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6 Ways To Improve Your Ability To Walk Correctly

Written by: Nick Jack
Category: 2014
on 26 September 2016
Hits: 25638

Walking is one of those movements we all take for granted. We don't regard this as an exercise, it is just something we all can do. But what happens if you have an accident, injury or suffer with some type of disease that affects your ability to walk correctly? What can you do about it? A severe loss of balance, strength, confidence to do things that were previously easy and taken for granted now can completely change your way of life. A stretching program will help but will not be your answer for lack of strength. A strength program will help but will not be your answer for lack of stability and mobility. What do you do? To answer this is more than just one secret exercise or a one size fits all approach. We have worked for many years in the rehabilitation field (12 years now) and work closely with many health therapists successfully helping people overcome all types of injury, from spinal injury and back pain to ACL reconstruction rehabilitation. But out of all these injuries, the loss of the ability to walk would be right up there with being the hardest and trickiest to work with, and find successful solutions for the client. In this article both myself and trainer Nathan Fejes are going to share with you some of our most successful exercises, strategies and methods for helping people learn to walk correctly, or in some cases getting out of the wheel chair and learning to walk again!

What Is Gait & Why You Must Train Patterns Of Movement

Some of you reading this may know of someone who has trouble with walking or you yourself have difficulty walking on a daily basis. In the health industry walking is known as Gait. What is Gait?

A gait cycle is a sequence of events in walking or running, beginning when one foot contacts the ground and ending when the same foot contacts the ground again.

The human gait cycle is a very complicated, coordinated series of movements. Which is one big reason why so many rehabilitation programs fail when they use simple methods to improve it!

In the book Movement by Gray Cook he says, "movement patterns are destroyed by reductionism." We have become so good at looking at things in such great detail we lose sight of how we really move. Focusing on single muscles and areas of weakness will do little to improve the ability to walk. I am not saying it is a waste of time, just that we must move to integrated complicated patterns of movement to make any significant change. Gray Cook says it best,

"Patterns are groups of singular movements linked in the brain like a single chunk of information. This chunk essentially resembles a mental motor program, the software that controls movement patterns. A pattern represents multiple single movements used together for a specific function."

Many of the clients we currently work with, have spent a lot of time working with other methods of training that were predominately isolated training techniques, or methods using machines or equipment to assist with their lack of stability. Just changing the strength or flexibility of a body part will not change a movement pattern unless the motor program is also changed. This is where we might use isolated exercises but with the purpose of instantly adding the movement pattern straight afterwards. To train balance you must be out of balance. And with this comes risk, however with us being there to support them and guide them we are able to enhance the movement faster than any other form of training. It is not easy, and can take some time to do. Mentally as much as physically the clients are tested with these patterns but it is exactly what the brain needs in order to reprogram a new sequence that is more efficient.

Read the article Movement Not Muscle for more detail on this.

Watch the video below where I explain why we must challenge the brain and nervous system to change movement.

We currently have clients here who have goals of improving their walking ability after an accident or from a long-term neurological condition and throughout this article I will use REAL LIFE examples of what we have come across that works well and how YOU can improve your gait. As Nick has already mentioned we have found that this the typical “muscle” approach used by most health practitioners and rehab centers is very ineffective when it comes to ths problem. Because the walking difficulty is caused by a “neurological” problem, in easy words, the problem is coming from your nerves; only a neurological solution or movement can solve this. With neurological impairments like stroke, TBI (traumatic brain injury), MS (multiple sclerosis) and cerebral palsy the damage is done within the central nervous system. If you can imagine an electrical system of a house: the meter box (being the brain & spinal cord) is the central nervous system, the wires leading out to the switch are the nerves leading towards the light globe (being the muscle). If there is a problem with the meter box (the brain, movement) you will never be able to fix it by changing the light globes (the muscle via stretching, the same floor exercises you’ve been doing for months). We are here to fix the meter box to help out the rest of the system. In order to improve this we need to put the body under a challenge in order to switch on more nerves.

We cannot ignore the role of the feet with this and this is the logical place to begin. Watch the 2 videos below for detail on just how important the feet are for providing stability when we move and simple exercises you can use to improve this.

Here I will show you 6 of my main exercises that I have been using for our clients which we have found to be working very well for improving gait. All of them work in a holistic approach though improving strength, balance, flexibility & coordination for gait.

1. The Line Drill

Watch the video above to see how this is done. With this exercise there are 5 different levels to achieve. This exercise challenges aspects of balance in different positions of your feet and flexibility. To regress this exercise we give clients a stick(s) to hold, or using your current gait aid. As a progression, you can perform this drill without looking, by doing this you will challenge your nervous system even more because you are using your spatial awareness and proprioception (touch/sensation) skills to test where your body is being placed, since vision is our strongest sense, we are cutting it out!

2. Walking On The Sensa Mat

   

I would go as far to say that this piece of equipment is the "BEST" thing I have added to our programs in the past 6 years, it is that good! This exercise can be very painful and daunting to begin with but the rewards are so worth it! The purpose of walking on the Sensa mat is to fire more sensory nerves within your feet, by doing so this has been shown to improve motor nerve function within your feet and up through the rest of the leg. The image above shows me using this and also one of our clients who has been improving the control aspect of her walking after suffering from a severe car accident that left her with symptoms similar to a stroke. Since adding this type of training she has demonstrated significantly better stability and walking patterns. Her improvement in just a few short weeks was nothing short of incredible! Her gait and overall foot stability progressed so fast she was able to begin walking over high objects, and is now walking down stairs without holding the rails! You can read her full story by clicking here

For more detail on the Sensa Mat make sure you read our full article Improve Your Foot Stability Using The Sensa Mat

A great video of this in action is below.


3. Progress Your Walking Difficulty

This exercise seems obvious, however, in giving you most improvements through your current gait it is viable to increase the intensity of your walking and not just the distance and amount of your current walking ability. Increasing the intensity of your gait will recruit more nerves through shocking the body, therefore recruiting more muscles and making you stronger etc. In here we provide the safety supervision in order to perform this. An example here we have one of our clients walking using a frame through a distance of 10 meter bursts, this is harder than what he currently uses; holding his parallel bars. Another example is steeping over objects, adding this object will initiate the nervous system to have no choice but to try and act upon it and therefore lift the leg up.

See examples below of where we use an obstacle course using mini hurdles and various heights of objects in all directions.

   

Want Proof That This Type Of Training Works Then Make Sure You Read The Stories Below

The two clients pictured above suffer from serious neurological injuries. The client in picture on the left and middle (Frank Cannizzo) has a spinal cord injury affecting his balance and motor control on his left leg. The client on the right Steve Nikolovski has Multiple Sclerosis. Both of these clients have been using many of the drills featured in this article and to see just how much impact it has made on their life here is their stories.

"My journey started some 18 months ago. After a couple of years of trying to find a cause for my back pain,  the doctors found that I had a 65mm long tumour growing inside my spinal cord between T4 – T7 vertebrae. I never would have expected anything like that! Doing nothing was not an option, so I was booked in and had the tumour surgically removed. Doctors did say there was a chance of paraplegia, but I thought that would never happen to me. “Lucky Frank” ! The tumour was benign, but it did leave me numb from the waist down and with no motor function in my left leg and impaired sensory function in both legs. I had never been in a wheelchair before but soon mastered it, as it was the only way I could get around. I spent hours just doing laps of my ward at Cabrini. Determined to regain some sort of mobility.

I then proceeded to endure a couple of months in Rehab at Caulfield Hospital. Great staff and facilities, but the accommodation and food are a good reason to get well as soon as possible and get the hell out of there. I was doing rehab at the Angliss when my wife asked me to consider coming down to No Regrets. Nella was doing the cancer patients program and was really loving her time with Elley and the crew. She told me about some of the different people that No Regrets had worked with, and how they had some amazing results. I came on down and had a chat with Nick and have never looked back. I have gone from barely being able to struggle from the street into the Gym, to now being able get around the garden, mow the lawn, wash the car and do all those things we take for granted when you are able bodied. Although still reliant on my faithful crutch, I am moving with some confidence and a lot more stability than months gone by. With the structured exercise programs developing core and targeted areas, we have been working towards getting up and down stairs, up and down off the ground, bending , stretching, and all movements which are part of every day life. Challenging the body to re learn and find new ways of getting these legs working again

Elley and Dylan are always encouraging and supporting me, and with Nick Nathan and Mel all putting their two bobs worth in, how can you go wrong? There is a wealth of knowledge and experience there, and they always have the day’s workout prepared and ready for me. It was pretty sedate in the past, but as I improve, the buggers are starting to make me sweat!!

I have found it a great environment to be in at No Regrets, and find encouragement from fellow clients like Dave and Laurie a great help to make sure you never miss a session. No excuses , No Regrets!

I have heard about good personal trainers, but I think this place is pretty special.

Thanks No Regrets". Frank Cannizzo.

Here is a picture of Frank doing a trap bar deadlift in June 2017!

And here is Steve's story.

"When I was around 16 years old I was really into going to the gym. I'd go 6 days a week with my mates and always reach new heights in strength and muscle size. One day when I came home from gym I felt numbness in my face and I could barely walk. I didn't think it was anything serious, as my mates and I would joke about it after a heavy gym session. Then, a few months before my 18th birthday I was diagnosed with MS and the specialists said it was an unknown cause. From then on I was getting medicated for my condition as the neuro-specialists were saying it was the best thing for MS, however, I felt it was making things worse. I was losing mobility in my legs and losing some strength in my arms, then, about 7 years later I couldn't walk. From then on I have been doing some rehabilitation with occupational therapists and physio's who have helped me gain function with certain tasks and getting around places in everyday life, although, there were some stages where I felt like I wasn't getting pushed hard enough, having my typical gym mentality haha. Now that I have found No Regrets I feel like I am getting pushed to my limits. Since I have been here I have had two operations on my toe that they had to take the toenail off from the ongoing MS symptoms, however, that isn't stopping me from trying to get back into things that I need my toes to help me walk and work my leg shard. Nathan has been getting me to walk with my walking frames, doing squats up and down the chair holding on sticks instead of using the frame, and now to the point of standing up without holding on! (see picture) I wish I would have found these guys earlier as I feel like I am getting closer to achieving my goal to being able to walk again. " - Steven Nikolovski.

Here is a picture of Steve standing completely unassisted for the first time in years!

4. The Toe Touch Drill

This exercise is used to improve your static balance on one leg as well as transferring weight into different directions which is important for gait. This exercise would be one of the best to do as it brings into play stability on one leg. This not only challenges the brain and nervous system with balance but can also become a great way to strengthen the lazy and weak glutes which can be a big problem that often leads to knee and back injuries. If you can do the Toe Touch Drill you need to learn how to do a single leg squat. For if you can do a single leg squat you can run! Read our article on Why Single Leg Squats Are The Best Leg Exercise to see more.

As a regression you can hold something for support to correct the movement without the balance factor, or begin with balancing on one leg.

Below is 2 videos of how to do this. One is me demonstrating how this works and the other is of a client who was recovering from surgery to her Knee learning how to walk again. This video highlights the faulty movement pattern causing her problems.

5. The Squat

 

This exercise is a great way to build functional strength within the legs, no matter what level you are at there is a way we can perform this exercise. By holding your walking frame or gait aid is a great start to get the nervous system fired up to help recruit more muscles, therefore, assisting you in improving your walking speed and endurance. Other progressions from squatting up from a chair with your aid is holding sticks to enhance the stability requirement needed for you to balance yourself up, needing more strength to squat up and to lower yourself down with control. The image above shows one of our clients with cerebral paulsy performing squats. The harder version, instead of using his frame, we are now using 2 unstable sticks, therefore increasing the strength and balance requirement needed to perform the squat.

We have written countless articles and filmed many videos of how to squat and you will find a stack of these in our article 7 Best Squats For Stronger Legs & Bulletproof Knees.

6. The Lunge

 

Again we have used Frank to demonstrate this. This exercise is one of the more difficult patterns of movement needed to learn in order to get program your walking on automatic reflex. Like the squat it will improve your strength, however, because this exercise is placing your legs in a split stance it simulates the action of walking much greater, and therefore correlates with walking more closely than the squat. The lunge is superior to most other patterns for it brings into play what is known as the Slings Of The Body. These slings are like chains or cross wires that integrate our lower body with our upper body to produce movement. This is why our left leg moves with our right arm. To read more about the slings read these articles Why Lunges Are Essential and Core Strength Training and How To Do It Correctly. The split stance position also requires more balance required to keep your body in the upright stance.

Prior to using this exercise and also in conjunction with the standing version we will use a kneeling version that enhances the stability component of the core and the hips working together. Below is the video of how to do this.

What About Foot Stability?

We touched on this briefly with the sensa mat but this is a complex topic in it's own right and a problem that affects a lot of the population. Weak and lazy feet flexor muscles attribute to many of the lower limb injuries we see and exercises that can assist in developing better strength and stability here may be needed to enhance function within the lunge as seen above and also the single leg exercises like the toe touch drill. Now we have spoken a lot about how it is not very useful to use isolated exercises, but this is where we may be forced to with the feet and encourage better feeling of using the big toe to walk and create ideal stability of the feet.

Below is 2 videos of how we might try to isolate the feet and then integrate into a walking pattern.

Conclusion

I know it’s a lot of information, so in summary for you to take in the difficulty of walking resulting from a neurological condition is the nervous system shutting down, not the muscles individually! Therefore, to improve your walking you must put your body under the stimulus to improve it through complex tasks and movements as seen in a few of the exercises shown above. These will work well in conjunction with your current stretching, nutrition, pharmaceutical or other therapies you are already undertaking. Just remember that you will only change according to the level of challenge you subject your body to.

Some great Free Reports to check out with ideas on how to use functional movement you can get by clicking the image below

If you live in Melbourne and would like to know more about this article or any of our programs fill in the form below and I will be in touch within 24 hours to schedule a Free Postural and Movement assessment.