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Monday, 30 July 2012

My Brain AVM: Gait Assessment Results - Time to "Brace" Myself


So, my right foot (the foot not affected by stroke) has been sore for quite some time. It took a while, but it all led up to me having a gait assessment, or observation and analysis of how I walk.

I'm sure that I had these done informally all the time in physiotherapy. But I never heard them called "gait assessment" that I can remember and it's been probably a decade since I've had one. I probably should have been referred to the woman who does gait assessment, who works right out of my doctor's office, a long time ago.

Ouch


I noticed the pain in my foot a few weeks after I started to use the treadmill in my apartment building. It was just a little bit of pain at first so, undaunted, I pressed on with my brisk morning walk. I liked the treadmill because with its support, I could walk quite a bit faster than I could normally. I pushed myself, but I kept it in check as well.

When it got too painful to walk in the shoes I was using at the time, I bought some sneakers and started using those. It did no good. The pain got worse, and I eventually stopped using the treadmill. I was starting to notice the pain when I was just walking around town doing errands. Soon that became terribly painful. Even walking around my apartment was painful. I finally went to the doctor.

"Stay Off It"


My regular doctor was on vacation. The doctor that I arranged to have my foot x-rayed, to check for microfractures. In the meantime, I followed her advice to stay off it, which wasn't difficult. It's been hot as blazes in Ontario, and when I've gone into town I've taken taxis anyway (I'd generally walk in the summer).

The x-ray showed nothing, so when my regular doctor returned she arranged for a bone scan. She also referred me for the gait assessment.

Gait Assessment Gives the Answer, Most Likely


I was surprised by what Jocelyn's gait assessment and examination of my weak foot and leg told her.
I have something called a "foot-drop" in my left leg, caused by the stroke. It has to do with how muscle weakness makes it difficult to lift the front of the foot. I'm aware of it most of the time. However, when I'm tired, I sometimes catch my big toe as I'm walking because I'm not lifting my foot high enough, and I trip. My left shoes are scuffed at the toes beyond all repair.

She showed me that the calf muscle in my weakened leg has become severely contracted, to the point where, when my leg is stretched out in front of me, she can't pull my foot back so that it's at 90 degrees with my leg.

She explained that my right foot compensates for the foot-drop by pronating (rolling in) as I walk. She thinks that when I put all the sudden pressure of the treadmill workouts on it, I overloaded it.
She showed me how to stretch both my calf muscles and told me that I will have to do it several times a day. When my calf will stretch to allow my foot to sit where she wants it, she wants to brace it.

Sigh


She showed me the brace. It's not huge and clunky. It slides onto my ankle and foot under my pants, shoes fit over it, and no one should know it's there. But I still don't want it.

However, the gait assessment showed that if I keep walking kind of skewed the way I do, I *will* continue to have problems.

Time to suck it up, I guess, and be thankful that:
  • We can catch these issues early, through things like gait assessment
  • We have the technology to keep gait issues from causing real problems

Happy Monday!

Blog post from another stroke survivor talking about foot-drop, with picture of brace:

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