Loss of coordination in leg - Official runner's dystonia / focal dystonia discussion thread

Did you read the article on the surgery Carrie Tollefson had? It doesn't sound the same as it involves pain but it does involve the adductors. Interesting article though.

http://www.minnpost.com/stories/2008/01/08/513/2008_olympics_countdown_anatomy_project_tollefson_running_toward_beijing

Yeah I read it as well and also found it very interesting. I'm going to put a lot of effort into strengthening my adductors, and if need be, maybe I will try some massage therapy on them as well.

What if we could all be part of a research project? Maybe we could contact different physiology/neurology/human kinetics/etc graduate programs around the county about this rare condition. Perhaps if a scientific study was done to compare all of us, a common denominator could be found, a root cause we all have. Identify a common thread and then test treatments/solutions...

For example, top to bottom, they could compare us--- everything from our blood profiles (look for out of range data), the integrity of our nerve pathways (look for peroneal impingements, etc), foot strike, stride analysis, pelvic tilts/rotations, muscle imbalances, tendon disfunction in foot and calf, knee disfunction, etc. I'm constantly reading through online sports med journal articles about injury studies that were done, looking for any clues about my own injury. Well, why not a study about all of us?

Is there any way this would work, or is this thinking outside the box TOO much???

I definitely would participate in a study like that. Like you, I research and read articles all the time. I read so much that half the time I'm confusing myself because of all the different information out there. One day I'll think it's simply major muscle imbalances in my body, and the next I'll think it's much more involved than that. Maybe it could work, because although there is a lot of general information out there, I have yet to find anything specific to our situation.

This question seems to come up a lot when discussing my mysterious problem with other runners and explaining that there are a handful of others on this forum with very similar symptoms. Like you, I have seen a number medical journals on other sports related injuries where a research project took place on a variety of subjects. I think it is a great idea and I would be willing to travel anywhere in the country for this. How can we get this started?

Dr dove in cedar rapids iowa works with a doc from chicago.He hooks a muscle similator to your different muscles and shows which ones are not working during running.i have an appointment and will keep you posted.Also Ron Hruska in Lincon Nebraska is a very smart man.he says this is a common problem and he too blames it on your inner thigh muscles along with your weak hamstrings.

I’ve been thinking quite a bit about what Miss Osage County and mlbfan24 have written. Thank you so much for sharing your insight. The whole “swing phase” and adductor role was something that I had never really considered.

I’ve noticed that when I am standing on my left (bad) leg and try to do an exaggerated walking “A” (i.e. march), that my entire left glute is severely restricted, my pelvis gets pulled down and forward and to accommodate this action, my left knee bends and quad falls “outward”. This does not happen at all when I'm standing on my right foot and bring my left leg up.

I’ve also noticed (but could never understand why) my left foot hits the ground quicker (I have a very distinct slapping sound on impact, that is quite different than from when my right foot strikes the ground). My left foot also seems to hit the ground more frequently than my right foot but seems to spend less time actually on the ground (i.e. absorbing the impact).

Miss Osage County quotes that:

“The swing phase leg, the non weight bearing leg, is responsible for generating a pull on the runners center of gravity. This advancing center of gravity acts on the leg that is in contact with the ground, using the foot locked onto the immobile ground as a lever to generate rearward thrust, which drives the body forward. Therefore, the power for maintaining forward velocity (pace), the acceleration for speeding up (kicking) and the rate at which you run (cadence), is initiated and controlled by the non weight bearing leg while it swings through the air”

I’m beginning to think that as my right leg swings through the air, because of whatever muscle tightness I have in the glute? Psoas?... the right leg is pulling my left leg/ foot off the ground prematurely, before the left leg has a chance to complete its firing pattern. Because the left foot is not properly “locked onto the immobile ground” as it got lifted off the ground too early, other less resilient muscles have to pick up the slack to “generate rearward thrust”. These muscles tire quickly under the demand and simply shut off, resulting in the loss of coordination.

I also think that the pulling action of the right leg causes my pelvis to turn inward and potentially inhibits the glute from firing.

The fact that my quad and knee turn outward (when I do an exaggerated marching “A”) could also potentially explain this foot splay.

Anyway, I’m just trying to piece things together in an attempt to make some sense out of all of this.

Like Miss Osage Country, I am constantly changing my hypothesis w/r/t to the cause of this injury! Thanks for keeping the ideas coming.

I started doing something new called Z-Health this week. I have been trying to fix all sorts of muscle-biomechanical issues for over 20+ years. I have tried a gauntlet of remedies (ART, Massage, chiro, Rolfing, Egoscue, ect) and nothing sticks. I don't have the loss-of-coordination that you all have on this thread but I lot of what is written here sounds like my running and problems and tried solutions so I keep following and sometimes contributing to this thread. I have a functional short leg, but the knee on the longer leg turns in and actually the pelvis drops down as I move, the whole femur rolls in too, but the foot everts out. I feel like I run with two different half bodies (both doing different things. I don't get the loss of coordination, but my hip jams up and I stumble often in races, my ankle on the same side also feels jammed and I can't rotate it as much as the other. I run a lot when I can but I often have to concentrate on every stride trying to balance out the body. It is a real crappy way to run but I have been doing it for years. This summmer my Gluteus Minimus was horrible and PT didn't do much to fix it and I know that is a common thread here. Anyhow because I read all I can and believe I can fix things (since every once in a while I pop a good day) I keep looking for something new that works.

I didn't find much info on Z-Health since it is very new but what I found sounded intriguing and I ordered a DVD. I can't explain it exactly but it involves opening all the joints in the body through simple movements and these movements retrain the body how the joints should move. It is very simple and the routine is short, pain free, and not hard at all (although the hardness would be in learning how to do the movements correctly). In just a few days (actually after the first day) things feel incredibly better as there is way more movement through my "stuck" joints and the running is so much more balanced. My twisted leg is going through the stride with a much more proper alignment- I ran a long treadmill run yesterday without thinking about the stride at all ( I am usually all over the treadmill) and the leg is balancing my weight so much better. It is too early to tell how well this will keep improving things and how well it sticks but I thought I'd pass it on and would be interested if anyone else has tried it oro heard of it. I learned about it after getting into kettlebells that past couple of months and I like them and was trying to read more on strength fitness rather than just running fitness. Here is the website:

http://www.zhealth.net/

. I have got a lot of ideas from this thread so thought I would offer something new here for the other explorers (even if I am only a beginner at this).

I would be willing to travel anywhere for a study as well.

I'm not really sure though how to get something like that started...

I suppose for me step 1 was just posing the idea to you all on this thread and see who thought it wasn't too out there! I'm very glad at least a couple of you don't think it's too crazy of an idea and share my hobby of reading other studies, looking for some sort of clue to our own puzzle...

I can contact a friend who formerly served as a thesis advisor in health and human performance at a major university. Perhaps he can give me some general information/advice on how graduate students choose topics for studies, and/or how academic institutions go about accepting/sponsoring studies.

I know I'm coming late to this thread, but I've encountered a smattering of symptoms that all of you describe, especially losing coordination after running on a flat, solid surface for an extended period. While I haven't tried any problem-specific treatment, I do have a couple of observations that might reinforce or offer additional insight.

1) The problem, for me, correlates to PF. I go through months without it, then it comes back. When I have PF, some days are awful (days after indoor track workouts are especially awful), but some days I barely notice it. Painful PF makes my loss of coordination much worse- when the PF is gone or mild, I rarely have the loss of coordination. This suggests a link between the two problems, at least in my case.

2) The loss of coordination, for me, starts in the upper hamstring/lower glute. From there the leg sort of goes numb and it feels useless. Although when this happens, I can still usually feel the PF.

3) I've been returning gradually from a bad marathon in the fall, and now that I have 4 consecutive weeks of 50+ miles (a mileage load that is steadily increasing) I'm finally starting to notice soreness in my hip flexors and abductors. I noticed in one of the posts it said that these are the last muscles to get into shape, and I'm definitely experiencing it now- and a corresponding lessening of my PF and loss of coordination. This appears to confirm the link between strength in those muscles and relief from the coordination problem.

Good luck to you all... I'll watch the board for more posts.

BUMP

i didnt think much of this problem since it would only happen every so often on longer distance runs. now it has come up almost every day in practice this past week and a half, and ruined my race on the indoor track 1000 meters in on saturday. help!

I ran a half marathon on Sunday, and was somewhat nervous about it even though I have been able to get through some long tempo runs on a flat bike path without much incident. Normally on those tempos, my leg feels pretty tight and I feel like I'm on the brink of losing coordination but end up ok. I'm happy to report that I had no incident whatsoever with my left leg in the half marathon. In fact, this half marathon was probably one of my best races ever.

I have been having some trouble with my right calf losing coordination lately though, and that acted up a bit during the 3rd mile but went away when I started a climb on the 4th mile. I got really tired at 10 miles, but it was a normal fatigue in my legs, and I was able to push through the last 5k as I used to do so in the past before having any coordination issues.

It may sound a bit weird, but I feel like I am having an easier time running at faster paces as opposed to my normal easy run pace. Perhaps it has something to do with not engaging my hip flexors and adductors as much at an easier pace?

My left leg acts weird when I run and even when I am sitting down. It feels like my leg is tightening up/getting heavier.

any suggestions?

Sorry I didn't post some adductor exercises earlier... I use a balance ball and do the following: (these might not be the best descriptions... let me know and I can explain them further)

1. Traditional sit-up position (on back, knees bent) w/ ball between legs

A. Squeeze ball tightly, pausing slightly on each compression = 10 squeezes

B. Lift hips off floor while maintaining tight squeeze on ball = 10 lifts

C. On #10lift from "B", keep hips off the floor and squeeze ball = 10 squeezes

2. Lay on back, arms straight out flat for balance, w/ ball between ankles

A. Lift legs straight into air and squeeze ball between ankles = 10 squeezes

B. Lift legs straight into air and bend at the knees, while maintaining squeeze on ball = 10 bends

C. Lift legs straight into air and while maintaining squeeze on ball, twist ball between ankles (alternate bringing each ankle sort of in front of the other, rather than parallel to each other as in the other exercises) = 10 twists each side

3. Lay on back, knees bent, arms straight out flat for balance, with ball between knees so that shins are parallel to ground (like set 1)

A. Lift feet off floor and while maintaining constant squeeze on ball, alternate tipping your knees side to side as far as you can while controlling ball and performing steady movements = 10 tips on each side

B. Lift feet off floor and while maintaining constant squeeze on ball, circle ball clockwise (keeping hips even on floor) (as you get stronger, you can extend size of circle so that you're almost straightening legs and lowering them just inches above the ground) = 10 circles

C. Same as "A" but counterclockwise = 10 circles

D. While maintaining constant squeeze on ball, bring knees toward chest till ball touches chest, and then move ball away from chest (shift bent knees forward) till heels hit the ground = 10 knees to chest/heels to floor

4. Also, small exercise bands like in the link below are very good. You can loop it around both ankles and side step to the right, and then to the left.

http://www.amazon.com/SPRI-Spri-Xerband-Kit/dp/B0009TOEMC

I said I was looking for a root cause and I've got it. I saw 3 specialists last week and all 3 diagnosed my loss of muscle coordination as a NEURAL PROBLEM caused by my sciatic. They weren't in agreement on where exactly my sciatic nerve was getting disrupted/impinged on my left leg--- one thought piriformis, another thought where the ham and adductor cross in the very upper thigh, and another thought lower leg where the sciatic branches into the peroneal and tibial nerves. I have since since a 4th person who agreed NEURAL, and said I have piriformis syndrome, caused by sciatic nerve.

This is HUGE because EVERY person I saw prior said without a "sensory" symptom (ie: pain, pins and needles, numbness), my problem was NOT a neural problem. Everyone was directing me down the "biomechanic problem" path. So, yeah, I've got imbalances and weaknesses, tightnesses, that whole bit, but it's due to an UNDERLYING nerve problem.

EVERY one of these 4 recent specialists said that without the proper input from a nerve, muscles will not function properly. I do not have some inherent weakness; I have weakness due to a nerve problem. That is probably why after 5 f'in years of doing various exercises prescribed by people, I have yet to get over the hump where I've corrected my problem.

That's my latest and I wanted to share with you all. Per the guy who thinks my lower leg peroneal or tibial nerve is the culprit, I'm getting compartment syndrome testing on Monday. I found an old thread on compartment syndrome and noticed mlbfan24 on it. Specifically, the comments by 'scar leg' seem to match my symptoms and I've copied them below. From 2004:

http://www.letsrun.com/forum/flat_read.php?board=1&id=640963&thread=590957

"I had a rare form of compartment syndrome in that there was no pain, however I experienced all the other symptoms of compartment syndrome due to lack of blood flow. When ever I ran fast for a while I had problems lifting my toes off the ground, and would pretty much just lost control of my leg. I went through 6 years of running with this and was fine during cross country because of the uneven soft surface. I was referred to Doc. Turnipseed because he was one of the only doctors I was told who has treated this before, the only problem was my insurance wouldn't let me see him. A year earlier I went through one unecessary operation because they thought my peroneal nerve was the problem. The doc. I eventually saw did a great job with my second operation and removed all the fascia in my compartments. The leg has yet to bother me however I am still not totally positive that I will be fine once I get back in better shape. Has any one else heard of a case like this before?"

This is interesting, because recently I have been dealing with this in my right leg now. My left leg has always been the weak leg that seizes up when running on flat hard surfaces, but over the past few weeks my right leg has been losing coordination on hard flat tempo runs. It also happened in an 8k I ran in a couple weeks ago and cost me a chance to PR, although I was able to stay strong in the race thanks to a hill that relieved it.

I don't know why I forgot about this, but I experienced this a few years ago. It seemed to affect my calf and shin the most, along with my foot. Whenever I'd wear shoes, my leg would feel tight, similar to what compartment syndrome is I guess. I had no pain though. It disappeared one day and didn't return until recently. Now, I'll be running along fine, and in an instant my right leg will lose coordination. It feels like my leg slaps the ground and flys back up.

This makes me wonder what really is going on with my left leg now, because it's not so much a loss of coordination as it is the muscles simply tightening up and forcing me to stop.

As for my right leg, massaging my calf and shin seems to relieve things a bit, but that is not the answer. I think the 4th doctor you saw is onto something with piriformis syndrome. When I was 17, warming up for cross country practice one day, I felt an intense, radiating pain shoot from my hip, through my hamstring and peroneals and down to my foot basically. I didn't take much time off and ended up battling that injury for a year or so. I think that injury and my stubbornness created many of the imbalances and rotations I have on the right side.

I can feel something going on in my piroformis when I lose coordination, so I think that is a good starting point in looking for a nerve impingement. I guess it's possible it could be originating in our backs as well?

Interesting. Out of curiosity have you ever received a nerve conduction test? I'm more than 90% sure that my problem is also nerve related...ie the nerves aren't able to make the muscles in the left leg function properly, but I completely "passed" the nerve conduction test. I have my doubts about the effectiveness because I was not tested in motion.

This nerve problem is the most likely explanation since all of the strengthening and stretching in the world never made a difference....it's just incredibly difficult to pinpoint the source.

Thanks for the replies guys. No, I haven't had a nerve conductivity test. I'm trying to get one currently. I volunteered for a biomechanics study and as a return favor, their trying to hook me up with a test in their biomechanics lab. As for the problem possibly being in our backs, I considered that too mlbfan. The fourth guy I saw (who said piriformis syndrome) is a back specialist, so that's why I went to him after the first 3 folks said sciatic nerve... just to see if this guy found anything farther up the food chain in my vertebrae. He did not find a problem in my back. His opinion was my neural problem was waist down, not inclusive of my spine/back.

As for one of the docs request for a compartment syndrome test, I was/am skeptical. But, recent reading has shown me that there is a rare form of deep peroneal comp. sydrome that doesn't have pain and some of the symptoms fit my case...

http://www.physsportsmed.com/issues/1998/07jul/hutch.htm

Yes, the above article is old, but it is a good one for trying to generally rule out various leg problems. If I substitute the word "problem" where the word "pain" occurs, (because I don't have pain-- but granted, this may not really be a fair way to sort through the various injuries the article covers) my problem does seem to align with compartment syndrome--- here's one line to consider:

"...Pain that is absent at rest but develops and gradually increases in intensity during activity, such as halfway through a 10-mile run, is common with CECS."

When I push and push through my problem, I get EXTREME internal foot/ankle rotation and uncontrollable toe curling with each foot strike. The toe curling/clawing seems like it would be a clue to a neural problem as well.... A lot of my symtoms could possibly be because of the lower leg nerves getting compressed in the calf muscle compartments, I suppose??? Foot flopping/rotating, toe curling, etc could be neural...

Thanks for the replies guys. No, I haven't had a nerve conductivity test. I'm trying to get one currently. I volunteered for a biomechanics study and as a return favor, the advising prof is trying to hook me up with a test in their biomechanics lab. As for the problem possibly being in our backs, I considered that too mlbfan. The fourth guy I saw (who said piriformis syndrome) is a back specialist, so that's why I went to him after the first 3 folks said sciatic nerve... just to see if this guy found anything farther up the food chain. He did not find a problem in my back. His opinion was my neural problem was waist down, not inclusive of my spine/back.

As for one of the docs request for a compartment syndrome test, I was/am skeptical. But, recent reading has shown me that there is a rare form of deep peroneal comp. sydrome that doesn't have pain and some of the symptoms fit my case...

http://www.physsportsmed.com/issues/1998/07jul/hutch.htm

Yes, the above article is old, but it is a good one for trying to generally rule out various leg problems. If I substitute the word "problem" where the word "pain" occurs, (because I don't have pain-- but granted, this may not really be a fair way to sort through the various injuries the article covers) my problem does seem to align with compartment syndrome--- here's one line to consider:

"...Pain that is absent at rest but develops and gradually increases in intensity during activity, such as halfway through a 10-mile run, is common with CECS."

When I push and push through my problem, I get EXTREME internal foot/ankle rotation and uncontrollable toe curling with each foot strike. The toe curling/clawing seems like it would be a clue to a neural problem as well....