearing from you when you get the test results back. Did he give you any exercises or suggestions on how to deal with the problem before the tests are done?

lenchiksf | @lenchiksf | May 21, 2022

In reply to @ray666 "Hello! This is in reply to Teresa (@hopeful33250) and everyone else who has posted in reply..." + (show)

Amazing,
Yes takes time with tests, but you will be well squared away in this specialty care !

lenchiksf | @lenchiksf | May 21, 2022

In reply to @lenchiksf "Amazing, Yes takes time with tests, but you will be well squared away in this specialty..." + (show)

Ray,
Look into local Tai Chi!
No matter which factors are contributing to falls, Tai Chi is proven for fall reduction! I bet your local Park & Rec offers these

Ray Kemble | @ray666 | May 23, 2022

In reply to @hopeful33250 "Hello @ray666 I'm pleased to hear about your appointment with the physiatrist. I agree that they..." + (show)

Good morning, Teresa

I'm strangely excited to have found a physiatrist––or just to be told there are such practitioners. Add to that, the physiatrist I found seems to be exceptionally thorough.

You did ask if he had given me any specific exercises to do while I am getting tests done and waiting for the results. He did not. Is there an online site you might suggest that has such exercises?

Ray

Ray Kemble | @ray666 | May 23, 2022

In reply to @lenchiksf "Ray, Look into local Tai Chi! No matter which factors are contributing to falls, Tai Chi..." + (show)

I have Tai Chi close to No. 1 on my list of Things to Look Into. I heard only the other day that my local Parks & Rec will soon resume the Tai Chi classes they had had to abandon when Covid came to town.

Ray

Teresa, Volunteer Mentor | @hopeful33250 | May 23, 2022

In reply to @ray666 "I have Tai Chi close to No. 1 on my list of Things to Look Into...." + (show)

@ray666,

The doctor probably did not give you any exercises as he does not yet know what your diagnosis will be. However, Tai Chi is a great exercise program for balance issues. It is highly recommended by doctors for Parkinson's and other balance problems.

It is good that the COVID crisis is beginning to lift so that group exercise programs like Tai Chi can get back into the community schedule.

I have done Tai Chi both with YouTube videos and in classes prior to the pandemic. I hope you find it helpful. Most people with back/balance problems find it gentle, relaxing, and a great exercise routine.

Here is a link to one of the Don Fiore YouTube videos with a 20 minute Tai Chi program,

Teresa, Volunteer Mentor | @hopeful33250 | May 23, 2022

Hello @ray666, @lenchiksf, @bonnieb81, @jakedduck1, @sueinmn, @loribmt, and to everyone else who is interested in improving their Balance and Gait.

Mayo Clinic posted an article about practical tips to help us not lose our balance and be prone to falls. Here is a link to the article,
https://www.mayoclinic.org/connected-care/4-surprising-ways-to-lower-your-risk-of-falling/cpt-20524961
What I found most interesting was the suggestion of activities including Tai Chi, walking, water work-outs, and dancing.

I have used Tai Chi and water work-outs. What have you tried to help with balance?

Ray Kemble | @ray666 | May 23, 2022

In reply to @hopeful33250 "Hello @ray666, @lenchiksf, @bonnieb81, @jakedduck1, @sueinmn, @loribmt, and to everyone else who is interested in improving..." + (show)

Hi, Teresa

I'm always encouraged by balance advice that promotes "keep moving." I'm a great believer in that. It goes back to my earliest days dealing with arthritis. I would hear people advise "keep moving," but at first I doubted that advice. Then I tried it, and WOW! it really did lessen of not eliminate my arthritis pain. Thanks for this link. I've bookmarked it for ready reference.

Ray

Lori, Volunteer Mentor | @loribmt | May 23, 2022

In reply to @ray666 "Hi, Teresa I'm always encouraged by balance advice that promotes "keep moving." I'm a great believer..." + (show)

Ray, I think you might like this article I found for you. It explains why exercise can help alleviate your arthritis pain, which is caused by inflammation.
https://www.livescience.com/59988-exercise-fights-inflammation.html#:~:text=When%20you%20start%20exercising%20and%20moving%20your%20muscles%2C,alpha%2C%20which%20itself%20triggers%20inflammation%20in%20the%20body.
That’s a pretty big motivator to keep on movin’. 😉

It’s great that you’re signing up for Tai Chi classes! I think you’ll find it very relaxing and beneficial on multiple levels! Do you feel uncomfortable attending classes in person with Covid climbing again?