Staying active may have felt more difficult over the last year. With fitness centres closed, limitations on leaving the house and multiple lockdowns affecting our motivation, many people may not have been as physically active as they’d usually be. If MS affects your walking and you haven’t been as active over the last year, you may have noticed some changes in your walking ability.
To help you start to get back to where you were, we spoke to neuro physiotherapist, Rebecca Farrington who shares her tips for keeping moving and improving your walking.
How MS can affect your walking
There are lots of MS symptoms that can affect how you walk. Some people with MS may experience reduced sensation or strange sensations in their legs and feet, like numbness or pins and needles. These symptoms can make it difficult for you to tell whether you’ve placed your foot correctly on the floor.
Other problems that can affect walking include muscle tightness (also known as spasticity), muscle spasms, an increase or decrease in muscle tone, muscle weakness, problems with coordination (ataxia), balance issues, dizziness, fatigue and visual problems. Some people may experience more than one of these symptoms at the same time. These symptoms can all impact how your muscles work for you meaning that walking can become difficult. This can make people feel less confident when walking, particularly if they’ve had a fall before. Sometimes people might also be using their walking aids wrongly or overusing them. This can impact your posture and the way you walk.
How a neuro physiotherapist can help
A neuro physiotherapist can you help maintain and maximise your function and movement. We understand how muscles and nerves work, and we have an understanding of MS. We would initially carry out a full assessment to identify the problems you’re having with your walking. This would include looking at your range of movement, muscle strength, whether you have any issues with tone or spasms, your coordination and balance, how your sensation is and your core strength. We would assess how you move – that might start by looking at how you move from a seated to standing position and how you get into bed. Then we’ll look at how you’re moving when you’re walking and how far you can walk.
Once we’ve done a full assessment, we’ll give you an individual treatment plan tailored to suit you. This may include a range of specific exercises to help you improve your muscle strength, balance and your core strength. We’ll also explain whether we think you’d benefit from using a walking aid or a splint.
Physiotherapists work with you to keep you as motivated and as active as you can be. We may push you to get the most out of you – that’s how you make improvements and get your gains.
What you can do if you’ve noticed a change in your walking
Ask for help
If you notice a change in your walking, the most important thing is to ask for help from a health professional. Speak to your consultant or your MS nurse. If you already know your neuro physiotherapist, give them a ring. They may be able to do a virtual call and set you up with some simple exercises to get you started. Services may be running differently at the moment, but they are still there to support you.
Set realistic goals
Set yourself achievable goals. Be realistic about what you can do in a day. Your goal might be to go for a walk in the garden or down the driveway. Then go a bit further and walk to the next lamppost and then to the end of the road. Set small, achievable goals that you can do daily.
Break it down
Everyone should aim to be doing 150 minutes of activity each week. This sounds a lot but it can help to break it down. Aim to do 30 minutes of activity a day. You can break it up into short 5 or 10 minute bouts through the day.
Work with your physiotherapist
Be honest with your physiotherapist about how your treatment plan is going. Are you managing to keep up with your exercises? Are you finding them too easy? Work with your physiotherapist to get the balance right.
Consider your posture
Be aware of your posture throughout the day. Try standing in the corner for a few minutes every day. Bring your shoulders back and stand up straight and tall. This simple activity activates so many muscles and is a welcome relief from sitting down all day.
Maintenance is so important when it comes to walking – if you don’t use it, you lose it! Do something you enjoy and try to build exercise into your routine so you’re more likely to keep it up. Think about what you enjoy doing – whether that’s chair-based exercises, an online yoga class or walking up and down the garden – and keep doing it! It’s about giving yourself the opportunity to be active and trying to do something that interests you so you can maintain that motivation.
Think about why you want to be active. It’s not just about keeping you strong. Is there an end goal you’re working towards? Maybe you’d like to be able to walk a certain distance. You can also use tools like step counters to help keep you motivated.
Don’t be afraid of using a walking aid
Don’t be afraid to use an aid if your physiotherapist suggests one. Walking can be difficult and it can require an awful lot of concentration. Some people feel like they’re giving in to their MS by using a walking aid. But if you use an aid correctly, it can open the world up to you and enable you to go for that walk or do all those activities that you enjoy and do them for a little bit longer.
Find activities to do at home
Think about activities you could do while doing tasks around the house, for instance, walk around the kitchen table a few times while you’re waiting for the kettle to boil. Take the opportunity to do an exercise while your carers are with you. Simply standing up can count as exercise. Why not try moving from a seated position to a standing one five times? If you’re safe using stairs, go up and down a few times.
Set some reminders
If you’re a little bit forgetful, perhaps set an alarm a couple of times throughout the day and whenever it goes off, that’s your prompt to get up and do an activity.
Be kind to yourself – there will be tough days
Be realistic and be kind yourself – everybody has bad days. It’s about accepting that this may be an off day but there may still be small tasks you have achieved. Have some rest and start again tomorrow.
Don’t compare yourself to before
Don’t think about the past and what you were able to do before this pandemic started. You’ve decided that you want to be more active. Take that positive note and move forward. Make realistic goals that you can achieve each week and celebrate even the small successes.
Rebecca Farrington is a neuro physiotherapist who works in a neurology rehabilitation unit at Belfast Health and Social Care Trust.
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