FROM A PERSONAL AND PROFESSIONAL PERSPECTIVE
TODAY?
             Thomas L. Clouse, M.D.

                                      
                          WALKING WITH ATAXIA   

TOMORROW!
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     You are your enemy.    
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     To move, to walk.
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TO MOVE, TO WALK

 

I have different exercises which I regularly do to help me walk and dance.  The most important thing for us to do is to strengthen our legs.  Most of us can use more exercise and will greatly benefit from being more fit.  You don’t have to go out and become a body builder, just trim down a bit and build up what you already have.  The concept is simple.  You need to strengthen your foundation to better support your body.

 

Rule one: strengthen your legs and your balance will begin to improve.  Go walking for exercise and push yourself.

I’m not taking about ambling around the block, moseying around the neighborhood, or strolling through the mall!

I’m talking about the type of walking where you work up a sweat and start to pant like your dog.  

 

Do the walking regardless of whatever else you do.  Why?  You need the practice! 
Vary the speed and your posture to find what works the best for you.
 

Fight yourself to walk as fast as you safely can and still stay on the sidewalk or within some imaginary lines on the road.

Walk farther and farther each time until you’re doing 3-5 miles at a time. 
It’s going to take some of you quite awhile to get to that distance.

Rest when you need it, but push yourself to do more. 
Within a short time you will start to notice an improvement in your balance and walking abilities.

 

There are also some simple exercises which you can do to help strengthen your legs without the need of special equipment.

You are going to use your own body weight and something to hold on to so you don't fall. 
You can do this in your house or anywhere for that matter.

Find an area with a smooth wall.  You will need something to hang on to, on at least one side of you, for support.

I used a tall filing cabinet (full of whatever we put in there) for support when I started.

Whatever you choose, make sure you can't push it away or pull it onto yourself if you start to fall.

 

Backup to the wall until your heels are approximately 6 inches away from the baseboard and keep them approximately a shoulder width apart from each other.  And use your support!  Now put your butt, shoulders and the back of your head against the wall.

While bending your knees lower yourself as far down as you can go towards the floor, then stand back up.

While you are going up and down keep your butt, shoulders and head against the wall. 
Repeat this until your legs get tired, then take a break.

Keep repeating this basic exercise until you can go all the way down and back up
 without having to use the support to keep you from falling.

 

When you can safely, and remember I said safely, step away from the wall and try to repeat the same exercise without any support.

You may find that you are having some difficulty with your feet side-by-side. 
If you are, then simply move one foot forward and try it again.

Use your arms like the wings of an airplane to help you balance. 
This may take you a little while to do but it is possible.

 

Keep this tidbit in mind when you start this exercise, wall or no wall. 
Your feet need to be planted on the floor before you start the squat.
 

When I say that your feet are planted on the floor, I mean that your weight is evenly distributed on your heels and the balls of your feet.

For those of us with a cerebellar problem this is very important. 
When you step away from the wall and try this exercise without support make sure that you begin,
and continue throughout the up and down, maintaining your weight evenly distributed on both planted feet.

If you can do this and maintain your “planted feet”, you will find it easier to walk properly.  Now what is walking properly? 

(As you go further down, you will naturally transfer your weight onto the balls of your feet as your heel rises off the floor.)

 

Now that you have learned the strengthening exercises against a wall and understand how to keep your feet planted on the ground,

let's talk about transferring your weight. 
Standing away from a wall just as I described above, bend your knees just a little bit.

Try to keep your butt, shoulders and head in the same line that you did against the wall.

If not, stand as it feels comfortable to you, BUT keep your feet planted on floor! 

Now I want you to think of some music that you like that has a nice beat to it.

In fact, play the music while you're doing this. 
I want you to move back and forth from one side to the other, from one foot to the other, little by little.

Each time transfer just a part of your weight onto your right foot, then you're left foot, then back a forth from one foot to the other.

(Remind you of a high school prom dance?)
 

Keep doing this without bouncing up and down, keep your feet planted on the floor and keep your knees slightly bent.

As you get the hang of it start to transfer a little bit more weight as you continue. 

 

Now we’re going to do the same thing with your feet in a different position. 
Take one normal step forward with one foot and plant both feet.

The only way you can do this is to have your body centered over both feet.

Now do the same rocking exercise, but shift forward and backward instead of side to side,
as you did when your feet were side by a side.

What you are doing is learning to transfer your weight from one foot to the other without losing your balance.

 

 A word of caution!

Do not transfer you weight entirely onto the ball of your forward foot yet.

If you do, it is very easy for you to continue moving onto your toes and then onto your nose!  
Also, do not transfer you entire weight onto your heel!

The back of your head will thank you for keeping it safe.  Keep your feet planted for the most part.

 

Practice all the exercises I've just given you and they will help you more than you can imagine.

Let's move on to the next part of this transferring of your weight with walking.

 

Those of us with cerebellar problems tend to shuffle walk, then stop and rest with most of our weight on our heels.

This puts us in an awkward position. 
The proper way is, with each step forward, the first part of your foot to strike the ground will be your heel.


To get ready for this first step, one foot must be free to move, hence, no weight on it.

Bend your knees slightly, transfer your body weight to one foot and step forward with the other foot. 
Make sure your heel hits the floor first.
 

As you make this step forward, and as the ball of your forward foot hits the floor, you’re body weight should move forward and become evenly distributed on both planted feet.  As you continue to walk forward simply repeat this same process.

This is a basic which everything else is built upon.

 

It is much better to demonstrate this to you and help you through it, but keep at what I've just given you and you will walk better.

There is no doubt in my mind because this is what helped me, and in part allows me to dance,
and I've seen it help many other people.
 

You will find that your "normal" back and forth sway has decreased and you feel more stable.  And that is the point!

It won't be easy.  It's going to take some time.  And the result will be worth it.  I guarantee it.  Let me know how it works for you.