Learning to Walk by Alan Ray
Walking is one of those things that, by the time we get to be adults, we forget how hard it was to learn. Until we have to re-learn it.
The mechanics shared here come from Dr. Koen De Smet’s former and surpassingly gifted physical therapist Marc Martens. In the simplest description (offered by De Smet hippy Gordon Jackson): push back at the knee, flex the buttocks muscle, keep a one-two metronome pace, keep the foot fully on the ground a tad longer than comes naturally.
That’s the broad-brush description. Let’s now break it down.
The step
Lead with a solid, pronounced heel-to-ground contact (plant the heel first.) The metronome count one-two would be marked by the heel plant of one foot, then the other.
(Gordon's parts on levering at the knee and leg muscle flexion are quite correct, and will be much more natural and comfortable if you do let yourself roll heel-to-toe.)
Marc also emphasized with me the need to hold the shoulders back and walk straight up. I had unknowingly developed a forward-leaning motion over the years of limping. This led to shorter, quicker steps.
Critical to all this is that you must to remember to relax the toes. (That's the magical part that took me the longest to figure out.) When the toes are relaxed, and able to spread, you achieve the part that Marc was looking for. You can keep the foot on the ground longer. If you have limped, it will seem you’re keeping your feet on the ground an unnaturally long time. But a correct step begins with the heel plant, rolls through the arch and ball of the foot…and rolling off the toes. You can’t roll off scrunched-up. It may necessary to concentrate specifically on relaxing the toes.
In the beginning, I found myself trying to walk too fast, and I dropped immediately back into limp-mode. As soon I concentrated on slowing down and thinking about the step, it became easy...and the limp went away. There were a number of means I used over the first two months after surgery to remind myself of the wrong things I was doing…and how to do the right things.
Ways to get there
There are some “tricks” that will make it easier to restore natural gait. These are a few that have worked.
- Pool walking. Drs. De Smet & Rogerson have incorporated this into their rehab in the earliest days post-op. Other surgeons require their patients to wait longer…sometimes as long as six weeks. But even then, pool walking will give you a chance to learn to stretch your step with the support of water. In my own case, I did 20 pool walking laps a day for a month, beginning on the third day post-op. In the pool, practice stretching the step. You can also do the “Groucho” walk bent at the knees.
- Go to the treadmill. You’ll need one that has solid hand rails. Set the “incline” at 0 or flat. Set the resistance at 0. Now… just walk. Hold the handrails, and look at your feet. You’ll know almost immediately if the step-lengths match. That is the goal. Go slowly, deliberately. Concentrate on feeling the heels hit the track first, then concentrate on rolling through the feet, as mentioned above. The treadmill can be a great asset in learning what it feels like to walk again.
- Get a wall mirror, and watch yourself walk. If you belong to a gym or health club with wall mirrors, they will be your best friends. They are long enough that you can watch yourself walk toward the mirror. But you can also watch yourself from the side walk past the mirror. You’ll know what needs to be corrected within three or four steps.
If it takes longer than you think it should, don’t be discouraged. It took you months to learn to walk the first time. Then, you were a blank slate. This time… you’re not a blank slate. You may well have learned to limp and walk badly for years… Now you have to un-learn the wrong way. And re-learn the right way. It is not a race. If you have no pain, you have already won. The rest will come, sooner if you are patient.
Parts of this posting are offered from experience (my own). The techniques and mechanics of walking, including gait and cadence, were gifts from experts who had helped hundreds before me, and hundreds after me.
Walkin’ in Straight Lines
Alan
LBHR 15Dec04 Dr. De Smet