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Learning to walk again...


The faboo hubby got awesome Dr. news just before we left on vacation. Clearance to start physical therapy, bend the knee while walking, green light to swim and to "please start to walk with that brace off as soon as the knee is stable." Wh-hoo! I am really, really grateful that I can be part of his healing process in more than an observational way. Being able to actively help him heal with movement, massage and strength homework is going to be amazing. And once there is a program in place, we can play creatively with safe alternatives.

So we bid adieu to "Peg Leg Knowlton", Scourge of Nyack. Since his surgery eight weeks ago, he has been able to walk without crutches, fully weight bearing, but with a straight leg ONLY. A forced peg-leg as it were. Arrrrrr Matey. As you can imagine pirate jokes have abounded arrrrround our house.

From a movement point of view, it's created what I'm calling "Psoas Walking" or "FrankenWalking".

Since he was unable to bend in the knee joint, he's had to slightly elevate his hip, sometimes slightly externally rotate and then swing the leg through, landing the foot on the ground as a whole. So today, as he started to walk with the knee joint bent, we realized he had kinesthetically forgotten how to roll the the foot from heel to ball on the release, despite the fact that we have worked on ankle mobility and movement. There is a tremendous amount of movement that has to happen in the knee and ankle to create the movement of walking. Breaking down the mechanics of walking is complicated, but here are the basics for blog purposes. There are two phases the stance phase and the swing phase. The way I've illustrated it is that steps 1-3 are the stance phase, 4 and 5 represent the swing phase. Maximal knee flexion happens after the initiation of the leg swing through, so 4-1/2ish.

  1. Hip flexion/Knee extension/Dorsiflexion

  2. Initiate knee flexion/Dorsiflexion

  3. Increase knee flexion/Dorsiflexion

  4. Hip extension/Knee flexion/Plantarflexion/Toe extension

  5. Hip extension/Knee extension/Dorsiflexion/Toe extension

So it's my job is to be Steve's eyes and auto-correct system. To notice when he's leading with the psoas and not the knee. Also to make sure he's not elevating the hip out of a six-week old habit, in other words, FrankenWalking. It's very exciting and but also very humbling. It's made me realize that we sort take our bodies for granted. That we can "just walk" or "just run" or "just get into the bathtub" or "just get down on the floor". While these things are all basic human movements, we don't "just" do any of them. It's a complex interconnected system that creates those movements. If one piece of the system breaks down, we may have to adapt the movement until we can heal and correct back to an optimal, healthy motion.

Learning to walk again indeed.

So it's my job is to be Steve's eyes and auto-correct system. To notice when he's leading with the psoas and not the knee. Also to make sure he's not elevating the hip out of a six-week old habit, in other words, FrankenWalking. It's very exciting and but also very humbling. It's made me realize that we sort take our bodies for granted. That we can "just walk" or "just run" or "just get into the bathtub" or "just get down on the floor". While these things are all basic human movements, we don't "just" do any of them. It's a complex interconnected system that creates those movements. If one piece of the system breaks down, we may have to adapt the movement until we can heal and correct back to an optimal, healthy motion.

Learning to walk again indeed.

UPDATE: After two weeks in the healing waters of St. John I'm happy to report that as of today, the hubby is at 113-degrees of knee flexion and has mostly stopped the FrankenWalking. The physical therapist was stunned!

All art ©2014 Heidi Broecking Graphic Design

#healing #movementpatterns #walking #knee #kneeinjury #ytu #yogatuneup

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