A youthful gait and posture contributes to the appearance of health and youthfulness, every bit as much as the appearance of things like your skin and teeth.
I often saw patients between the ages of 50 and 80, who complained of walking like their Granny, and they didn’t know how or when it happened. Sometimes a family member noticed. “Dad, you’re walking like Peepaw!”
Patients who develop a limp after an injury or the acute onset of a disease process are well aware of the source, but the rest of us can develop it insidiously…a slow creep…and then it’s there.
I like to talk about recognizing the onset of your Granny’s Gait, and then discuss things you can do to prevent it. But first, let’s review the definition of a normal gait, so you can understand the goal.
A normal gait is:
Strong. Your muscles are working!
Efficient, and essentially effortless.
Purposeful. You look like you’re going somewhere and not meandering…even if you are!
Balanced. The same muscles are firing on both sides! You lift one foot off the ground, set it down heel-to-toe, followed by the other. You’re not shuffling. You’re not teetering.
Painless! You’re not limping.
You’re looking straight ahead, and not at the ground…very much.
If any of these factors are missing, you’re probably limping or shuffling. You’re focused on the ground, so you don’t trip on uneven ground or step in a pothole. You’re not getting anywhere efficiently. You might have pain. In short, you’re walking like your Granny!
There are many reasons we develop a chronic/permanent limp. Some limps are permanent and unpreventable. I’m talking about the limps which might be temporary and preventable.
Any painful injury or disease of the back and lower extremities, has the potential to lead to a limp, and depending on whether or not the process is reversable, if you recognize there is a limp, and you realize that part of wellness is recreating your normal gait, then you’re ahead of the game.
As we age, our expectations, as well as the expectations of our physicians and therapists are at risk for lowering. We’re more likely to accept a limp…because we’re old. An expectation of achieving a normal gait, and not just healing the injury, should be part of the discussion. Your expectations are that you will heal, have less pain, regain your flexibility and strength, then recreate your normal gait.
The development of a limp might be the cumulative result of repeated insults to our youthful gait.
-You might have an injury to a foot or ankle,
followed by the coincidental development of visual problems, or the use of transitional lenses.
-Then you buy a poorly fitted pair of shoes.
-Then you had a surgery on your colon, and sat around for a while with your feet and ankles flexed in a relaxed position, resulting in a slight Achilles tendon contracture.
-When you started exercising again, you developed plantar fasciitis.
Boom. You’ve got a limp!
The causes are multi-factorial, and it will be hard to correct it. The nail in the coffin is that you learned to compensate for the painful left foot and ankle, by matching it with the right side. You disguised it for a year, and now correcting it might be beyond your reach.
Prevention
- Recognize the potential to develop a limp.
- Discuss this with your doctor and physical therapist as you’re recovering from a painful condition.
- Maintain your balance by doing balance training exercises, like single-leg standing. Do them regularly if you’re able to.
- When possible, correct visual and inner ear conditions, which contribute to an unstable gait.
- Wear healthy, painless shoes. Ditch dangerous shoes, like flip flops and high heels.
- When possible, correct painful back and lower extremity conditions. Even a blister can have long term repercussions for the elderly.
- BE MINDFUL! Simply the awareness of the factors contributing to a normal gait will put you ahead, in terms of prevention.
When walking, I intermittently refer to a mindful checklist.
–Is there any pain? If so, why/what and can I fix it? If I can’t, I’m not going to continue to do the thing which reproduces the pain. I’m going to figure out where it’s coming from and if I can correct it with a modification or work-around. Is it my shoe? Is it because I’m taking too many hills, walking too fast? Does the pain go away when I stop walking for exercise? Do I need to see a doctor? Oh, right…I do have a little advantage there. I can ask myself. But you can deal with a lot of things on your own too. Resting, changing shoes and changing the exercise or the pattern of exercise, are some simple steps. Time can help. Have some patience.
–Can I take a few steps and feel secure in my ability to hold one foot, and then the other off the ground. I take a normal, healthy step. Then I extend it, and see if I can balance myself, while one foot is briefly in the air.
I’m not trying to get in between you and your own doctor. I’m not advising you to self-medicate or treat. Mindfulness of your normal gait is the key. I’m advising you to be mindful.
I have witnessed my parents (now 90 years old) slowly develop their Granny’s gait! Now, many of you would say, “Who cares at 90? We should all be so lucky as to live a long life and have peace with a little limp. Lighten up, doc! Meanie.” But they had no significant pathology. Any pain they had was addressed long ago, and in a timely fashion, cuz as a dutiful daughter, I was on it like flies on poop. It’s not a pain induced limp. It’s just an unsteadiness. It’s multifactorial; some combination of weakness, stiffness, visual and neurological changes, balance issues. It just happened. And once it happened, there was no reversing it, because it had been there for a long time, and they’d have to really devote a lot of time and energy to correcting it…perhaps to no avail. And at this point in their lives…they’re gonna have some peace with that limp.
At 70, I’m wondering if that gait can be prevented. I’m going to try. I’m being mindful. I’ll keep you updated.