I
always love having a good “aha!” moment, especially when it helps improve how I
manage my ALS
symptoms. Better yet is when I learn that what I thought was a symptom
of ALS was
actually an impostor, the result of something called “learned nonuse.” Here’s
what happened.
As
I wrote in my column “How I
Shift into ALS Manual Mode,” when I sit in a chair and want to cross my
legs, I have to reach down with my hands to help lift one leg over the other.
“You have weak hip flexors,” the physical therapist at my ALS
clinic would tell me.
Hip
flexors are a group of muscles toward the front of the hip. They help move or
flex the leg and knee up toward the body, as you do when you march, step onto a
curb, or cross one leg over the other.
Why
were my hip flexors weak? Well, I thought it was just another part of having
ALS. But recently I read how patients with neurological conditions like mine
experience weakness in certain muscles that would normally be strong, simply
because these muscles aren’t being called into movement.
The slippery slope
Not
using these muscles becomes a habit, so the muscles further weaken and finally
atrophy to the point of not responding at all. That’s something I want to
prevent for as long as possible.
It’s
important to know that this type of atrophy is different from what happens in
ALS from the death of motor neurons. Learned
nonuse, or disuse atrophy, is from a lack of voluntary movement; for
most of us, that happens because we’re sedentary. I’ll
have to admit, I certainly am, since ALS has severely weakened my feet and
lower legs.
My solution?
I
decided to strengthen my hip flexors by following a strategy I used to
accomplish 40 chair squats — by being willing
to do just one.
While
sitting, I’d raise one knee up off the chair, lower it, and do the same with
the other knee. Mind you, I could only lift each knee about an inch. But I knew
that was OK. I did two lifts on each side in the morning and two again later in
the day. Every time I sat down, I’d do two sets of knee lifts. Soon I could do
five lifts, and my knees went higher, too.
Feeling
confident, I tried some knee lifts while standing with my rollator. This became
my new routine: standing knee lifts plus sitting knee lifts.
The
other day I called my husband over to watch and showed off how I could perform
a seated knee lift so high my knee touched my outstretched elbow. He responded
with a “Wow, that’s great. Keep at it!”
Crossing
my legs? That’s easy-peasy now.
Of
course, I can’t wait for my upcoming ALS clinic visit in March so I can
demonstrate my new skill to my physical therapist. For me, this was another
lesson in never assuming there’s no hope — and learning that you’ll never know if
you don’t try.
Let’s
strive to live well while we live with ALS.
----------------------------
Want more motivation? I suggest: How I Use Showing Up to Help Me Live with ALS
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| Dagmar Munn ALS and Wellness Blog |
"One of the most common causes of failure is the habit
of quitting when one is overtaken by temporary defeat"
Napolean
A version of this post first appeared as my
column on the ALS
News Today website.
This is so helpful. I recently got so sick from the Rilutek that I didn’t walk for about four weeks. When I discontinued the medication, all of the other problems went away fairly quickly, but my legs and feet are much weaker than they were before the Rilutek. I have started walking and find that, if I keep at it every day, it is slowly getting a little better. I am going to physical therapy for some additional assistance. Your post was helpful and encouraging.
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