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

Hey Neliah! Yes I have had X rays. Nothing abnormal was seen, and they actually said my hip looks really good, no wear and tear at all. I did take note of what you said though, I passed the ROM tests everytime and I did ask my Dr. if this could be an unusual presentation of impingement. He acknowledged it was possible but he was pretty stern on not wanting to operate me, he said even if it is a mild impingement I'm just to healthy in every other way and he doesn't want to cause additional problems unless he was absolutely sure he could help me. But, we'll see what the 3t arthrogram says, maybe he'll change his mind (fingers crossed)

My hip started hurting about 2 years ago right before my final track season in college. It never hurts when running, just every other hour of the day, haha. But when I do run, especially tempos or any run on a treadmill, I just can not control my right leg, it feels like I'm about to initiate the normal drive phase with my right leg and then it just flares out, usually with my right toe pointing much to far to the right, its an unstable landing and I usually have to slow down, especially if it was supposed to be an up tempo run.

So, really I didn't stop because of pain, it hurts if I'm running or not. I just get frustrated attempting to train and just never being able to make it happen so I kind of temporarily threw in the towel. Thanks for the interest though, can you tell me more about your current situation and your ideas about dysplasia. I'm still trying to get to the bottom of this

I'd try some pulley work first (or something similar) before considering surgery.

Mahogany your experience sounds exactly like mine. An update for me: I got a cortisone injection back in November, which did not help the coordination issue. After that I took 5 weeks completely off—no cross training, no strength, nothing. Then I started doing some aquajogging and light strength stuff...to my dismay, my hip started hurting almost right away. This actually a NEW development, as earlier I only got hip pain if I did hard running when my leg was not coordinating well. Even on the first day of aquajogging I would periodically feel a "twinge" in my hip on the "down" phase of the aquajog gait. I also feel it when I do a frog kick, like when swimming the breaststroke.

Now I also get hip pain (around the back of my trochantor) when doing pretty much anything that involve hip rotation. Example: I can do a side leg lift just fine (which involves only abduction) but it hurts do do a "clam" leg lift, which involves external hip rotation. Interestingly (and alarmingly) it also hurts when I do "clam" lifts on the OPPOSITE side, as my bad hip (right side) is isometrically resisting internal rotation. Some passive ROM motions irritate it too, but I still don't get the "classic" groin-pain-with-hip-rotation that doctors look for in FAI. But hell most of the time I can't even SLEEP on my right side. And I'm 22 years old! Makes me feel like an old man.

I'm seeing Dr. Larson again on the first—my experience has mirrored yours: he's been very hesitant to discuss surgery, as I don't have the "slam dunk" signs of FAI and if he can't guarantee that it will help he doesn't want to do it. I'm somewhat hopeful that with this change in symptoms, plus the confirmed labral tear on the MRA he'll be open to it (for what it's worth, Larson said my x-rays showed "mild" hip dysplasia). If not, I will ask him if he can recommend someone else who might be able to help.

It's unfortunate for us since he's "the" guy for FAI/labral tear issues in Minnesota. There is one guy at the Mayo Clinic's Young Hip Clinic who I suppose I could pay a visit to...and since my insurance doesn't cover the Mayo I DO mean PAY :(

My original plan was to start up running in a week or two, but that was of course assuming cross training went well—which it hasn't. I might do that anyways to see if I can "provoke" my leg and see if it gets worse or not before my appointment.

Otherwise, I'm not really sure what to do. Give up? Buy a bike? I'm not even sure I can cycle without pain; that's on my list of crosstraining activities to try this week. What really irks me is that I KNOW deep down that pushing this thing 'til it hurts is NOT good for me, but I almost HAVE to in order for it to be diagnosed.

Well wishes to all fellow sufferers.

Scatia Road, I have tried an incredible amount of physical therapy and still am, but I suppose only some of that involves pulleys, what exactly are you suggesting, I'm open to ideas?

Frustrated Runner, I feel for you man! I am only 24, and started having these issues when I was 22. I can't sleep on my right side either, not even for 20 minutes before I'm in quite a bit of pain. I am an old man indeed.

Our symptoms do have many simalarities. However, I can do every movement without pain and all my pain comes when I'm sitting, standing around, or sleeping, and sometimes it gets pretty bad. Can you describe to me what your loss of coordination feels like/what happens to your leg when it occurs?

I have a feeling Dr. Larson is going to tell you "all high level athletes can have mild labral tears, and that surgery might not help" Thats just what he told me last time. What Physical therapist are you working with?

Dr. Larson also told me the hip specialist in Vail, CO named Marc Phillippon is more likely to operate on cases like ours pending the MRA shows something that can be fixed. Maybe you could have Larson give him a call for you if it goes down that road, that is what I plan on doing. From everything I have heard on this site, and just looking around, he seems to be on Larson's level of expertise when it comes to hip orthoscopy.

Maybe the combined effect of two young runners with the same problems might get Larson thinking about possible causes. Please keep me updated when you have your appointment.

I haven't been following this thread because god knows I have plenty of other injuries to worry about.

But I was reading Richard Olney's obituary and he mentions lack of coordination in a leg is a symptom of Lou Gehrig Disease.

maybe there is some junior version of it that is limited to legs?

http://www.nytimes.com/2012/02/03/us/dr-richard-k-olney-als-researcher-dies-at-64.html?scp=1&sq=Richard%20Olney&st=cse

As he explained in an interview with The New York Times in 2005, Dr. Olney first experienced stiffness in his right leg and loss of coordination in 2003. The initial diagnosis was a herniated disk. He underwent surgery, but his physical slide continued.

Thanks agip....that should cheer everybody up a bunch!

Hi Sciatica Road,

You quoted me from 9/23/2008, page 30 of this thread:

[/quote]

Miss Osage, is it possible you may have discounted all the potential ramifications of a herniated disc in your subsequent pursuit of. the labral tear problem?

Or was the 'Miss Osage County" moniker taken over by someone trying to sell labral tear surgery?[/quote]

I posted the following in 2009 (from page 31 of this thread):

*****Miss Osage County RE: loss of coordination in leg 1/6/2009 12:01PM

The week before Christmas I reconnected with one of the specialists I mentioned in the above old post from March. He was curious about whatever came of my injury. I updated him on all my various tests over the course of the year, and that a back MRI showed 2 bulging discs in the lower back and that was determined to be the cause of my loss of muscle coordination. He asked a lot of questions and he wasn't convinced of the diagnosis because of this clue: I can work around my injury in tempo runs by running a mile, and then stopping for 30sec to let my leg calm down. I start up again with no symptoms. The symptoms come back, and I stop again at the end of the next mile, but after another 30sec break, they're gone again. He said if the back was causing my problem, my leg would not respond to such little rest, that some sort of protein is released by the nerve when it is irritated by the disc and that protein essentially paralyzes the muscle it serves. Even in a highly-trained elite athlete with a fairly high metabolism and rate of recovery, it would be unlikely that in 30sec, I could essentially, "go back to normal".******

So, I ruled out a herniated disc being the root of my problem at the end of 2008/start of 2009.

Hope that helps. Sorry for taking a year to reply--- I avoided this thread for quite some time because it just made me more down about the injury...

Hello fellow loss of leg coordinaters! I am in a great mood today. After 2 years of trying to find some solid evidence on what is wrong with my hip, I got a call today, on the results of my 3t mr arthrogram. Impingement was found in my right hip. And now I'm getting a 3D CT scan that will be run through A2 software to give us a more detailed look. I'm getting this done on March 8th. I will keep the thread updated. Maybe some of you should also look into some impingement theories (I stated in an earlier post that I do not show many of the classic symptoms related to this)

Hi Mahogany,

Sorry for the late reply. I did not see your last one for some reason. That is awesome that you at least have an answer! I know how relieving that is (even if it's not the best news). At least you have something to work with and you can formulate a plan for treatment.

From your first response regarding the treadmill, that sounded like a classic issue I had with impingement. From your description it sounds like you have an anterior form of impingement, and possibly both cam and pincer? I am not certain what results they gave you. One piece of advice I have is sometimes it is helpful to get the same imaging on each hip. Impingement is usually a congenital issue and many times even if the onset of symptoms is not synchronous, the deformity and articular damage is fairly symmetrical. My left leg gave me problems for 3 years while I had no problems in my right leg. However just before my surgery was scheduled I could tell my right leg was feeling tighter than normal and I asked them to check it out as well. They informed me that I had the same type of impingement in both sides but it was actually worse in my "better" leg and my labral tear was worse as well. They weren't sure why it was not showing symptoms sooner. I also had a bad case of synnovitis in that hip too and it was pretty out of alignment. I'm not saying you will be the same but don't be afraid to ask them to take a look. Good luck and let us know how it goes!!

Hi everyone! I have been following this thread closely for a few months now. I have the same loss of coordination in the leg as many of you here, so I thought I’d post something so you know there’s another one of us out there! Mahogany – your description sounds exactly like what I experience:

mahogany wrote:

But when I do run, especially tempos or any run on a treadmill, I just can not control my right leg, it feels like I'm about to initiate the normal drive phase with my right leg and then it just flares out, usually with my right toe pointing much to far to the right, its an unstable landing and I usually have to slow down, especially if it was supposed to be an up tempo run.

I have only had this for 6 months though and have no pain (yet…). Mahogany, I am very happy to hear you have confirmed the cause of your problem, even though it is not the best news to hear. It gives me hope that I might find an answer soon too - it feels so silly to tell people that after years of running I suddenly can’t run anymore because my leg has become too uncoordinated!

So far I have gone down the PT road like everyone else here, and have seen very little improvement. I’m hoping I can get an MR arthrogram soon. If I do, I’ll let you all know how it goes!

Have you guys who were diagnosed with labral tears and had them fixed had any improvement after the procedure?

I had the same problem years ago when I was competing at an international level at cycling. Ankle was turning outward on right leg and toe was turning inwards, gradually the rotation got worse on long rides. I went to several physios who all recommended different treatments and exercises - none of them worked. Was eventually recommended to see a highly regarding sports physio who works with the AIS and she immediately identified the problem.

I do not know the medical jargon but there is one long nerve which runs from the top of your spine, down your back, across the outside of your knee and down to your big toe. If you exercise a lot this nerve will become tight and your body will try to find a way of shortening the distance from one end of the nerve to the other to relieve the tightness. This will manifest itself in a leg rotation as your brain trys shorten the distance from your spine to big toe to relieve the stress on this nerve.

The solution was a series of stretching exercises to lengthen this nerve. The main exercise was to arch back across a plastic exercise ball (big size), extend arms fully behind head and then slowly draw arms, fully extended, round your body to your sides. Repeat this slowly for 10 minutes in the morning and 10 in the evening. Within a couple of weeks the rotation has completely disappeared.

Since "retiring" from cycling I have taken up running as a hobby but have neglected stretching a bit. After a couple of months running the rotations on my right leg began again. A couple of weeks doing this exercise and the problem had corrected itself.

I now do this for about 10 minutes a day and there is no leg rotation while running, regardless of surface, distance, pace etc.

Other runners I know have the same problem and this exercise has worked for them all.

I'm trying to think of a nerve that would run from your upper spine to your big toe. Your sciatic nerve starts around L4 and is the only one I can think of that would course down the back of your leg and cause pain in the big toe and also the muscular dysfunction you are referring to. However using flossing techniques are different than the one you are describing. That's an interesting exercise though I will have to keep that in mind...I have a lot of external rotation in my right leg (started on the bike). I will definitely give it a go and see if there are any improvements. Are you laying on a swiss ball while ON your back? I'm assuming not your front so that you can counteract the hip/spinal flexion that you do during cycling. Thank you for the tip!

I've read over the entirety of this thread and I have a few questions for those of you still experiencing this syndrome. I myself have been dealing with this for about two years and have some comments to note, but am still searching for an effective cure.

1. When exactly is this condition at its worst?

For me, tempos and races on roads as well as long runs of 16 miles or more bring it on. However, track races in spikes have yet to produce anything. Intervals are also completed without an issue.

2. What injuries did you incur prior to the onset of this condition?

I've had my run of the mill in terms of running injuries, but a stress fracture to the tibia of my affected leg immediately preceded the onset. Also, in recovering from the above fracture, I experienced ankle instability and peroneal tendonitis on the same ankle.

3. What type of shoes do you wear/what type of feet do you have?

I run in the fairly minimal Saucony Grid Fastwitch, but I also have fairly flat feet.

4. Do you find that running on alternative surfaces or in alternative shoes impacts the condition either positively or negatively?

As I stated above, I've never experienced anything in spikes or while running barefoot on soft surfaces. I actually find that moving to a sandy should of the road immediately after symptoms appear helps to keep it at bay.

5. Finally, what has proven to be YOUR most effective method of treatment?

While I have not been able to cure mine, increased mobility in my hips through exercises as well as a general strength routine and work on my lower abdominals has helped me complete workouts and races without too much difficulty. However, the condition still remains and I'm looking to rid myself of it for good.

I think answering these questions will be an effective way for us all to update this thread instead of scrolling back through page after page. Please take time to update your progress and offer any advice as you see fit.

Hi One of You (and everyone else):

First I'll answer your questions, then an update from me.

1)The specifics seem to vary a bit from person to person in this thread, but in GENERAL, the loss of coordination is WORST when doing a fast, sustained run on a level, hard surface. So a tempo run on the roads. A fartlek on trails is sometimes better, although I've had instances where trail running seemed to irritate it worse than flat grass.

2) I was a fairly healthy runner up until 2009, when I straight-legged a steeplechase water barrier landing and smashed the fat pad in my heel and rolled my ankle (right side for both). After that, I had ankle issues, obviously, but soon after developed adductor problems on the left side. A few months later I had piriformis/glute pain on the...right side I think? I'd have to check my logs. A few months later I had some muscle issues behind my right knee (popliteal muscle), and during the summer of 2010, soon before this problem initially presented, I had mild ITBS on my right side. There is a *chance* that this all could be related to smashing my right leg down so hard back in '09, but that's far too tidy of a story, I think....I do wonder about whether any of my prior injuries were indicators of this problem developing, though.

3) I was wearing supportive shoes with OTC orthotics (superfeet) when the problem initially presented. If you've read my earlier posts, the first time I got the loss of coordination problem I tried to run through it and got a sacral stress fracture on my left side because my stride was so messed up. I took ~8weeks off, aquajogged, and was able to come back and run again with no problems, and during this "comeback" I was wearing fairly minimal shoes (Kinvara, Free 3.0, NB Minimus) and midfoot striking. Things went pretty well until I had a series of pretty bad bacterial and viral infections in the spring, and when I tried to come back from that, I got adductor pain again (left side) and my loss of coordination issue on the right side quickly resurfaced. It has not really gone away since then.

4. See #1 for surfaces, but different shoes did not seem to help, no. When it was bad, I still had issues whether I was barefoot, in flats, etc. I don't think the roots of this problem are in the foot/ankle.

5. Like I said, the first time I had it, it went away when I took 8 weeks off (2 completely off, 6 in the pool IIRC). When it came back, however, nothing really made it go away (except possibly lidocane injections). However, other people in this thread have found success with hamstring stretching and glute strength. None of the other wacky "cures" (running clockwise, cell phones, injection sites, whatever) have worked or revealed an anwer for anybody.

***

As for the previous poster, Neliah had the surgery and has recovered and is running again, if I recall correctly. Look back to about 10 pages ago. Several other posters have had this problem and found that they have a labral tear. I *think* one person reported having an MR-A and NOT finding a labral tear.

***

An update for me: Last time I posted, I had taken two months completely off from running, cross training, and strength, and had started up again with some basic aqua jogging and hip strength, only to find that I was getting hip PAIN (not just "loss of coordination") with many of the things I was doing, which quickly spread to daily activities (getting out of bed, sleeping on my right side, etc.). So I went in to see the doc again. Now that I had actual hip PAIN (a new development, remember) with simple range-of-motion stuff, he had me go in for another injection. Just lidocane, no cortisone or anything, along with a CT scan of the bone structure. The lidocane made a noticeable difference on the hip range of motion pain and a HUGE difference on "isometric" pain (resisting internal rotation more specifically), so looking at all the evidence, the doctor and I decided to go ahead with the surgery. Recall that my MR-A came back positive for a labral tear back in September, but I was not having hip pain at the time.

So I'll be having surgery in April. Until then, I'll be working on my front crawl, bench press, and pull-up PRs :) I've decided it does not make any sense to try to run on this between now and surgery, now that I know I'd only be doing more damage to my hip joint. I am also still working on clearing up the adductor issues on my left side. My PT thought they were related to the coordination issues on the right side, although scar tissue might also be a problem. I thought for a while I might be having hip joint issues on the LEFT side too, but the adductor pain is just that—ONLY adductor pain. No hallmarks of a sports hernia or FAI or labral tear. Just pain along the last 2" or so of my adductor. So I've been working on clearing that up, and putting up an "impressive" 120 on the bench press. Perhaps I'll make a twitter or something so I can log my recovery post-surgery.

***

I've read and studied a LOT on this problem, and once I've gotten to the other side of surgery and done a bit more research, I'll sit down and write out something more substantial. As for now, the best advice I can give anyone with this problem is:

1) try stretching and glute strength, along with working with a good PT, for a month or two and see if that makes a difference

2) If it doesn't, in the words of Miss Osage County, "get the f***ing (MR-)arthrogram." Partially for your own benefit and partially so the others in this thread can get a better picture of the "geography" of this injury. I have a hunch right now (and it's only that) that the problem IS caused by a labral tear/hip joint instability in most people, but in some cases strong hip muscles can counteract or overcome that. That would explain why my problem got worse when I got sick for a long time, and when I took a lot of time off from everything (but not when I cross trained for most of it).

Good luck to all.

Neliah, thanks man. I actually am getting the next scan done on both hips. At this point it sounds like somebody, even if it isn't my current doctor, is going to be willing to operate on me since I do show moderate impingement, and it is obviously affecting me, although I do not show the classical signs for diagnosis.

Frustrated runner, I like your hunch. I feel like high level athletes are able to mask the problem. Our hip muscles (TFL, Flexors, etc) are able to take over and helps us function, but in an improper/inneficient way. I also think the labral tear occurs without as much pain as medical professionals describe it. It comes on gradually, and in my case the impingement came on so gradually that its hard to distinguish feeling fine as opposed to true pain, its constant, so you kind of forget about it.

My 1-5 list is pretty similar to yours but, a few exceptions or additions.

My leg pain is actually alleviated when I'm exercising. Its at its worst when sitting, or trying to lay down on the affected side.

The coordination problem is by far the worst on a treadmill, and then on tempo/threshold runs. Tempos on the treadmill = absolutely not possible for me.

Lastly, running on snow, mud, grass, hills helps. For some reason it doesn't show up, or maybe I just don't notice it on these surfaces, that one still stumps me, but its a common theme on this thread.

These problems got worse and worse over the past two years, I know I developed lots of muscle imbalances as my body tried to cope with the impingement in my right hip and I feebly attempted to train. These imbalances were THE TARGET of all my PT, but they were secondary, even with correction the problem remained, and in my opinion, that is why you can do PT forever, these things will continually pop up as long as the original cause remains.

Osage is right, get the Arthrogram! I'm so glad I did, I feel like I have been waiting at a red light for two years in traffic, but after pushing for this for a long time, we found something to go off of, thank you, finally!

Anyways, sorry for being long winded there, but hopefully I said something of value. On another note, would anyone that has gotten the impingement surgery like to elaborate their rehab and current running state for me? I know a few of you that I can email but I am really interested in everyone's expiriences. Thanks guys/gals, keep working at it! I know it sucks

1. When exactly is this condition at its worst?

-Any track race or road race longer than two miles

-Any tempo on flat ground at 5:20 pace or under

2. What injuries did you incur prior to the onset of this condition?

-None, this was my first "injury"

-This injury has led to achilles problems in my good leg. When I lose coordination in my right leg about 2/3 into a race or tempo, I begin to rely on my good leg to get me through the race or tempo. Compensating causes the calf in my good leg to tighten and puts extra strain on my achilles.

3. What type of shoes do you wear/what type of feet do you have?

-Mizuno Wave Rider

-I have normal feet.

4. Do you find that running on alternative surfaces or in alternative shoes impacts the condition either positively or negatively?

-Yes, I can run 8k XC races fine. However, if the XC course is too flat (i.e. a golf course) I have problems in the last 2k.

-If I were to race a 2 mile in trainers versus a 2 mile in spikes, I would lose coordination earlier in the race when wearing trainers.

-It takes me longer to lose coordination running clockwise on an unbanked indoor track than it does running counter-clockwise (the normal direction). My right leg is my bad leg. So if my bad leg is the leg on the inside, I can run further before losing coordination. Weird.

5. Finally, what has proven to be YOUR most effective method of treatment?

-doing steady state progression runs

-running my easy runs at a faster pace

-doing planks

-1k intervals

-strengthening hamstrings

1. When exactly is this condition at its worst?

Any tempo run on flat, hard ground. I can only handle about 2 miles.

2. What injuries did you incur prior to the onset of this condition?

Broken ankle 2 years ago. Lots of rehab had me back running at a similar level as before I broke it for at least 6 months before the loss of coordination appeared.

3. What type of shoes do you wear/what type of feet do you have?

-Asics Kayanos

-Normal feet

4. Do you find that running on alternative surfaces or in alternative shoes impacts the condition either positively or negatively?

-Softer surfaces seem to be better

5. Finally, what has proven to be YOUR most effective method of treatment?

Nothing yet. Strengthening glutes and improving core strength and ankle stability hasn't helped much (if at all). I've been cycling a lot more as I have had no problems on the bike, however if I try running after a long ride the loss of coordination is far worse than before.

Great responses so far everyone. I encourage others to keep them coming. I have another round of questions for those of you who are checking back frequently. I'm asking further because I really believe there is a commonality for all of us. So bear with me and answer as carefully and specifically as you can. I have a good contact in the physio world who is my "miracle worker" that I have yet to present this problem to. I'd say it's about time. Anyway:

1. How would you characterize your training level? Mileage? Workouts? Long Runs? Strength Work? Be specific in your description.

I myself run very high mileage (100-140) with 1-2 workouts per week and a long run of 20ish miles. I also incorporate core work and weights 3x weekly.

2. How would you describe the effort level that brings on the symptoms of this condition? Does it come on with acceleration? Sustained effort?

For me, if I begin to amp in up 2-3 miles into a tempo run, I start to feel it in my hip and it very quickly affects my whole leg.

3. How would you describe your posture? Do you slouch? Do you spend significant time sitting in a chair (Letsrun viewing aside :) ) Has this condition affected any sort of physiological alignment that your are aware of?

I ask because I have always struggled with my posture and after I suffered that very first stress fracture, I have had alignment issues on the affected side. Specifically, I've been told that my left ilium is rotated FORWARD along with my left clavicle/scapula, which is also rotated down. Now, this is due to compensation from the period of time that I ran on the fracture.

4. Do you have "inactive glutes"? Many elite distance runners, including Meb, have found that their glutes don't fire properly during the gait cycle. Do you have any experience with this condition?

I have been told that while my hamstring strength is fine, my glutes on both sides, but especially the weak side are terribly weak. I've been working hard in the gym to correct this problem

5. Lastly, please describe the onset of symptoms as you experience them, especially how your footstrike changes.

When my leg starts to go, it initiates in my hip, moves to my knee and I feel like my IT Band just lost its ability to flex. My ankle gets locked in a severely inverted position that makes pronation far worse. My foot seems to bang against the ground through the pronation motion as I have no control to stop it.

Finally, if applicable, why do YOU think running on hills, soft surfaces, and in spikes lessens/eliminates the symptoms of this condition? Does running downhill worsen symptoms?

This last topic, for me, seems to hold the key. And I think the key may lie in a simple biomechanical flaw. What happens when you run in any of the above described conditions? Your form changes. You run more on the balls of your feet with less heel strike and pronation. Now, I need to do a little more research, but I'm wondering if the impact of heelstriking at an accelerated effort level on a hard surface may be irritating something in the hip joint that electrically shuts down your control of the leg. This would seem to suggest something sciatic, but as I said, I need to do more research.

Thanks again for everyone's input!