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

You may also want to research popliteal artery entrapment or iliac artery endofibrosis ... iliac issues more common in cyclists but can occur in runners. Causes weakness, loss of power, tight/contricting feeling, very sore ache, worse at high pace and up hill, can cause numbness in feet, and due to the weakness, etc can make you feel like youf foot is slapping. Symptoms are very similar to compartment syndrome when running - I felt it in my calf and quad and it always started several minutes into the run, and went away as soon as I stopped. When cycling it appears whenever the pace really jacks up and on steep fast climbs. Basically the artery is entraped or blocked so blood isn't going to the leg. My docs thought I had compartment syndrome, nerve entrapment, or artery entrapment. Compartment syndrome pressure test proved that wasn't the issue. A visit to a vascular surgeon (who works with athletes and has treated this issue in runners and cyclists) and various tests confirmed my issue to be a vascular issue. Depending on the exact cause, it can be treated with a stent or balloon in the artery or possibly require a graft. It took me 5 years to get doctors to take my issue seriously after trying to tell me is was a muscle imbalance, strength issue, tight muscles, etc ... Worth checking out ... a simple muscle weakness or imbalance is not going to cause the entire leg to have such severe issues.

Thanks bum leg, I will ask about having a vascular test done.

"Because of weak gluteus maximus, the hamstrings became overdominant, resulting in compensation in the lower back. This created lower-back spasm, which produced nerve pressure."

So, yes, many of us have a glut weakness, but WHY? We need to know why so we can address the cause. Otherwise, we all keep trying to strengthen the glut and other muscles and never make any headway. I will look into vascular issues as a possible cause for the break in the kinetic chain...

Before my symptoms started i was diagnosed with tarsal tunnel syndrom?

I have had some problems with hip alignment in the past, especially on my left side from track running while I was growing up.

Inversion tables decompress your spine, allow your discs to reset, and thus other joints fall into place as well. Regular use is necessary. They are a very simple piece of machinery, and not too awfully expensive.

http://www.inversion-table-direct.com/p/calm-calm-inversion-table

Here is my latest update.

The primary cause is in my foot. Abnormal foot strike=abnormal leg function. Sounds like a prime example of, "usually the simplest answer is the right one." I have developed a cascade of problems (ie: mild peroneal nerve disfunction, hip malalignment, leg muscle disfunctions) because of what is going on in my left foot. My "dead leg" is more of a "heavy leg" that because of the inability to properly bear weight through the foot, I have developed an abnormal adaptive foot strike which has further affected the kinetic chain of muscles up my leg and in the hip.

So it is narrowed down to the left foot, but now I am in the process of trying to figure out what specifically is going on in there. As far as symptoms:

1. Incredible left foot stiffness compared to the right foot, both walking and running. Sometimes on really bad days, my left foot feels rigid and bricklike. Comparably, I feel ZERO symptoms of anything in my right foot EVER.

2. When walking, my left foot turns in so that my big toe is not pointing straight ahead but is pointing to the right. Picturing a clock face, if the big toe were pointing straight ahead and that was 12 o'clock, my big toe is pointing at 2 o'clock. If I try to consciously correct this and force my big toe to hit the ground straight ahead at 12 o'clock, I feel pain right on top of the foot where the ankle bends, but a hair more medially than laterally. So, I imagine to avoid this, my body has developed the adaptive behavior of turning the foot to avoid putting weight through the ankle there where it causes pain.

3. If I am standing on two feet and relax so that I am weightbearing evenly on both feet, I feel tightness in my left midfoot. Specifically, closer to the ankle than the toes, and closer to medial than lateral. It feels like something is caught, or gets caught in there.

4. If I am standing on just my left foot and lift my heel off the ground so that I am fully weightbearing on the ball of the foot, I get a sharp pinching/shooting pain through my midfoot. Sometimes I feel the shoot of pain when I release the weight from my foot.

5. Because of #3 and #4, I can see how my body has adaptively learned to avoid bearing weight on the left side--- my left foot strike is very passive with longer ground contact time than the right. On my right leg stride, I have a quicker toe off than the left. On my left leg stride, I sort of "roll up" to a toe off so that my ground contact time is longer. That is IF I'm able to get up on my toes on a good day. Often times my left foot/ankle feels inable or somehow physically inhibited to do this and bear weight--- the result being I am completely flat footed on the left and weight is through back of foot nearer heels. If I consciously/awkwardly force myself to get up on my toes more, I get the sharp pinching/shooting pain (the same one I explained about that I can simulate by simply standing on one foot with the heel off the ground) and my foot buckles/gives in as though I've stepped in a divot.

6. My left leg is a whip leg (left heel doesn't stay directly behind left butt cheek but flares outside a bit). If my foot is pointed to 2 o'clock, I guess my heel would come around at 7 o'clock (butt cheek being 6 o'clock)? It takes longer for me to bring my left leg around through a stride cycle than the right. This is probably because that "slow" foot strike and longer ground contact time on the left slow the momentum of the leg... ???

7. Just standing on two legs shoulder width apart, I pronate. BUT, when running, my right foot is very neutral and my left foot actually supinates with inversion. Meaning, as in my description above of the big toe pointed at 2 o'clock when WALKING, when RUNNING, picture that same foot placement, but with the foot tipped laterally so that I'm almost running on my 4th toe and pinky toe some bad days. This is highly visible in the different wear pattern of my right and left shoes.

8. My symptoms have changed through the years. My left foot used to get a bit of a foot slap/floppy foot but now is pretty much beyond that. It's either evolved into a stiff foot, or, again, I've developed some sort of adaptive behavior to avoid/correct for this. As a testament to the changing foot symptoms, I posted about this same thing in 2004:

http://www.letsrun.com/forum/flat_read.php?thread=651955

Does anyone have any similar symptoms? Thanks to everyone. We've just got to keep working and we will figure it out!!!

Wow, Osage, I've had the same symptoms for 20 years. Everyone thought I was nuts. Tempo runs my leg would "go out" but not intervals, because of the short rest between runs. Just like you. Cross Country races I'm free from symptoms 98% of the time, but on harder surfaces like the track and roads I'm only symptom free 50% of the time at best. Very interesting stuff. Yes, my left foot always feels "off" and not right. A real bummer that I've had to run 50,000+ miles with this problem. I wish everyone else knew how good they have it with two normal legs.

Yesstiles, I'm sorry to hear you have the problem, too. But maybe we can help each other and the others on this thread.

A few questions for you yesstiles and anyone else:

1. If you do single leg calf raises on each leg, how do the feet compare?

*My right foot (good leg) is normal. But, my left foot is not. As I lift my heel off the ground to come up on my toes, my ankle does not "come up/stay straight" in line with my hip to knee to big toe (picture a ballerina on pointe as the gold standard), but rather shifts out laterally (away from the body)

2. Progressively from simply calf raises to a more dynamic test with impact and weight bearing: If you stand on one leg and hop, how would you compare the two feet/legs? Steadiness, strength, foot position...

*I am strong and steady, up on my toes on the right side. Feels springy. But, on my injured left side, I cannot get up on my toes and fully bear the weight of my body on ball of the foot. If I really force the foot up on the toes on the left, I cannot hop steadily as on the right. I can hop once, absorb the shock and stop completely, and then hop again. I cannot easily hop in succession as on the right.

3. Have you ever had seen a doc or specialist for your feet, relative to the primary cause of your injury with the loss of coordination?

4. Do you have an accessory navicular?

*I do and it's HELLA HUGE! Pesky booger might be at the bottom of all this...

WEAK INNER THIGH MUSCLE ON LEFT SIDE.WEAK RIGHT GLUTE MAX. If the adductor (external rotators) on your left was weak your glute muscle would be dominate then shutting down that adductor muscle. The opposite leg your adductor is so strong they are shutting down your glute. Why is your right hip pushed back? Then your left hip is pushed forward or in. When I start my run as long as my left inner thigh muscle is tight I might be fine. As soon as I feel my glute med muscle get tight I start to loose coordination.

I'm just going to throw this into the mix. It might be totally irrelevant, given the recent posts, but worth noting.

I've had this "loss of coordination" for the last 9 years.

I am now 5 1/2 months pregnant and my ankles and lower legs have started to swell regularly. I've noticed that on days when I've been sitting for prolonged periods (and hence the swelling is significant) that my symptoms when running are a LOT worse than prior to when the swelling began.

And because of the pregnancy, I have slowed down significantly. In the past, intensity / speed would bring on my symptoms but I'm surprised at how quickly they come on now running at 1 - 1:30 minutes per mile slower than before.

This therefore leads me back to thinking this issue has got to be vascular or somehow related to nerve impingements. (As a side note, I've had compartment surgery release on my bad leg with no noted improvements).

I understand what you're saying, but the primary cause FOR ME of all the muscle imbalances/weaknesses like you describe, is an underlying foot problem.

Ok. Picture that running is a series of bounding, essentially. Bounding is like jumping. AND I CANNOT JUMP properly on my left foot because it cannot fully bear weight. If it can't bear weight properly jumping on it, it is not going to bear weight properly when I run on it. Because I run on it anyway, my leg muscles and hip are going to have to compensate for this weakness in the foot to strike and toe-off properly.

Abnormal foot strike=abnormal leg/hip function.

Then, if your leg is functioning abnormally, your hip gets tilted/rotated/jacked up/whatever and thus further contributes to perpetuating the cycle of dysfunction.

I realize we all have similar symptoms, but we may not all have exactly the same thing going on. Maybe your foot is not a factor for this injury.

The hypotheses out on my foot are so far: anterior impingement, talo-navicular problem, posterior tibialis tendon disorder, maybe some other type of soft tissue problem, and talar coalition.

I'm going in for an MRI.

exactly so you just have to strengthen some areas that have been discussed over and over on this tread. Trust me you do not have some vascular problem or a rare case of compartment syndrome or peroneal nerve entrapment. Stop spending money, you can fix this problem in your bedroom.

You have too much pronation in your right foot. If it is not a glute med problem do the hip hike exercise. I will bet after 30-40 lifts on your left you will feel your TFL on your left screaming. The exercise is geared to fire your glute med muscle. Why is your TFL compensating? When you are doing this with your right foot, after 30-40 you body will start to bounce and shake and wobble. If your loss of coordination is in your left foot. Why are you having such a difficult time with your right?

Theory

1. Your weak glute med on the left during the exercise has a muscle that will compensate. This would be your TFL. This is exactly the same thing that happens when you run. That dominate of a TFL and Glute max will shut down the inner thigh and the smaller glute med muscle.

2. On your right when you run the muscle that compensates is your inner thigh muscle. That will never activate during this exercise. If it could you would have no problem doing the exercise. This explains the difficult nature to perform this task?

3. Your back will be very much affected. If your glutes don’t fire properly your back muscles will not shut off either.

If you can get that left inner thigh to fire and that right glute max along with you left glute med you will be cured.

cliffF wrote:

exactly so you just have to strengthen some areas that have been discussed over and over on this tread. Trust me...you can fix this problem in your bedroom.

Why SHOULD I trust you cliffF? So, you think I can perform foot surgery and remove my accessory navicular and tighten up my PT tendon in my bedroom?

Let me illustrate something to you relative to MY injury: I had the kinder procedure on my right foot. When the cast came off six weeks later, my calf was atrophied to the disgusting size of my forearm. I did strengthening exercises and 4 months later I was not only racing on the track again, I was PRing with 2 equally strong calves.

If I could strengthen my calf in 4 months, why after YEARS of exercises, have I not been able to strengthen my symptomatic LEFT leg sufficiently so that this loss of coordination problem goes away? I'll tell you. It's because in my case, and maybe not in your case, there is an underlying cause to the muscle weaknesses. I believe that underlying, primary cause to be something wrong with my LEFT foot. All the leg and hip strengthening exercises in the world are not going to fix something intrinsically wrong with my FOOT so that I cannot properly bear weight on it.

"… foot mechanics didn't look right. You were still avoiding transferring forces through the left ankle, almost like you were running on a pogo-stick..."

"you were running on a pogo-stick..."

This is exactly the same phrase my PT said when I could no longer activate my right glute max. This just may be caused by too much pronation in that foot.

Miss Osage:

I had (and still do have) similar things that go on with my left foot - it is much more rigid and slaps a bit when running and I am unable to roll completely up on the toe because the bunion it eventually formed is underneath the toe instead of to the right side - like most people form over time.

The navicular bone is higher and more rigid - I always thought it was years on the tracks - but looked at my mom and sister's feet and saw the same deformity and they are not runners!

caused me years of problems - eventually so bad that I didn't run for nearly 3 years until and osteopath put my pelvis back together. I told him about the "foot" and he looked at it, but proceeded to perform his treatment on my left back and pelvis and it did work - pain free and running for over 4 years - BUT - he did put a heel lift in the left shoe - and it has worked. So, I don't even question it anymore - just wear the heel lift and enjoy my runs. But yes - the left foot still strikes very differently despite trying to do heel lifts on both legs in an attempt to even them out.

I have similar symptoms, but they just shift in intensity from place to place. But one diference is that my problematic left foot and leg CAN bear weight very well.

I think it might be more than one area of cause. I certainly agree for now that your left foot is a major cause. It could be the root cause, or another contributing factor.The tricky thing with the human body is that it functions and breaks down nearly always as a whole, and so it looks to melike we have a chicken and egg quagmire here.

Consider these as well:

1. Do you have different strength in both ankles? You are right that problems with the foot travels upwards to the hip and back. If your left ankle is weaker it can lead to a tilt inwards from your pelvis down to foot whichcan bring on adhesions to your glutes and ITB. This relates directly to the low back which can lead to disc/nerves problems.

This tilt keeps the shin perpetually leaning lateraly outwards which sustains presure on the foot metatarsals. The nerves in that foot will be perpetually impinged. This may affect your lower leg control. Something like you are always at the same angle of diagonal/lateral lean as when you are rounding a track curve.

Can be due to training surface/habits, postural misalignment, leg length discrepancy, past trauma to the area, etc. Try foot and ankle flexibility and strengthening exercises?

2. The low back can be the actual cause too in that your core may be weak and misaligned. Do you engage TVA when you perform daily life and athletic activities? If core is strong enough AND PROPERLY ENGAGED the foot strike will never be off from safe parameters.

If you allow your trunk to rotate/lean excessively when you run its almost certain that one leg/foot will take unhealthy load. This is especially so for overstriding and heel striking.

Have you been performing exercises to your trunk? They can be helpful in alleviating back pain in relatively short time. Key lies in TVA. With engaged TVA the glutes can fire optimally. The feet will never land and under/over pronate unless you do it deliberately.

Usually back pain has link to lower extremity problems, and vice versa. Maybe someone more knowledgeable in the field can offer better advice. But from what little I've read and seen and experienced, this is my contribution thus far.

I need to correct myself.

Its when your left ankle is way stronger than your right that the aforementioned problems occur. If it also has shortened ligaments and tendons this can impinge nerves, over engage shin,ITB, Vastus lateralis, TFL, causing anterior rotation of left hip.

Your left foot will then land abnormally, leading to all sorts of compensations from below to above.

Could you have been trying to keep weight off previously injured right ankle/foot, to the extent that your posture and/or walking pattern has been affected? This could mean overloading your left.

Miss OsageCounty,

More issues to consider:

Do you have a desk job? Do you spend long periods seated for whatever reason? Overstraining the low back by too much bum time can lead to disc problems, which can affect hip and leg function. This is esp so if you have a favourite position in your chair or when you drive that puts pressure on one side more than the other.

Hey everyone,

I'm not entirely sure this is the same thing you guys have been feeling, and I haven't quite read through this whole thread, so forgive me if this might be misplaced.

For the past few weeks I've been getting this weird pain down my left side. It's at its worst when I'm in bed trying to sleep. If I either tighten that quad or stretch that calf (think of it as just extending that heel) there is a pause for a few seconds and then a rush of pain--almost a sort of warmth, pressure, and tightness--that I feel over my entire lower leg. I also get this some during the day. I haven't noticed anything more dramatic than some soreness and calf pain when running, but I do definitely have the same quick twitch coordination in that side as I do on my right side (although I did recently return from a stress fracture on my left side, so this may be just left over weakness from that). So far this hasn't done anything too negative for my running besides make me lose a good deal of sleep, but I'm worried it will progress.

Any ideas? Thanks for any help.