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

                                      
                          WALKING WITH ATAXIA   

TOMORROW!
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STEPPING…NOT SHUFFLING 
 

            Sit back and observe the ataxic walker.  Or, really observe how you are walking; or should I say “trying to walk.”
We barely lift our feet from the floor in a shuffling pattern.  We shuffle forward awkwardly with irregularly spaced steps of uncontrolled foot placement while our head is cast slightly forward with a downward gaze.  Our intention is to attempt to maneuver well enough to avoid the inevitable fall. 
“Which attempted step will cause me to flounder onto the hard surface below? 
Where is that irregular surface which will inadvertently send me tumbling when I stumble on it? 
I must prepare myself and learn to fall so I don’t hurt myself as much.  I must be prepared for the fall.”
And we tense up like the Tin Man in need of oil.
 

             You have probably heard that the tensed and rigid person involved in a car accident is more prone to injury.  It’s true to a large degree and the same principal applies to the “trip and fall” injury victim.  We’re acutely aware of this fact aren’t we?
And that my friend is part of our problem; it is the FEAR OF FALLING.

We are so consumed with the “inevitable fall”, and rightfully so, that it hinders our progress in the realm of moving more safely.  I’ve heard some of us say they are taking lessons on how to fall.  That’s great and I hope it helps them, BUT what are they over looking.

             Let’s regress a little bit and go hop in the passenger’s side of your car; we’re riding shotgun today!  You’re teaching your son or daughter how to drive.  “OK kiddo, here’s the deal.  You will have an accident, so I’m going to teach you how to react so maybe you won’t get hurt as badly when you crash.  First thing, when you feel like you’re headed for a crash, like when you hit a bump, something “jumps out” in front of the car, or the road feels weird, stop driving and slump into the seat!  Let the darn car go off by itself because you can’t control it anyway.  That way you’ll be more relaxed and hopefully won’t get hurt as much.  GOT IT!”  Sound like good advice? 
And the correct answer is...  A:  NO!
 

             It’s like thinking we put diapers on babies to soften the butt thump on the floor.  We should all go back to the driver’s education mindset but call it walking education.  We need to learn how to walk more safely, not simply learn how to “take the dive”. 
Point made, so let’s get back to the task at hand, or foot. 
 

            Return to the shopping cart exercise of the previous tip page and you’re walking behind the cart.  Let’s bump it up a notch!
Bring your knees up each time you step as if you are in a marching band. 
Forget about lifting your feet; instead think about lifting your knees.

With each step forward imagine that your legs stop at your knees.  Imagine that you are walking on your knees.
Flex your hips and knees, loosen up.  The Tin Man just got oiled and he’s moving, he feels a little bit odd and hopes no one is looking, but he’s moving.  He’s also starting to walk more normally. 
 

             Another thing to add about right now is to watch where you’re going.  In other words, work on keeping your head up, don’t look at your feet or the cart, and walk that thing around the store like you are driving your car.  Look down the aisle just as you look down the road while driving.  See what’s out there in front of you.  Be anticipatory instead of reactionary. 
Begin to trust your feet, trust your balance a little more, and put it all together.  Begin to feel the flow and relax. 
You’re in a safe environment and you’re working the program.   
 

            Recheck your posture.  Don’t lean on the cart handle.  Pick up your knees as you move forward from your belt.  The heal of your shoe hits the floor first while the toe of your shoe helps your forward movement. 
Loosen up, relax and flow through the movements.

Memorize how it feels, what you are doing, and how.
Note what your feet and legs sometimes want to do and what you have to do to keep them going straight ahead.
 

            Here’s one more thing to look at while you’re doing this.  Periodically, look at your feet to see where they are pointing.
You may be surprised at what you see compared to what you think you are doing.
“I know I’m stepping straight ahead with my toes pointed straight forward,
but when I look down the toe of my shoe is pointing inward.”
Yep, it happens to me too.  So make it go where you want it to go.

If it’s turning in, force yourself to walk with your toes pointing out.  When you do this your feet most likely will be pointing straight ahead,

 but you’ll feel as though you’re walking like a penguin.  Get used to it until it feels “normal”.
Do the opposite if the toes of your shoes want to turn out instead of in.

In addition, add some ankle strengthening exercises to help correct the problem. 

            Master walking behind the cart with steps, not shuffles.
Master the concept of moving your body forward from your belt.
Commit the feeling to that hard drive in your head and store it.

We want this feeling to start up each time we begin to walk, so make sure you file it under the “auto boot” format! 

            Don’t forget to continue the leg strengthening exercises…