Heel Strike: Walk better after a stroke
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- Опубліковано 27 бер 2021
- Heel strike is a moment in the walking cycle at the end of the swinging phase. Contrary to what most believe, heel strike is NOT always due to weakness in the muscles that lift the foot. There are other factors that may influence this small moment in the walking cycle (gait cycle). Learn these exercises and improve your walking efficiency and balance confidence!
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You are our angel, thanks so much, Dr.Tobias! I've been following you from Italy for 5 month and thanks to your exercises I managed to make a visible improvement. What I would find really useful is a video on the whole walking cycle, putting everything together. Dealing with foot drop, (eliminated circumdaction and other complementary strategies) I have to resolve balance issues during walking. I don't know where to put my weight, in which phase of the walking cycle, which muscles I need to relax, how to move my upper body in harmony with my hips and legs... It's a complete mess.. please, Dr. Tobias, if you can, upload a video on this! I'm sure many of us would find it useful.. priceless in fact. 3 physical therapists were not be able to help me, only you, from the other part of the Atlantic.. Thank you 😊
Hello Dr. Tobias, videos like this is the reason that I check this channel out often. You always have informative videos to help me.
Hi Fred! Thanks for watching. I hope it helps 😊
Thank you, Doc! Very helpful and clear video!
Great video, in the end I understood why I walk incorrectly, even quite fast, so there is no way to fix it. Now I understand where the problem is and how to fix it. I see that dorsiflexion is very common, as is knee flexion. You gave us very good instructions as a recipe for cakes and now I will practice and I will walk like a ballet dancer. Thank you very much Dr. Tara.
Hi Tara. I must say your descriptions and remedies are si clear! Very helpful for me at 70 years old. No stroke or spinal injuries, getting older combined with fibromyalgia - the latter worsened temporarily by the stress of losing my husband four years ago and then packing up solo for two relocations in 3 years! The way I sat to sort and pack: legs tucked under chair, hunched over really tightened ankles knees and hips! Where I live now lively paved walkways in scenic gardens, but walking is simply painful. So I will implement your exercises......excited that I will eventually walk upright again and walk correctly!!! Thanks for your generous help!!!!🤗💜
Wow! This is something I have needed help with. Thank you Dr. Tabias, you always amazed me!
Hi Teresa! Great to see you in the comments again this week 😊. I hope this video helps you!!
You are a "Master Mechanic" of the body. I use your suggestive exercises daily. Thank you so much.
In my 10th month of recovery after two mild strokes Memorial Day weekend 2020. Only issue now ( beside normal sore knees) is right ankle will not flex with brain command. Starting to be able to go down a bit, but coming up is the issue.
Working everyday on it, have many of your vids saved.
Thank you for everything you do .
Hi, It’s Mirranda, thanks so much. I also have difficulty transferring weight to involved leg and pushing off. Thanks for all your videos and encouraging emails they have inspired me to keep going when I don’t seem to be improving very much.
Hi MIrranda! Thank you so much for sharing and for watching. I am so glad that you are continuing to stay motivated and pushing forward!!!
Thank you so much for sharing your expertise. I am learning a lot from your videos.
Giving a good knowledge about this problem. Really appreciate.
Thank you your videos are helpful while I am recovering from stroke and I am following you from India. Keep making videos
Omg Dr.Tobias I'm really glad I got this notification 😍
Tbh I've been stuck on the abnormal synergy pattern for a couple of months now mainly with my ankle and eversion
My physio therapist had to take a break because of COVID
This video really helps me to understand how my lower extremity should be.😇
God bless you and keep up the good work 🧡
Looking forward to your video for the upper extremity since I have been struggling with the extensor synergy for my affected arm
Stay safe
Thank you Dr Tobias your videos are all big help to me, I am a stroke patient, I am on my second month and I just watched and follow all the drills, it's helped me a lot, I am practicing my waling the right way, and looking forward to walk normally very soon, thank you again and God bless :)
Thanks for the video Dr T. It’s helpful, and furthermore since I have been following the Instagram profile of Neo. It’s amazing how diligently you’ve been following up (for everyone’s benefit)
Kudos!
Great channel! So glad I found you.
Thank you very much for posting these videos. I fractured two vertebrae in my kneck December of 1970 in a car accident.
Your videos are the first I seen on the subject. I learned to walk again at the Health Science Centre in Winnipeg. Use of my upper body returned fairly quickly, but I lost the use of my left tricep. I could walk as fast as people normallly walk, could not run at all. Things began to go south for me about twenty years ago. Got to where I needed something to lean on fast. used the handle of a broom to help me walk till I found a walking stick. That winter,I used a walker because of snow and ice. I still use the walker outside, but just lean on stuff when I walk around the house. This is the first I heard the term synergy, it puts a better slant on thoughts of walking unaided again. Seems important to me to learn how to fall properly, and getting up w/o the use of objects.When I try to walk across the house unaided, sometimes something similar to vertigo hits, and I fall fast. Thank you for reading my rant. Again, thank you for these videos.
Thank you a lot! That's what I need!
❤❤❤
As an ALS patient your videos are super helpful
Yeh! The last piece to my walking rehabilitation. Thanks!!!
happy 2022 Doctor!!!
Thank you dra. Tara..very helpful..
your tip on keeping my knee extended its just a life saver..instantly gave me much needed stability.thank you
can you please advise on a knee stabiliser that could worn at all times.thank you
Thanks for your video, it's makes it easy for improving walking.
Thank you so much
Thank you very much for this info, really helped me out %1000 , omg so happpy for your great knowledge ❤️,post stroke aug 4th 2022
Thanks!great help !
Thank you so much! I am so glad you found this helpful!
💫💛💫 Dear Dr. Tara, thanks for touching this topic. In fact, I am fighting this since day one with lunges and elastic band stretches. Your exercises are great, I will try them... Many greetings from Hamburg 💫💛💫
Hi Nina!! Hamburg.....got it. I learn a little bit more about you each week. 😊 Yes, lunges also work really well to learn how to keep the knee straight with the foot dorsiflexed. Thanks for sharing this awesome tip!!! Chico and I sending love to Hamburg 😊
I am writing this comment while trying to grasp what just happened. I did the exercises and today while I was walking noticed that something is different while I walk. I was able to straighten my knee , and I I gave a call to my family members to share my big news. I hope one day I can visit you in person Miss Tara. I.‘d like to show you how your videos changed my life. I couldn’t even sit up after my stroke . I did inpatient therapy for 2 weeks, and 1 week outpatient therapy, but all those therapies were useless. Since I started following your videos and strengthening my legs at the YMCA on a recumbent elliptical machine I have achieved a huge progress in my recovery.
Zita, I am so excited for you! What an amazing accomplishment! I am so happy for you and so grateful that you took the time to share this with the community. I am confident that this will inspire others to stay the course. Keep going!!
LOVE THIS!! How about feeling weakness in the knee walking down stairs. Knee feels weak and floppy outward?
My knees always feel/look bent when I walk. I have trouble dorsiflexing my foot (due to MS) and bad foot drop on one foot. Unsurprisingly, heel strike is hard for me. This video makes so much sense. Thank you, Dr. Tobias!
Thank you for watching and for sharing! I believe I have seen you in the comments before. I am so appreciative of your loyalty and you willingness to share your story. If you feel comfortable, please share your name to help me put a "comment" with a name 😊
@@rehabhqofficial I'm Katherine :) I find your videos so useful, particularly those that help with MS-related issues like foot drop, spasticity, and so on! If only your clinic was located in NYC!! Oh also, I've said this before, but your dog is absurdly cute.
@@saltycrunch Hi Katherine! Thank you for sharing. I am so happy you find the content helpful. 😊
@@rehabhqofficial Neelam Sharma I live in canada
btw, Chico (the dog) and I sending love to NYC 😊🐶
Hi dr. Thank you for your info. I really needed that. 6 yrs in allready. Following your teachings. Am allready looking forward to improvement. Thank you. From Aruba, One Happy Island.💟
Hi Rudolf, thanks for watching and for sharing 😊
Very timely! I always thought I needed to keep the knees flexed. My walking instantly improved. Working on the exercises starting now. Thank you Dr. Tobias.
Hi Don! Generally speaking, in most cases, it is best to focus on keeping the knee bent. This video was inspired by one very specific movement problem. That being said, extensor spasticity is MORE common and in that case you want to keep the knee bent. I hope that helps you!!
@@rehabhqofficial 8iiii
Many thanks
Thanks for very informative video. Please also do upload videos to strengthen hip muscles after stroke.
Good video dr. T. Should do a video on aligning ankle, knee and hip. Due to scissoring, my knee flexes outward. It starts from ankle. My hips are very strong now. The flexion of knee outward gives an illusion of weak hip.which it's not.this is how I test physiotherapists on how much they understand static and dynamic forces. In one of your videos you said everything starts from bottom up. That was the aha moment for me. I knew you were ahead of other therapists in terms of understanding the forces.thanks again. This knee flexing outward is my last issue with the lower extremities.
Lady you just saved my life
You just get it! Thank you
April 5. I had a strok. This. Year. Rt. Side my thankyou. For. Being here on. The. Tube .
Dr. Tabias, tomorrow is Easter and don't expect to receive a video from you. Happy Easter to you, your family and your cute little dog.
Great info!
Hi Hector. Thanks for sharing!! I hope it helps 😊
Thanks for the info, it was just what I needed Dr Tobias
Hi Ivette!! Thank you for watching. I hope it helps 😊
thankyou all very very helpful
Hi Robina! I am so glad that you found this video helpful. Thank you for watching!!
So very good. Timely for me. What do you think about my time-line? I had the stroke nearly four years ago. Still trying to improve.
Thanks for sharing...👍👍☺️👌👌
This is helpful because i have a real problem with heel strike
Your channel is amazing. Have you done any work on contrained induced movement therapy. I am setting up a program for myself. What exercises would you recommend for supination, pronation. I Have got cards, trowel and bucket. Any other ones? Mike
You are the best 🙏❤🥀
Your circumduction videos are helping but I find I lean forward and towards my uninvolved leg. I feel as if I have a weak core and hip. Have foot drop due to ms but keep trying to improve things. Also very hard to bend knee when lying or standing. So glad I found your site!
Hi MG! If you are comfortable sharing, I would love to know your first name. Anyway, you are not alone with this particular "problem". It is actually very common and I am amazed I have not addressed this yet. Stay tuned! Video coming soon with solutions for this 😊
I wish I could find a physical therapist like you, who knows what they’re doing, in the Charlotte (NC) area. I have a frustrating, painful gait issue. I have been to 3 different physical therapists here and none of them really helped me.
Thank you….
Hello Dr.Tobias, thanks for these. It's been nearly 30 years since my RTA and subsequent brain injury. I am sure that I've relearnt walking badly? I still fall over, hard - banging into the pavement - I just seem to collapse! Luckily I don't hit my head, I know I've got to be strong and find my own correct walking patterns.
Often my foot skims the floor and I hit cracks in the road, or even when I suddenly walk somewhere smooth like a shopping centre my feet get tangled up? - I was never shown how to walk again here in London, because it appeared I seemed to be coping. I knew there was something missing in my rehabilitation. Things were confused again because I suffered a stroke 10 years ago, so once again I had to attend a hospital - and again the small steps in recovery were completely missed out. I'll start doing your exercises now.as my falls are getting worse! Is there something else I need to consider?
Best.
This is exactly what I’ve been searching for! Where can I purchase the equipment to do these exercises? It would be a godsend! Thank you in advance!
Thank you I appreciate this I have foot drop and my hip and hamstrings are always bothering me and I was trying to find out why and how to make some changes
Thank you once again I will include these in my daily workouts
I have foot drop also , I had my stroke almost 3 months ago.
So many elements of this video pertain to me. Thank you! On a side I've noticed that eccentric work is easier on my spasticity than concentric. Is there any evidence that eccentric is as/more beneficial than concentric?
Another home run! Just the issue that I've been trying to solve!
Symptom - when I am exercising on the mat, if I lie flat, push my foot (weakly, but as hard as I can) into dorsiflexion, I cannot leg lift, even a little, until I bend my knee a little. If I point my foot and extend my knee, I can easily lift my leg. If I understand, this is an extensor synergy pattern. When I walk, foot wants to point and the knee wants to extend just before my heel should 'strike.' I utilize a pre-stroke Charko brace but it has a built-in ankle pivot - still working on better dorsiflexion. My AFO turns my foot out 90 degrees as my heel strikes so I can't use it.
In p/t tomorrow, can't wait to them these exercises! Thanks!!
Thank you for watching and for sharing! These are all very common problems. Generally speaking an extensor synergy is when the knee extends and the foot points at the same time and it is difficult to do one without the other. As far as the AFO, this is extremely common, but in my opinion an AFO is the only way to break up a strong extensor synergy. You gave me an idea for another video though. "how to relearn how to walk with an AFO". Stay tuned for that!
LOVE THIS SUBJECT REGARDS TO STROKE !! WE NEED MORE DR
Thanks! I hope it helps. Btw, about that book you were asking about. It seem pretty comprehension for general understanding of Neuro. If you think you may specialize in neuro, CE is the best way to learn more treatment techniques. 😊
@@rehabhqofficial Thank Y. Last question ? CE - means ?
I am more than happy to meet Y in Your Clinic and Have some Volunteer work. I am based in the UK, but work in Africa.
@@Simon_Aesthetic Continuing Education.
@@rehabhqofficial Thank Y Dr
Most of the Time I feel like We Therapist from the UK are less educated than Therapist from USA and Australia. But This is my Honest Feedback . Thank Y for All.
Can you post a list of your videos and the order that we should watch it.
Is there any exercises to straiten out the leg? If so can you please upload videos appreciate your help!
I started to walk after the first week. The issue I have now is my balance and spasticity.
These are my problems, too
Same here
THANKS NEVER HAD. PAIN WHILE CLIMBING STEP ON MY ANKLE JUST. FEELING PAIN WONDER WHY....PLS EDUCATE ME. REALLY ENJOY U LECTURE
you are an angel!
Thanks
Hi Vilma! Thank you for watching!!
Hi Tara, happy To have u as my guide.
To be frank, i retire in a day mostly by seeing your guidance.
Can you help me out with deltoid strategies, for a subluxated shoulder, right side, stroke case.
Much have reduced, but still..
Waiting for your videos.
Thanks.
Thanks for watching and for your support! I am so glad you find the videos helpful. And yes, I will add a video for shoulder subluxation to the agenda :)
@@rehabhqofficial yes, plz..
And a request, whenever you make a exercise video for Subluxated shoulder, plz do put the title of the video related to Shoulder subluxation, that'll become easy to access..
I have Hereditary Spastic Paraplegia type 5a, or SPG5a. I'll be searching through your videos for help!
I need the opposite - heel strike with an extensor pattern, it's hard to get my knee to bend or lift for walking
Thank you so much for sharing the above. Very useful indeed. In my case, the knee caves in more . I am advised to wear braces . Please suggest which kind / brand of braces i should wear. You are a gem of a person indeed ❤❤❤
wear a afo with raised heel/ wedge. i find it difficult to get full sensation in my heal as it feels like it is kinda floating. any suggestions. also when do you know you are ready to retrain movement in ankle post afo?
is there a way to capture the exercises in a static graphic method so I can review & print out??
love this so much.thanks. But I have a question, when I sit on a chair to straight my knee, at the same time my ankle will straight too. What should I deal with this problem, please help me. I appreciate
Thank you, Dr. I've been in aqua therapy and we haven't talked about heel strike. I wonder why?
You answered a question I have had for over 3 years since my stroke. That when I sit in the car for any real length of time. Whenever I go to stand up feels like my leg is shorter than the other one. I even bought this up years ago to my therapist he told me that there was no way that could happen. It does all I do is push my leg down but actually what I think is happening is straighten up of the knee. Thank you
Hi Fred. Thanks for sharing this! I hope this helps 😊
How did you know this was what I needed? Thank you.
😊, Hi Lynn.......I guess good energy finds its way into my brain 😉. I hope it helps!!
@@rehabhqofficial it will I’m sure.
Hi
Can you make a video about how to train for walking?
Thank you for another informative video . I’m just confused what is applicable to my problem . Although I have been able to improve a lot following your exercises . My left leg is good leg but this hurts more than my involved leg when I practice walking front outer side of leg and toes become so stiff and my foot dorsiflexes on it own .
Dr Tobias I have had two surgeries on my neck and two surgeries on my back. My left foot does not flex and I tend to drag it after just a few minutes. What is the best foot brace do you recommend for me to buy? I have either a foot drop or splasticity. All I know is that I cannot flex my foot.
Please if you can, What muscles to address while massaging using PNF?
Good one. Was thinking what a coincidence when the video popped up 🤓. Doing some of the stuff and looks like there is some more to incorporate. One thing that might be nice to add is range of motion and how to work on it. It’s where part of my gain is coming from at the moment I feel. 🙏
awesome! Can't wait to see an updated video 😊 Curious, range of motion at what joint?
@@rehabhqofficial ankle, toes, foot. hip. Especially toes and foot at the moment for me
Have MS and need ti bend knee so foot doesn’t catch ( severe foot drop). You mentioned you were going to recommend best brace for foot drop. But when walking knee locks cuz leg super spastic, foot points down.... perfect storm for a fall. Suggestions?
just watched this one again and does make me think about a few things to adjust now there is less rotation. good to rewatch sometimes and reprocess the info.
Believe it or not, I actually had you in my mind when I made this one. :) Btw, your movement quality is getting sooooooo good!
@@rehabhqofficial Thank You.
somehow had that feeling but then didn’t full add up but that’s months ago.
Working on it 👍🏽.
@@neothe_road_to_recovery_2062 absolutely! your walking looks nothing like it did when I made this video. You are doing awesome!!
Thanking you for all your videos doctor Tobias! Please 🙏 can you tell me if these exercises are compatible with MS, especially heel strike? Cordially. Olga Bobrovnikova pianist teacher
Hi Olga. Yes, generally speaking MS and a stroke/brain injury both involve an "injury" to the brain. With that said, I see very similar movement problems and treat them both very similarly. I hope that helps!
Another great one Dr. Tobias but my problem is I have a problem picking my foot up while walking... What can I do?
Hi Michelle! This is a very common problem. I suggest searching "orlando neuro therapy" and foot drop" and "spasticity" here on youtube. That should bring up some helpful videos :)
Hi Tara this week when i when for a gait assesment we found that my uninvolved foot is supinating i was wondering if you talked about this situation before, thank you.
Thanks for watching and for sharing your story Ayman!! Here is a video where I talk about a supinated foot ua-cam.com/video/iWEtH-A_6uk/v-deo.html
Do you have any videos about treating hearing loss after a stroke?
I have a lot of trouble with weight bearing on my affected leg and flex my knee
Dr Tobias I can’t flex my ankle towards my leg therefore I can’t do some of these excersises. What can I do to help my knee and ankle bend?
Is it possible for someone to come to your clinic from out of state?
Nicely explained!!!🐬🐳🐋🐟
My walking is very slow. My therapist wants me to increase the stride length with my affected leg but my mind won't let me do that for balance reasons and because I've fallen a few times( not recently)due to ankle supination during my steps. Got anything to trick my mind into allowing me to step farther? Thanks
Thank you for all your help. My issue is the front of ankle doesn’t bend and then my knee pops backwards when walking
Me too!
Ok hi, I really need some help from you...just advice...because since January 2020 my left foot has been drop and my muscles around the tibial area have been stiff/stuck and yes I have been facing the heel strike problem and no one has yet discovered the cause of my neural problem... my brain MRI was fine...spinal MRI had some inflammation in the L region but it has subsided now...but I still feel numb on the left side of my left leg...the right side of my left leg is just fine...but I can't lift my foot up and my muscles below my left knee are stiff...really stiff...PLEASE REPLY ❤️
Greetings Dr. Tara. I am Adrian A Ramos from the Philippines. I just came from a 4th stroke last Mar 1 of this year.how can I get my upper limbs stronger and reduce heaviness,?, thanks to reply soon
I haven't had a stroke but have been in a pattern for years without realising it. I think it's due to small leg discrepancy. Spastisity is so severe that I feel unsteady on my feet. I do your exercise but as soon as I start moving, it's back to learned pattern. It's very frustrating. Any hope for me?
Thank you for your videos
Yes when i walk my right knee also bends a little. It's quite hard to straighten it. I have still a foot drop 4yrs and 6 months post.
Thanks for sharing your story Richard! This is a pretty common issue that has several different causes.
How to get ready for running?
Does this work with plantar fasciitis and tendinitis ?
Would it possible to send you a video of walking and get your opinion what I can I should work on please.
No. My license does not allow me to provide individual services if you are not a patient of mine. That being said, any email with a video attachment is deleted.
Treatment for runner dystonia??
Hey Doc. My father had a stroke hes recovering now but he's struggling walking he make his full balance on the fine leg the leg that paralysed he don't use it much can u give me advice?
It's been 6 years since my stroke and I still need to get that heel strike right. My husband actually walks next to me saying heel toe, heel toe. It feels as if I have to limp. I would like to know how to get that correct movement. I always thought it was because of my foot drop.
I really would like to ask you something, i had a stroke n oct 2022, i feel nausiated and dizzy i felt that way when i first started moving. I got a 2nd operation to remove the clot in jan 2023, i was still dizzy n nausiated after surgery, so for the next 2 months i was able to walk with pt help. I got to go home march 2023 then i found id have to have a third surgery for total thyrodectomy and my dizzyness changed. So did my nausia. For walking i found im feeling more heavy and have less anticipation on when that will happen while walking. I have a constant internal dizzness that for the most part is clockwise. I feel it as heavy rotation when i walk. Sometimes heavy on the heel, the side and ball of the foot as it circles around. How do i control this so i can walk more normal. Im trying to explain as best i can. Is it too late to improve? Ill be going to gym class as my pt up to the surgery time hasnt been too helpful with walking or balance. Yes i can walk but definetly like a toddler about to fall. If i lean forward inside i feel like i wanna fall forward. Same with left n right side or back. If i keep my head stright n not look around its like being in nutural. As for nausia it happens on computer when i try to enter passwords, pt said go slower n stop when i get nausiated but thats like everytime. Sometimes it all gets to me. Any help is appreciated. Thank you