Physical therapy—gait correction

Andrew learns to walk again and overcomes a long standing health problem.

Andrew had a walking problem. His gait was unusual in that he normally threw his right foot toe-outwards on a forward step, instead of pointing it straight forward.

To an uninformed person that might not seem so drastic but the problems that it caused for Andrew, now in middle age, meant that his personalised walking style had to change and change quickly.

His physiotherapist had diagnosed the cause of his swollen Achilles tendon, his tight calf muscle and his persistent lower back pain as all due to his unfortunate walking style. The prescribed treatment was that Andrew should actively concentrate and practice a new way of walking. Instead of throwing his right foot out to the side he now had to point it straight forward when walking. In fact, he had to learn how to walk all over again.

The prognosis was dubious at best. Given a lot of effort and sufficient time, Andrew might re-learn how to walk in 6 months, or perhaps longer, or maybe never. He was somewhat pessimistic about his own chances of making the change. Having had the problem for so many years the injurious walking style was deeply ingrained.

Fortunately, Andrew was conversant with Old Way/New Way® and sought the assistance of the PBA facilitator. A session was scheduled for the next day.

Andrew had paid close attention to his physiotherapist's explanation of the problem and could give the facilitator a detailed description of the problem. After this Andrew spent some 15 minutes walking back and forth in a room, with his shoes on and at other times with them off, and sometimes with his eyes open and at other times with them closed, all the while speaking aloud of his sensations while he was walking in his usual way with his foot thrown outwards.

While walking in his own way he described the sensation of feeling the back of his right heel strike the floor first, followed by a "foot roll" or something he later described as a "rocking motion." He said that there appeared to be a two-stage impact. When asked to walk in his new way he described the sensation of feeling less heel strike, making a flatter impact, having more bend in the foot and in the centre of the foot and feeling more lift-off from the ball of the foot and from the toes. His foot seemed to be "working harder," he added thoughtfully. Andrew also mentioned that he could feel his right knee "working" to keep the foot pointed straight ahead when he walked.

The remaining part of the half-hour session was taken up by Andrew comparing his old and new ways of walking, followed by a short practice session where he walked in his new way. He was given a simple procedure for self-correcting his walking whenever he detected he was walking in his old way and was reminded that his progress would be reviewed in two weeks.

In an informal discussion a few days later Andrew said that the metacognitive treatment appeared to be working and that he had been able to successfully apply the self-correction procedure a few times. He also complained of a new pain in his right knee. The facilitator suggested that he should mention this to his physiotherapist on his next visit that evening and also asked him to explain to the physiotherapist that the Old Way/New Way® process had now enabled Andrew to exert more conscious control over his walking such that he was actually walking more often in his new way and consequently using his right knee more to maintain the new direction of his right foot. Andrew agreed that this was a likely explanation of the knee pain and said that he would mention this to his physiotherapist.

2 Weeks Later. The knee pain has gone and Andrew's walk is now much improved. He has noticed the improvement himself and so has his physiotherapist. Altogether, its been a very positive outcome for all concerned.

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