Wednesday, November 18, 2015

Learning to walk again

For once, not a metaphor.
Following years of pain in my feet, mainly in my Achilles tendons, I finally decided to go to see the doctor about it. Coinciding with a flare up of gout, and with pain in the same region being hard to differentiate, I needed to know what was what. So as the gout subsided and the pain remained in my Achillies, I got the doctor to check them out. The diagnosis, Achillies Tendinopathy, aka a swelling and stiffness in the tendon, causing pain and difficulty walking. Anyone who reads this blog a lot will know, I LOVE walking! It is a huge part of my daily routine, and of course needs to be with the dogs.

One referral to the physios at Lewisham Hospital later, and I was examined, and given a series of exercises and stretches to do daily.
We went through a series of tests do check the distances the tendons moved. Measurements taken on day one showed quite a large difference between my left and right tendons. The right has always caused me the most pain, but the left plays up too.
After the first appointment I came away with a positive mindset that something could be done about the situation, and got stuck into the routine of following the program I had been given. Much to my surprise I started to notice a bit of a difference, and by the next appointment I felt like I was getting somewhere with it.

Unfortunately I was starting to get pain in my lower back and glutes now. Transference of the issue to another point. By the time of the second appointment I had a new physio with a new idea and checks. On mentioning my pain she checked the strength in my glutes by doing a side leg raise, then pushing the leg back down. Now she is only a little lady, so on the good leg she probably could have hung off it without it moving. But when we got to the right side, I was shocked, I lifted my leg fine, but it just collapsed as soon as she put any pressure on it at all. Truly shocking as I have never felt  had any weakness in there at all.

By all accounts, while I have been subconsciously managing the pain in my right achillies, I have in fact avoided using my right leg a lot, and because of this the muscle strength in that side has deteriorated quite badly. Cue the addition of more exercises to bolster strength in the right side. Side leg raises, and one leg stand to squats.

By the third appointment a few days ago, things have improved remarkably, and the balance between left and right is slowly equalising. The strength returning to my right glute and quads, and the pain when walking disappearing by the day.

And finally I reach the reason for the title of the entry. Learning to walk again.
Since realising there was hope, and taking health seriously again, I have decided to make my own contribution towards the fight for recovery, and made some changes of my own.
The main one being, teaching myself to walk in a different way to how I have done so for 40+ years.
I have always been a powerful walker, able to average 4.2mph a few years back (GPS measured) long strides, good endurance, and able to chalk up 10-20 miles in a day without worrying too much about it. In recent years my goal has been 10 miles a day, but the flare up of the tendinopathy has really dented that goal, with some days me not even wanting to walk the dogs.
However it was time for change.

Just a quick note, so powerful are my downward thrusts with my feet when walking, that I am prone to slipping, so as I push off with the leading foot, the foot will slip on the surface as I roll onto my toes. I also wear through trainers at an alarming rate!
So, with all the progress being made with the physio, I decided to give my feet a second chance. Consciously walking with less vigour, taking the pressure out of the strides, smaller steps, a more upright stance, and trying to block out the goal of time or distance, and instead concentrate on my strides and keeping them smooth.

Amazingly it seems to be working, I can do a full 5 mile walk in the mornings now with no ill effect on my achillies or any other part of my feet really. Maybe a little tightness in the toes, but I guess that is all down to a transference of impact from one part to the next.

The last time my tendons were measured, and the test done on my glutes, the improvement was huge. Greater range and motion in the side leg raises, surprising the physio somewhat as the leg carried on rising into the air almost out of reach for her. As well as an improvement in the strength too, able to resist the downward pushing much more. As for the elasticity of the tendons, the lunges I can do now are massive compared to when I started, even causing the physio to suggest easing off on stretches for the stronger left side, as otherwise I will be doing the splits next time I'm in.

I am really grateful to the NHS for providing me this physio, they take a lot of stick, but at times like this, they are a god send, and very competent at what they do. I can feel the changes happening as I do my stretch routine daily, so know it is playing its part.

The tough part for me now is to stay focused enough to continue with both aspects of the program, and maintain my determination to learn to walk again, but in a way which is beneficial to my body and health, and caring less about getting somewhere quickly, and being the fastest person on the pavement.  Changing the way you walk at this time in life really isn't easy. I realise there are other people out there overcoming much greater challenges with their walking, but from this small experience I have learned to respect them even more.

Just to add, I am familiar with changing how I walk regularly in the past, with flare ups of gout causing me to improvise, it be immobile. From those short spells alone, you soon learn about weight and pressure transference, and how it impacts other parts of the body.

Anyway, after a long  morning of walking, training and physio stretches (3 hours to be precise) its time for me to have breakfast.... Or is that lunch now?

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