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)

Interested in more discussions like this? Go to the Aging Well Support Group.

I'm 75. About 15 years ago I read that most older people fall and break a hip because their leg muscles atrophy. I went to a physical therapist who agreed. People trip because the foot no longer moves the way they are expecting it to and they trip over their own foot.
This doesn't have anything to do with dizziness. But keeping the calf muscles strong is important.
I exercise them every day. When I wake in the morning I do one series in bed. With your leg straight move your foot up and down slowly. Three sets of ten. Then move your foot sideways outward 3 sets. Then sideways inward 3 sets. (Build up to doing 3 sets).
Then, while I am at the stove I use the oven door handle as a bar and I go up on my toes, then back on my heels. Three reps of 10, holding on toes and heels as long as you can. I do other stretches and exercises there too, but these are the ones you need to do every day for balance.

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@ray666

Hi, Teresa

I may have to keep this short because I have some shopping to do, but I want to thank you again for your additional thoughts, particularly the movement disorder specialist. I'd not heard of that specialty before. You say they're more easily found in large medical facilities. Luckily, my primary and the various specialists I've seen over the years are affiliated with Porter Adventist Hospital, one of Denver's better staffed and better equipped hospitals. I'd wager they've got a movement disorder specialist on their staff. And I'll be sure to ask.

As for PD symptoms, I've done a little snooping online, reading up on symptoms, and I don't seem to have any, at least what the various sites called the more prevalent symptoms. I did see, however, that there is such a thing as asymptomatic PD. I'll certainly not rule out PD as something to investigate. And now I'd best get started with that grocery shopping!

Best wishes,
Ray

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Ray,
Try to see a Physiatrist, they are movement specialists.
Physiatrists are medical doctors who have gone through medical school and have completed training in the specialty field of physical medicine and rehabilitation. Physiatrists diagnose illnesses, design treatment protocols and can prescribe medications.

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@lenchiksf

Ray,
Try to see a Physiatrist, they are movement specialists.
Physiatrists are medical doctors who have gone through medical school and have completed training in the specialty field of physical medicine and rehabilitation. Physiatrists diagnose illnesses, design treatment protocols and can prescribe medications.

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Thank you for this suggestion! I have requested an appointment with a physiatrist, as you suggest. I'd already had a referral, submitted weeks ago by my primary doctor, but I hadn't followed up on it. Now I will! ––Ray (@ray666)

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@lenchiksf

Ray,
Try to see a Physiatrist, they are movement specialists.
Physiatrists are medical doctors who have gone through medical school and have completed training in the specialty field of physical medicine and rehabilitation. Physiatrists diagnose illnesses, design treatment protocols and can prescribe medications.

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Good morning! Thanks to your suggestion, I have an appointment to meet with a physiatrist on 5/18. If you're curious, I'll let you know how that appointment goes. ––Ray (@ray666)

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@ray666

Good morning! Thanks to your suggestion, I have an appointment to meet with a physiatrist on 5/18. If you're curious, I'll let you know how that appointment goes. ––Ray (@ray666)

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Thats great !
Yes, would be interesting to hear what they say.
They are best at figuring out the puzzle. Think of PT with md degree, they will rule in/rule out contributing factors. The more descriptive you can be when it happens (1st thing am, mid day, evening, after prolong walk, etc ) where you are (home, in the community, etc)
Good luck and my best

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If possible see a Physiatrist, a specialist who oversees skeletal problems & who directs you to the specialist you need for his diagnosis of your condition. This has been my experience & a successful one.

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Hi reading your experiences on gait and falling issues struck a nerve. Last December I was casually walking from kitchen to my living room and foot felt like jelly and my whole body flipped to the left when falling and I ended up breaking my foot.

Prior to the fall and afterwards I’ve been having pain in the back of my legs and a noticeable drop foot. The drop foot is relatively weak and I walk with extreme care. I have been unstable with walking after my knee surgery five years ago but I had osteoarthritis for yearrrs.

Went to a neurosurgeon recently who ordered a MRI and EMG. Man I did not like that EMG for sure. Got a diagnosis of stenosis. Neurosurgeon ordered a brace made for the dropped foot and it should be ready in a couple of weeks.

At this time I am not opting for back surgery. I have been paying more attention to what I eat and how my body relates to food. I noticed certain foods causes inflammation which lead to increased joint and leg pain so I cut down or stop eating them all together causing me to move better. Nothing like pain free days!

I know we are aging gracefully but the body sometimes seems to be aging aggressively.

Hopefully you find what is causing your gait and balance issues as knowing is half the battle.

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@riana1

Hi reading your experiences on gait and falling issues struck a nerve. Last December I was casually walking from kitchen to my living room and foot felt like jelly and my whole body flipped to the left when falling and I ended up breaking my foot.

Prior to the fall and afterwards I’ve been having pain in the back of my legs and a noticeable drop foot. The drop foot is relatively weak and I walk with extreme care. I have been unstable with walking after my knee surgery five years ago but I had osteoarthritis for yearrrs.

Went to a neurosurgeon recently who ordered a MRI and EMG. Man I did not like that EMG for sure. Got a diagnosis of stenosis. Neurosurgeon ordered a brace made for the dropped foot and it should be ready in a couple of weeks.

At this time I am not opting for back surgery. I have been paying more attention to what I eat and how my body relates to food. I noticed certain foods causes inflammation which lead to increased joint and leg pain so I cut down or stop eating them all together causing me to move better. Nothing like pain free days!

I know we are aging gracefully but the body sometimes seems to be aging aggressively.

Hopefully you find what is causing your gait and balance issues as knowing is half the battle.

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The other thing that is VERY helpful, no matter the cause of falls, is to strengthen the muscles, in legs thighs and buttocks to the extent possible given your general health. And to improve your ability to balance on those stronger legs. Many of these can be done while standing at the counter waiting for something to heat, chatting on the phone or (holding a safe support) while watching TV. Here are some thing to check out.

Balance: https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/balance-exercises/sls-20076853
Seated strengthening: https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/balance-exercises/sls-20076853
Standing strengthening: https://www.youtube.com/watch?v=ao8YEP9d8AQ

Rest assured that all of us who are older probably have some spinal stenosis. The trick is to keep everything as strong and flexible as possible so you can safely keep moving. I had a drop foot after ACL surgery in my 40's which eventually healed with 2years of daily exercises. Doc and PT assumed a nerve was damaged when I tore up the knee, and my brain had to be retrained to take over.

Let's see if @loribmt has anything to add, as she had to rehab after a bone marrow transplant, and now is able to get out and walk miles a day safely.
Sue

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@riana1

Hi reading your experiences on gait and falling issues struck a nerve. Last December I was casually walking from kitchen to my living room and foot felt like jelly and my whole body flipped to the left when falling and I ended up breaking my foot.

Prior to the fall and afterwards I’ve been having pain in the back of my legs and a noticeable drop foot. The drop foot is relatively weak and I walk with extreme care. I have been unstable with walking after my knee surgery five years ago but I had osteoarthritis for yearrrs.

Went to a neurosurgeon recently who ordered a MRI and EMG. Man I did not like that EMG for sure. Got a diagnosis of stenosis. Neurosurgeon ordered a brace made for the dropped foot and it should be ready in a couple of weeks.

At this time I am not opting for back surgery. I have been paying more attention to what I eat and how my body relates to food. I noticed certain foods causes inflammation which lead to increased joint and leg pain so I cut down or stop eating them all together causing me to move better. Nothing like pain free days!

I know we are aging gracefully but the body sometimes seems to be aging aggressively.

Hopefully you find what is causing your gait and balance issues as knowing is half the battle.

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Good morning! I love your comment “I know we are aging gracefully, but the body sometimes seems to be aging aggressively!” Isn’t that the truth?!? 🙄

@sueinmn had some great suggestions for increasing leg strength and asked me to join in the conversation. At this time I don’t have spinal stenosis but I did suffer spinal cord damage a few years ago, which significantly affected my walking. I felt like a toddler! With the help of my PT, as Sue mentioned, I’m back to my 20 year old self in a 68 year old body! 😅
I’ve posted a link from last year where I gave my detailed exercises. The side benefit is that it also helped reverse the osteoporosis in my hips to osteopenia by strengthening the muscles, encouraging new bone growth. Only do these if you are comfortable!

https://connect.mayoclinic.org/comment/638759/

One more that I’m going to add is a good video for strengthening core and our glute muscles. All of these together can help keep the muscles around our spine strong and in good alignment for less pain. https://video.search.yahoo.com/search/video?fr=yfp-t-s&ei=UTF-8&p=glute+exercises+for+senior+women#id=1&vid=d75954b17136d9d2dcde966e5e053294&action=click

I think you also really nailed a cause of pain with the realization that certain foods can increase your discomfort. What foods have you found which cause you issues with inflammation?

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@riana1

Hi reading your experiences on gait and falling issues struck a nerve. Last December I was casually walking from kitchen to my living room and foot felt like jelly and my whole body flipped to the left when falling and I ended up breaking my foot.

Prior to the fall and afterwards I’ve been having pain in the back of my legs and a noticeable drop foot. The drop foot is relatively weak and I walk with extreme care. I have been unstable with walking after my knee surgery five years ago but I had osteoarthritis for yearrrs.

Went to a neurosurgeon recently who ordered a MRI and EMG. Man I did not like that EMG for sure. Got a diagnosis of stenosis. Neurosurgeon ordered a brace made for the dropped foot and it should be ready in a couple of weeks.

At this time I am not opting for back surgery. I have been paying more attention to what I eat and how my body relates to food. I noticed certain foods causes inflammation which lead to increased joint and leg pain so I cut down or stop eating them all together causing me to move better. Nothing like pain free days!

I know we are aging gracefully but the body sometimes seems to be aging aggressively.

Hopefully you find what is causing your gait and balance issues as knowing is half the battle.

Jump to this post

You might also find that walking in water can keep up your strength without injury or pain. I went to PT, but don't have your same issues, but I do have a painful leg. Magnesium, lidocaine patches for nighttime pain help. I agree on the EMG!

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