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

I agree,but it feels less of a problem in a lower profile shoe. I should say less coushioning.

I have suffered from this problem for a few years now too and have found that running on the treadmill makes it even worse. Has anyone else found this to be true? How high should the bed be to perform the exercise that has been discussed?

I don't know if it has been mentioned but here is a simple stretch for the psoas. I have had this problem for years and it comes up when I overtrain. The psoas gets tired, goes into spasms, and pulls on the pelvis. That then causes a host of other problems that are all related.

http://www.julstro.com/what_happens_exactly.html

Thanks for the psoas exercise idea, i think i'll give that a try. I know that running on the treadmill does seem to make the whole thing worse for me. I train and race in Vibram Five Fingers, which definitely feel better than running in a shoe with a thick cushioned heel. Quicksand is right though, the problem has nothing to do with the type of shoe you're running in.

snxc wrote:

I have suffered from this problem for a few years now too and have found that running on the treadmill makes it even worse. Has anyone else found this to be true? How high should the bed be to perform the exercise that has been discussed?

No question. The treadmill makes it worse, no question. In fact I was forced to run on the treadmill the other day, and a hint of it started to come on towards the end of the workout.

As for running outside, it hasn't happened in a VERY long time. The glute exercise works.

snxc wrote:

I have suffered from this problem for a few years now too and have found that running on the treadmill makes it even worse. Has anyone else found this to be true? How high should the bed be to perform the exercise that has been discussed?

Sorry I forgot about your height of bed question. That really doesn't matter to much. As long as you have a couple of feet off the ground, you're fine. Don't think that just because your upper torse is more levitated off the ground that this exercise will be more effective. What you're trying to replicate has very little to do with how high you are. The key is noticing at what point your pelvis shifts forward. Have BOTH of your hands touching both "hip bones" (the protruding bone on either side of the pelvis). Then, VERY SLOWLY lift the left leg until you feel the RIGHT side of your pelvis move forward very considerably. It should feel as though your whole pelvis has shifted forward. At this point, stop, and hold for 10 seconds, and then VERY SLOWLY lower back down. Then do that nine more times. Then do the other leg.

I was wondering if this exercise would be as effective if it were done in alternative positions?

1. Standing. Use stretch cords/gym cables to perform hip extensions with foot turned laterally out, starting with the entire working leg in front of the body, then moving it rearwards against the resistance of the cord/cable until it is level with or slightly behind the supporting leg. Pul navel to spine to activate TVA to lengthen and support spine, with back of neck long also.

2. Supine plank. The working leg is once more facing laterally outwds and supporting the body together w the arms wh are straight. The nonworking leg either rests on top of the working leg or is lifted above the ground on its own. Engage TVA to stabilise torso as in 1st position above.

I've tried both both body positions and these seem to work better for me. Also, I did them w/o the 10 sec hold, but something more like 1-2 sec, like normal strength training. Works better for me and saves time/less stressful. Comments, please?

Sorry, forgot to describe exercise in no. 2 position in prevoius post. From supine plank position, lift entire hip/trunk up with working leg until a straight line forms from head to feet. Hols 1-2 sec, then lower. Again, comments from Quicksand or anyone?

Has anybody with this problem noticed any problems with movement of the toes on the problem leg? I noticed today that I can't really lift my pinky toe on my left foot (left leg is problem leg), but I can move my right pinky toe fine. I'm not sure if this is related to the problem but I do find it kind of strange. Anyone?

centraljg wrote:

Has anybody with this problem noticed any problems with movement of the toes on the problem leg? I noticed today that I can't really lift my pinky toe on my left foot (left leg is problem leg), but I can move my right pinky toe fine. I'm not sure if this is related to the problem but I do find it kind of strange. Anyone?

I would have to say that's unrelated.

quicksand mcghee wrote:

centraljg wrote:

Has anybody with this problem noticed any problems with movement of the toes on the problem leg? I noticed today that I can't really lift my pinky toe on my left foot (left leg is problem leg), but I can move my right pinky toe fine. I'm not sure if this is related to the problem but I do find it kind of strange. Anyone?

I would have to say that's unrelated.

I take this back -- in my physiotherapy I have learned that my problem leg ALSO has incredibly poor toe/calve/ankle flexibility. Essentially the significance of this is that if your glutes aren't doing their part, other things start trying to do the work. For instance, do you suffer from exceptionally tight hamstrings?

It's been 3 years since I posted the quote below. Yeah, yeah, glutes not firing, muscle imbalances, on and on and on for all of us with the same symptoms over and over page after page... but WHAT is causing this chain of events? Go get a f***in arthogram for a labral tear. Foomiler and shoegoo and whoever else were/are negative are never going to listen to anything I have to say anyway and will just keep talking about god damn counterclockwise circles on the track, but I have been and am trying to help anyone who is interested. I am not the first person to post on this thread with a labral tear diagnosis.

[quote]Miss Osage County wrote:

Hey, you will get back to normal. 100% of your expectations will be met. If you believe there is no help, no answer, then you've sealed your fate. Never let a nonrunner in the medical field have the final say in your injury.... Noakes, The Lore of Running.

Miss Osage County wrote:

Jer,

I've been struggling with this problem since the fall of 2001. This February it was suggested to me to consider a labral tear, but similarly to you, I didn't have any pain that is usually associated with a labral tear and didn't have the test done. I haven't been on this thread in a long time, but I'm very interested in your labral tear discovery. What is your next step in treatment? Who are you seeing? Juli Henner told me the top doc for labral tears is a guy in Colorado Springs, I believe...

(1) So did you get positively diagnosed for a labral tear?

(2) How bad?

(3) Which physician?

(4) What was/is the treatment?

(5) How long recovery?

(6) Are you completely recovered and back to running as before the problem?

(7) Was 'pilates type' core strengthening (as suggested in this thread by foomiler, et. al.)prescribed as follow-up?

(8) Did a weak core, resulting in fatigued pelvic tilt, contribute to injury, if it wasn't the primary culprit?

(9) Were there other factors involved, like improper form/technique, etc?

I have all the symptoms....sort of a deadness in my quads, tight hip flexors, weak glutes, easily fatigued quads, etc. After 14monthes, I was diagnosed with labral tears in both hips. Unfortunately, the labral tear diagnosis doesn't always translate into fixing the problem.

First of all, I have little to no pain in either leg/hip. I do get twinges from time to time, but nothing major. This is rare for people with labral tears (or labral tears that are bothering people as you can get along with some labral tears and never know you have one).

Second, labral tear surgery is a relatively new procedure and not one that any orthopedic surgeon can or will do. You want to find somebody that is experienced because surgery is not always successful. I know people who have had success and others who have not. Even if you have a labral tear, you may be a poor candidate for surgery.

Third, and this is the most disconcerting part for me, the tear may have cuased this problem, but surgically repairing the tear may not fix the problem. My PT explained that the initial tear may have caused inflamation around the hip that threw off the hip flexor muscles. This inflamation has since gone away (for me), but the improper muscle patterns remain. Therefore, in my case, he recommends lots of the same conservative stuff people have been reccommending on this board.

Since I have done all the stretches and external rotator exercises ad nauseum to see only moderately encouraging effects, I wonder if the labral tear is just another red herring. I am in the process of seeing how a cortisone injection will feel, but I am starting to look into parasitic causes also....I am trying anything and everything. Has anyone else had success with this hip surgery?

1) sitting in chairs, that puts pressure on the nerves;

2) tight briefs.

Hi "curious what happened",

In typical Miss Osage County fashion, here are some long-winded answers to your questions... ;-) thanks

(1) So did you get positively diagnosed for a labral tear?

Yes. It took from Feb '09 to Jan '10 to get a referral. When I got it, I chose to go to SimonMed in Scottsdale, AZ because: 1) Dr. Lund there is highly regarded in the west and considered the best hip radiologist among the professional sports teams there, and 2), because they have 3Tesla MRI machines which have the strongest magnets presently in use and consequently produce the best images. (Knowing labral tears aren't always visible on MRI, I wanted to reduce the likelihood that it would be missed by getting a 1st-class radiologist and a 1st-class machine.) My arthrogram confirmed a large anterior-superior quadrant labral tear from 1-3 o'clock.

(2) How bad?

I'm not sure as the next step in this process is for me to have an ortho-consult and I haven't yet. I've been told that's when things will be explained in detail. From what I've read, in almost every surgical procedure, there are issues that may not have shown up on the MRI but are visible when the surgeon gets into the joint. If they found the tear when I was 23 instead of now, the prognosis would probably be a lot better as I've been dragging around my left leg for quite some time now!

(3) Which physician?

The process has been explained to me that you contact a few surgeons and you will be asked to send your supporting materials and it goes from there. They will determine if they want to do surgery on you, and you determine if they are the surgeon you prefer. I don't have a surgeon yet.

(4) What was/is the treatment?

There are 2 types of labral tears: a flap tear that comes off the wall of the labrum and fissure that is a disruption or crack in the labrum. Flap is like when the skin comes off a blister but is still partly attached. Fissuring is like when extremely dry bare earth cracks. Conservative treatments like PRP (platelet rich plasma) can be tried on fissuring because it can help the labrum cartilage regrow and fill in the defect. But, I have a flap tear, and that type must be surgically repaired as it causes the hip joint to lose stability and thus inhibit proper functioning of the joint. (and when the joint is unstable and the muscles try to compensate to continue to allow the joint to try to function properly, we get the gait disorder/loss of muscle coordination)

(5) How long recovery?

From what I've read, 4 months till you're up to even running 30 minutes continuous and 12 months till full recovery. But, there are always outliers and I hope to be one of them. I will be as cautious with running as I'm told, but I'm going to do my rehab like a madwoman.

(6) Are you completely recovered and back to running as before the problem?

n/a... BUT I sure as hell plan to be! I think the thing we all have to remember is what a special group we are that we've lasted this long and have been this tirelessly dedicated to finding out what is going on with us, all the while still trying to do the best with our own running as our bodies allow. That is part of our inherent nature and those traits of tenacity and optimism are going to be the same traits that increase our likelihood for maximal recovery, be it from surgery or anything else. If you've believed in yourself enough to keep looking for an answer and reading and posting on this board for years, don't you believe in yourself enough that you can successfully get through the most arduous of rehabs that a doctor may have to throw at you, that no matter what recovery may call for, that you can do it? I mean, we're all here. Just as we've looked for an answer together, we can help each other get through the next steps.

(7) Was 'pilates type' core strengthening (as suggested in this thread by foomiler, et. al.)prescribed as follow-up?

Since our bodies have all managed to keep us running through this injury by figuring out various ways of compensating for the loss of stability in our hips, I've been told I will most definitely be doing a lot of core work and retraining the muscles to do their job as they're supposed to. I imagine I've created some pretty bad neuromuscular patterns that will have to be addressed.

(8) Did a weak core, resulting in fatigued pelvic tilt, contribute to injury, if it wasn't the primary culprit?

No. I don't know what caused the labral tear and it's been very hard for me to get over the fact that it will probably remain a mystery and to stop obsessing about it. It could've been anything. I may have fallen one day and don't really remember-maybe I did something, my hip was tight, and I don't remember that I did have hip pain for a couple of days after a run or something back in 2001. Even the impact of falling hard on your knees can cause damage to the labrum in the hip socket as that joint absorbs some of the shock as well when you fall. I think it's key to understand that you don't *have* weakness that CREATES a tear. You *develop* the weakness or muscle imbalance because of an INTRINSIC CAUSE, the tear itself. My left VMO didn't become 25% weaker than my right and then my hip couldn't take it and then the labrum tore. It doesn't work that way. Again as I mentioned in earlier posts, I trained intensely with Bob Kennedy's trainer in Indianapolis for over a year and despite all the core work, my gluts *still* wouldn't fire properly and were *still* weaker on the left side; and that was even back in 2004 when my symptoms were much less severe... (I only name drop for credibility and for perspective; I had the opportunity to work with someone very accomplished in his field and even he couldn't help me get over the hump of one leg being stronger than the other)

(9) Were there other factors involved, like improper form/technique, etc?

Improper form didn't cause my tear, but I certainly developed some ugly tendencies in my form when my loss of muscle coordination problem would kick in. ie: I have big arms and it's not from lifting weights--- it's from a way of compensation my body has developed where I use my upper body more to run when my left leg starts dragging. It's as though my arms and back are trying to make up for what the leg can't do. But, my form wasn't this way before my injury- it evolved this way because of my injury.

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Miss Orange County,

Your quote that you "have big arms" because of your compensatoin struck me as interesting. I have noticed that my quads (vastus medialus), especially on the left side, have become larger. I in fact have a labral tear on each side and experience symptoms on both sides, but this is the confounding part: My right labral tear is much more noticeable (larger) than my left, yet my left leg usually bothers me earlier and oftener when running. So the side with the seemingly lesser tear bothers me more and has bulked up more while the larger tear hasn't had quite as serious an effect on its side.

I assumed that my compensation simply forced my quads to work harder and that built up the muscle, but my physical therapist put a different spin on things. He said he thought that my quads had actually suffered from fatty inflitration and so they are larger because they have lost tone, not because they are stronger. Ultimately I suspect I will have surgery but I will be doing PT in the mean time to help assuage some of the rough times ahead post-op. I live in NY and I have seen a Dr. Struan Coleman (Mets Physician) and am trying to schedule appointments with Bryan Kelly (also of NY) and Marc Phillipon (of Colorado). I hear these men are the best and hip arthroscopy is not something that most doctors have become deft enough to do. Have you talked to/seen any of these men? Are there any other men you would reccommend?

Its possible that the "larger" quads might be due to muscle spasm, and so are not really stronger per se. Fr my experience, this muscle spasm can be caused by back/spinal problems and nerve impingements. Its also possible that a labral tear might trigger off swelling in that hip that appears to be an increase in muscle size.

Check out what this article says. Not too much that's new, but still worth a read.

http://www.higher-faster-sports.com/noglutes.html