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

I couldn't agree with you more. Although for many the change in running technique may need to be accompanied by other corrective measures for complete results, I would say that this is one of the most important (and neglected)keys to regaining coordination. This has been discussed way earlier on in this thread but without concrete success stories like yours for inspiration and validation.

Here's an interesting video for you and others interested in changing their running technique. The contrast between overstriding and keeping your steps compact and landing under your general centre of mass couldn't be better explained in words.

Consider the much greater potential for overstraining low back, hips, knees, lower leg with too much of the overstriding style.

I want to point out esp the excessive trunk twisting to lend hip extension/flexion more leverage; this is extremely damaging to the hip flexors and hip joints, plus low back. Aren't these the common problem areas for many of us coordination-challenged runners here?

Success Story,

I hope your daughter's case is different from mine, but I have had spurts of problem free running lasting from a few days to more than a couple weeks. So before you claim that her problems are solved, and I hope they really are, you should probably give it a little more time.

I have been looking into the possibility of having surgury for my labral tears, but more and more doctors are advising against it. I am scheduled to have a doppler MRI to rule out vasculo-genic problems, and if that comes back normal, a biopsy - tests I should have had ten months ago. Has anyone had either of these?

yeah give it some time, these problems seem to come back when you think you figured it out. I would advise against any operation, its not fun having operations that don't work. What is vasculo genic problems?

Vasculogenic refers to some sort of blood flow problem. Could be a compartment issue in the queads, which I understand, is rare (if it exists at all). Or it could mean lack of enough oxygen delivered to the muscles.

Hey Fly137,

Quad tightness:

After my positive labral tear arthrogram, I talked to a runner friend who had a labral tear and then surgery. He had symptoms for six years before the tear was discovered and I went for about 8 1/2, so we had gone through some similar things trying to figure out what was going on. I bring him up because he said one of his biggest complaints/symptoms, was a nearly constant deadness/fatigue in his quad on the leg that ended up having the labral tear. He said his quad was tired all the time and he felt like he just couldn't lift that leg when he ran. I totally understand and respect what you're saying about your doubts about the labral tears in both your legs causing your problem, but your symptom made me think of him so I just wanted to pass that on in case you rule other things out and come back to the labral tears as a possibility...

Your old posts about pinched nerves:

Also, I was rereading some of your old posts on RE: Dead Legs/Muscle Fatigue/Pinched Nerve/Bulgind Disc. What ever came of that for you? For me, a normal EMG in 2008 led to 2 spine MRIs just to check my nerve roots, and everything looked pretty normal, except a pretty small bulge, which the doc said he highly doubted would cause my leg problem. But just in case, he suggested I try spinal decompression anyway. (Which didn't help...) At the time, it was thought that though a tiny bulge might not seem like it could be a problem at all while laying flat in an MRI tube, it very well might become a problem when I ran. However, this was ruled out by a clue from my training--- It was also explained to me that when it's pinched, nuclear material is squeezed out and irritates the nerve root, causing muscular problems. BUT, a clue that this *wasn't* my problem was because I could do a workout like 6x1mile @5:45 with :30 rest, and though my leg would start to bother me at the end of each repeat, I could stop and stretch for that :30 and when I started my next interval, my leg was back to normal. (My leg would bother me sooner and sooner on each subsequent repeat, but I could at least start each interval problem free.) I was told that if my disc pinched a nerve and released nuclear material that caused my leg problem, it *would not* be able to go away in only :30.... The effect would be more lasting and I would not be able to begin the next interval feeling fine. So, 1) the MRI, 2) the 'give it a shot anyway' spinal decompression treatments that didn't reduce or eliminate any of my symptoms, and 3) the clue about how I was able to get through workouts, ruled out any nerve root issues for me. But, I was just wondering about how/if anything neural was ruled out in your case...???

Miss Osage County,

I have had two EMG's done. There was no indication that I had denervation of the quads. These tests are very subjective, but as far as I know, this isn't a nerve problem.

I have an annular tear at L5-S1. The tear there would affect the back of my legs more than the quads. I doubt this is the problem since tears like this are common and my just happening to discover it does not mean very much in itself. For all I know I could have had this tear for 10 years. Of course, it is possible that it is causing the muscles in the back of the legs to underperform, which puts more pressure on the quads and hip flexors to work, but this seems far-fetched to me. Like you, I can temporarily, *and I mean very temporarily*, relieve my symptoms by stretching (basically any stretch will help: quads/rectus femoris, adductors, psoas), and almost all my doctors have denied the possibility that this is a bulging disc issue. They haven't been too helpful otherwise, but I need to rely on them for their experience and I take their word in this case.

A Couple of Questions:

1) What part of the quad was dead or fatigued on your friend? For me, my rectus femoris feels tight and weak (even if I do sit-ups and my feet are anchored under something the quads start to go on me) and my vastus medialus feel like there is a weird pressure in that compartment. Also, what are you doing for your labral tear?

2)Have you had any dopler vascular tests done? These would show blood flow deficiencies. What about a muscle biopsy? A muscle biopsy would show muscle dysfunction at the cellular level, possibly a result of over training. I don't know I believe in the idea of over-training, but if everything else is ruled out, then I'm open to getting my muscle cells tested.

3)Have you looked into polymyalgia? I was tipped off to this problem recently. It usually goes away after 2-4 years, so this might not be your problem, but also worth looking into.

Fly137,

You might just be right on the low back injury causing the posterior hip and leg muscles to dysfunction, thus shifting the load to the anterior muscles. In this scenario the femur is not sitting stable in the hip joint during ambulation and will drift forward to make contact with the pelvis in front. This can cause pain/numbness/weakness in terms of nerve impingement or overload of quads/hip flexors. Not an easy problem to conclusively detect or resolve, in my opinion......

foomiler,

If you are right, then that would explain the labral tears caused by anteriorly rotated femurs irritating the labrum in the socket. But my EMG tests have not shown any denervation in the front of my legs (quads) so I don't know if nerve impingment is the answer. Basically, the questions for me boils down to is the problem cellular or is it structural? If its structural, then is it muscle imbalances causing skeletal issues or vice versa?

16xWhat magical exercises did you use to get your leg to work again? i think my issue is my glut turning off but not sure what's causing it.

16x wrote:

andy b

i agree with everything you said, but it can be fixed. It is just a muscle imbalance. I don't know who you have seen, but I can give you some ideas.

I had it for three years and now it is corrected. I saw everyone too. It can be corrected.

Guys, has anyone here actually TRIED the gluteus medius exercises???

You should be focusing on making them strong -- like REALLY strong, like as strong as you can possibly make them. Like make them as strong/big as humanly possible.

I posted the following on 4/13/2007.......

This is the first time I have seen this post and I am totally amazed that there are so many people with the same problem as me!

I have also spent a rediculous amount of money on the problem with no real success. The only test that I would say came up positive was a nerve conduction study under stress (treadmill to bring on what I call the 'dead leg'), this identified a reduction in nerve conduction around the fibula head (right leg). I had a peroneal nerve release done (decompression surgery) with no success at all.

It is really interesting to hear that people believe clockwise running can really help the problem as it is something I have never tried.

I have had small amounts of relief from nerve stretches every day. Slump stretches and nerve mobilisation in particular. I have also strengthened my calfs and soleus (eccentric raises) as much as possible to eliminate the foot drop and overpronation that occurs as my foot starts to splay out. Balancing on my tip toes everyday has also helped. Last year I managed to complete my first 3km without the problem and ran 8:06. I got over excited then and ran a 5km but ran 73/73/74 for my last 3 laps resulting in a 14:18. I can run tempo's now up to 4 miles at 5:05 pace without the symptoms but anything over that and the problem starts to coccur. Progression runs have had less of an irritating effect.

Mine has certainly improved but the more I irritate it the worse it gets. After I have really lost the co-ordination in it it will take me 48hrs to lose the fatigue/nervey sensation in my leg.

I will keep reading this post in anticiapation for the miracle cure. Thanks!

Off to the track to run around the wrong way now!

...........................................................

04/14/2010

Since then I have tried everything to no avail and have followed everyone's progress (or not) on this thread. I have however been offered a solution after a Radiologist performed a doplar scan on my left calf.

This was performed because another Sports Physician I saw could not believe I did not have some sort of arterial occlusion despite already having had a doplar in 2001 ruling out a politeal entrapment. Anyway to cut a long story short the scan revealed a 50% arterial occlusion at the Tibialperoneal Trunk when I was maximally contracting my soleus (plantarflexion). The radiologist tested both legs over an over again to be sure and I saw the occlusion on the screen with my own eyes.

Basically the soleus is squashing the artery against the shin bone. I am having an operation on Monday to divide the muscle (decompression) and will be back jogging after 14 days.

I am sure this is it for me and I have a future still in my athletics! I will let you all know how I get on. Go and see a good radiologist and vascular sugeon asap. I live in the UK before you ask who I am seeing.

i agree do some glute work!

Tibealperoneal Trunk,

I am curious about your injury. You feel deadness in your quad(s) but the entrapment is in your calf? Can you explain how this works?

Very recently I had a dopler scan of my quads and everything was fine, except that the doctor noticed inflamation in both rectus femori, which are the spots I get deadness. Maybe I should have my calves tested.

Have you had any MRI's for labral tears?

Hey tibialperoneal trunk,

I'm sure this is gonna sound really off the wall, (but that's the case for tons of my posts in trying to sort out this injury!) but the reason your post seemed especially interesting to me is because I've noticed on my bad leg that whenever I really force plantarflexion, I get a weird sort of cramping feeling in my 2nd and 3rd toes. When I relax/release from plantarflexion, those toes are like in slow-motion as they slowly return to a neutral position in line with the other toes. I first noticed this in 2007 when I saw Phil Wharton and started following his stretching routines, including one routine for my lower legs. Any of the left foot exercises that included plantarflexion made my left foot have this weird sort of cramping feeling. But, the exercises on the right foot didn't cause this same feeling. So, this may be a really dumb question, but do you have any symptoms like that? Just that I read in your post that the doplar scan picked up your occlusion when you maximally plantarflexed...

Or, for you fly137, do you get any weird sort of cramping symptoms like that?

quicksand mcghee wrote:

Guys, has anyone here actually TRIED the gluteus medius exercises???

You should be focusing on making them strong -- like REALLY strong, like as strong as you can possibly make them. Like make them as strong/big as humanly possible.

yup tons of them over the last 9 months or so. I now have a much better looking ass and much more control of my glutes. It also improved my basic speed a bit and has helped me hold form in shorter harder efforts which has greatly improved my finishing speed in 3k, 5k, and 10k's. But during this time it has had no effect on the loss of coordination problem. Actually my issue has become slightly worse.

Hey fly137,As for your questions, I don't know that this is much help, but...1. I can ask my friend, because I don't know specifically. I just remember him saying it was hard to lift his bad leg--- that it felt tired and heavy... As for my labral tear, I'm waiting to hear back from Philippon.2. I haven't had any doplar/vascular tests done, but after your posts and the new post of Tibio, I would be interested in ruling it out before undergoing a major surgery like a labral tear repair...3. No, I've never looked into polymyalgia but because you asked, I read a bit about it. I would say it doesn't sound like it fits me personally because I don't really have pain (and that is the key symptom), I just have dysfunction. Which came first, the chicken or the egg, right? Well, for me, first, I have dysfunction in my leg and while trying to continue to get it to stride through, I end up with minor compensatory tight spots and soreness (or even minor pain, like up at the hamstring/adductor interface, but I hesitate to say "pain" because it doesn't bring me to tears or anything). It is not the other way for me, where first I have pain and then I'm limping (dysfunction) because my leg hurts... It's not that at all...

I was just going through the thread of loss of coordination in the leg and checking to see what suggestions you may have. I've had the problem for about 6 months now and get stiff in the same right leg and then lose coordination. No pain, just cannot control the leg. I started going to a chiro, but that has been costly and don't seem to be getting anywhere. They have me strengthing my right glute and were giving me deep muscle message. It's been a real challenge...right now I'm supposed to work on strengthing my glute for another 6 weeks before reporting back.

Would you happen to have any other suggestions or who I should see?

Thanks for any help you can provide.

Jason Dunn,

As far as my experience has been, and that of some of the other poster's who have had this for a while, strengthening doesn't really do the trick.

I recently had a muscle biopsey, which came back fine.

So as far as I can tell, this situation comes from 1 of 2 things:

Either some sort of vascular issue like a compartment syndrome

OR

Labral tear in the hip.

The problem is that there aren't really - as far as I can understand - any doctors who seem to think that a labral tear or a compartment issue can manifest itself in the quads. I would suggest you look into the hip/labral tear first. If you have a tear then maybe that would be the issue...and please let us know how you fare with any tests.

Tibialperoneal Trunk, Jason Dunn, and others interested,

Besides what you're doing right now, try working on your coordination. What I mean is that there's a pattern of muscle firing that should occur each time you walk or run, but for some reason you just cannot access it even after resolving whatever shows up on scans or doctor's opinions, etc.

The issue of gluteal strength has to connect with how you activate it during ambulation. If your psoas is strong and flexible, you shd be trying to get it to fire concurrently with yr glutes and low abs each time you take a step. What I mentioned about "hip suck" comes into play here. You've got to fire the psoas at the hip joint region at the same time you get the glutes to contract, meaning the muscles holding the femur from front and rear fire together each time you shift your body weight from one foot to the other. This alone will see the foot being picked off the ground.

The TVA and lower abs also contract to hold the pelvis and spine in neutral, while you pick your foot off from the ground. This does not mean you are crunching your stomach as you can contract your abs even when holding your trunk tall.

Try to get a feel of the respective muscles firing. This may be tougher with the psoas, but its worth while learning how to "hip suck" because if your psoas do not contract when you perform glute exercises, you may not be strengthening the glutes much at all in all yr exercises, but instead be recruiting the quads/hamstrgs/TFL, thus wasting all those glute workout sessions.

When you run you shd try not to lift the thigh and reach the lower leg foward, but simply pick up the lower leg under your hips even as you are consciously activating your psoas/glutes/abs. There shd also be a notable body weight shift each time you take a new stride. If your tendency is to keep your trunk stiff or on one side more than the other you will find that the glutes turn off, and yr stride messes up. A lot of the foot/lower leg nerve problems you experience can come from the misplaced steps due to poor trunk positioning and poor psoas/abs/glutes recruitment. This can happen even if you've got super strong in these respective muscles because you haven't yet learnt how to piece it all together in terms of muscle firing pattern.

I can't say the same for those with hip labral tears, but you can try it and see if it helps. For those with purely trouble in activating the glutes, you do need to re-learn how to use the muscles at yr hip and core to effect movement, or having those big strong glutes will count for nothing.