my new gait
 

I used to walk weird because my upper body swayed from side to side, because of weakness in my sides. Those muscles seem to be stronger. Now my problem seems to be around my knees. As I step forward with one leg, the other leg bends back too far--I mean my knee goes into the "locked" position (I don't mean anything actually gets stuck). I also seem to walk with a very pronounced limp, which I don't quite understand. I'm not (I try to remember to be grateful for this) in any pain at all. Maybe there is some weakness in my hip muscles contributing as well.

Any help figuring this out would be appreciated. Are there terms to describe this sort of gait? What words do I use to describe the way my knees go back too far?

Abby

There are some videos of abnormal gaits here:
http://library.med.utah.edu/neurolog..._abnormal.html

Mine is a bit like the myopathic gait, I guess.

Abby

Sorry, Abby, I'm not a doctor. I think that's what you need to put all of this together! ;)

What you describe is hyperextension of the knee most likely due to weakness of the quadriceps muscles. Your quads aren't controlling your knees well, you have to stabilize them in some way to walk so you hyperextend them for stability. Then comes the old question, how much exercise can you tolerate to increase the strength without exacerbating the problem? Only you can answer that question and it takes trial and error.

Suddenly, thanks. At first I thought, no, that's not it--I'm not hyper-extending them on purpose. They just slip back. But now I'm not so sure. Maybe I am doing it to compensate for other weaknesses. Isn't it weird how little you can understand what's going on in your own body--even when it's a matter of voluntary muscles? When I first noticed symptoms of MG, my doctor and I thought it was inner ear trouble, because my balance was off. It took months to realize it was weakness in the muscles of my sides (and I'm still not sure which muscles). We were so far off.

Anyway, that's very helpful. Annie, I will, of course, mention it to my neuro, and maybe he'll send me to a PT or something, but I frankly have very little confidence in that route. Meanwhile, this disease is always shifting on me.

Abby

I wasn't suggesting you hyperextend on purpose. The body is an amazing thing and will accommodate and adjust for weaknesses by balancing itself in any way possible. Hyperextending your knees isn't especially good for the knee joints but it does keep you up and moving and off the floor. It could also be aggravated by weakness in your hip muscles. It's hard to say without seeing you in person. You do need to talk to your neuro and see if you can get a referral to PT. Just be careful with PT, don't let them overwork you.

Right. I'm starting to understand the distinction. I thought my knees were just giving way, but now I am considering the possibility that the hyperextension is compensatory. This is very helpful.

I suppose I will consider PT. Getting to a regular appointment will take so much of my energy, that I will have to be convinced that there's a reasonable chance it will help me. But maybe he can just see me a few times to give me some tips or something.

Abby

My Neuro does not want to reduce any of my meds even though I am doing better because I have been complaining to him that I thought my left hip was weeker than my right. There was a slip in it when I walked that caused a limp. I also had pain in a very specific spot in my lower left back.

4 weeks ago I had a pinpoint steroid shot in that spot that completely relieved me of that back pain and now the slip is gone and I believe I was letting that hip slip because it made the pain less severe. Compensating if you will.

Can't wait to see my Neuro at the end of the month to tell him.

Tony

Hi,

As you noted with your trunk musculature, it just "got better" without you really doing anything to strengthen your muscles. That's the nature of MG. Following my reboot, muscles that had not worked right since 2004 were suddenly working again. They just started working!

I would suggest you see someone, tho. Hyperextension of the knee repeatedly during the day, which you would get simply from walking, can cause damage to the joints over time. You most likely need an assistive device to help protect your joints during this period of time, along with some instructions on safe gait.

Good luck.

See, that's exactly why this board is so valuable. I can get information from the doctor, but not if it didn't occur to me that I need to bring the problem to the doctor in the first place! I do notice that I'm straining something by hyperextending the knee--something feels pulled. But it didn't occur to me that this could cause me trouble later. Now that you say it, it makes a lot of sense. Thanks very much.

I am using a rollator whenever I go out (which, unfortunately, is a lot less often than before). It gives me some support, but since my arms are weak, too, it's not really ideal. Most important, it allows me to sit frequently in a department store, so as to preserve my strength.

Abby

OK, so my neuro is going to refer me to a physical therapist--he says he'll find one who has some understanding of MG. I am hoping the PT can help me understand what's causing me to walk so funny, and show me how to get around without doing any damage to my joints. I now have a very exaggerated limp, and I'm not sure why--it may be that my hip is weak and can't bear much weight.

Meanwhile, I am really having trouble getting around. It's not that I can't walk, and there's no pain (I am grateful for no pain). But even crossing a room is such a big production. Frustrating, since otherwise I feel pretty good, and I want to do stuff. This disease requires endless patience.

Abby

Abby;

Does using a rollator cause pain in your neck and shoulders?

Tony

Well, not the way I use it. I don't use my arms to support me at all--my arms are way too weak to do that. I either hold it very lightly just to keep my upper body balanced, or if my legs get so weak that I need help standing, I sort of drape myself over it. But mostly I use it when I go shopping in a department store, so I can sit down frequently.

Abby

Thank you so much for taking the trouble to write this. My knees are now swollen. It never would have occurred to me to connect this with the hyperextension if it hadn't been for your post, but I think that's exactly what's causing the problem. I am trying to get to a PT--waiting for the referral--and meanwhile trying to do what I can to go easy on my knees. Maybe the PT will give me braces, as someone else mentioned here.

Abby

You are welcome.

Ice the knees whenever you are sitting/resting. Try to stay off of your legs as much as possible.

Hope you see the PT soon.

Thanks. My husband, the Ice-Pack Man, is following me around with his ice pack. I had been avoiding it since I had to bring him to the ER for frost-bite after he over-did it on his sore shoulder a couple of weeks ago! :eek: So to placate me, he let me use a thick towel under it (he had put it on his bare skin). Anyway, I really can hardly walk without hyperextending my knees, so my neuro is sending me for some more IVIG.

Abby