Uneven walking after surgery

[JuliaAnn]

I've noticed some trouble walking since surgery. I don't feel balanced and tend to walk slow. Perhaps I should not think of what is inside, all that stiff fixation, and just let my body figure out a new natural rhythm? I had full fusion with pelvic fixation. To those with pelvic fixation, did you have any trouble figuring out a new way to walk? Before surgery, my physical therapist determined that I needed a lift in one shoe. But he wasn't sure if surgery would correct that or not so I didn't get the lift. He also said I would need to be measured to get the correct lift. It's not much, perhaps 1/4". Also, I haven't swung my right arm for years while walking because it hung too much in front of my body. Now my right arm is freer to swing but I haven't tried walking fast.

Now that I am three and a half months into recovery, I noticed that I can not stand with both feet flat on the floor without discomfort in my fixed pelvis because it's no longer able to tip. I will wait and walk for a couple more weeks just to make sure I'm not favoring one leg because of a tenderness from the surgery.

By the way, those who said the fourth month was a big change were right. Even from the very first week of the fourth month - Wow! The improvement is leaping forward! Thank you for posting things like that. In the third month, I looked forward to that magical fourth month and I was not disappointed. Thank you!

[JenniferG]

JuliaAnn, I too, leapt forward between 4 and 6 months. Regarding walking: I'm fused to pelvis and have a wonky gait. I'm assured it's not noticeable, but I can feel that I don't have a smooth walk. I did not have this problem prior to surgery when I had a 68 degree curve. I'm nearly 4 years post-op so I don't think it'll ever improve. I now have a 22 degree curve. I walk daily but the slight wonkiness doesn't really bother me. I have no discomfort or pain. My left shoulder is lower than my right but when I lift the heel on my left foot, my shoulder evens up perfectly. At my last surgeon's visit, at 12 months (I was then discharged,) I asked my surgeon should I use a heel lift and he said No. But didn't say why. Last year I bought one, about 1.5cm. I wear it in my walking shoes. I think it helps very slightly but it's obviously not the whole story. Perhaps I need a higher one.

I never was perfect and I guess I'm still not, however, I'm very happy with my surgery.

[titaniumed]

Hi Julia

I used a pair of ski poles with my walking. I would pick up a pair or use walking poles. They add equal support on each side, and help with staying centered while walking.

Go ahead and walk slow. There is no hurry.....walk often and take breaks often.

Transfer your thoughts off your back. I would start from a standing position, head up looking straight, think about pleasant thoughts, (not spine related) transfer yourself to a different place and take the first step. Its a one step at a time process.

I did many of my small hikes in the Redwoods of Northern California. The pine needles were so soft to walk on, and of course the scenery is outstanding. Hiking in wonderful places like this helps get your thoughts off your spine and onto other important thoughts. There is plenty to think about, other than your spine.

This worked for me. It was a needed mental “unwinding” and I then used this after I was home walking.

Think about the trees...

Ed

[jrnyc]

Ed...your PM box is full...

did you have walking problems after surgery?

jess...& Sparky

[titaniumed]

Its clear now.

Lets say walking was a slow process....My recovery took a year to get to 90%, then another year of fatigue and afternoon naps to complete my recovery.

You can see the pain in my face on my November 2008 Redwoods trip thread. That was 10 months and was doing about a mile at a time. The broken shoulder didn't help things....It had just been repaired.

Boy, do I miss the naps.

Ed

[Confusedmom]

Ed,

Thanks for posting that. I can only do about 1 mile at a time at 10 months, and thought I was "behind schedule." (I know, I know. Everyone's different....) Others have told me it took them a while, too. But it's always great to hear from another person who recovered slowly--but did recover! Makes me feel like there are good things ahead. :-)

Evelyn

[Susie*Bee]

Evelyn-- I was a slowpoke too. Turtle or hare, we all get there. It builds patience. I found it helpful to look back every once in awhile and see how far I'd come rather than to dwell on how slowly it was going. I had made a scrapbook and that helped me actually "see" the changes when I was discouraged. And at one year I thought I was done and that was how I'd be for the rest of my life, and I felt content enough-- but then it kept getting better. Each year I look back and see how I've improved more. This May I'll celebrate 6 years post-op. (big smile). I worked like nobody's business that first year to build back my strength and to straighten myself up, as some people need to teach their body to learn a new way to stand, to hold their shoulders a different way, to walk a little differently, because their muscles have been off for so many years. My surgery left me as weak as a kitten so I had to work, work, work at regaining my strength and that is what I did. I had to take the whole year off from school (my work). Now you would never be able to tell me apart from anyone else unless you asked me to carry something heavy or had me pick up something beyond my capabilities. Hang in there!

[jackieg412]

Hi

yes walking can feel strange for awhile and you are early in recovery. Even after 4years{1st Surgery} and almost 2 years{second part} on some days I feel as if I waddle more than walk. Maybe Glide is another term, but still strange. The only thing I can come up with is--just keep doing it. If I miss a day of doing a lot of walking, I can tell that it is harder the next day. So just keep walking alot!

[JuliaAnn]

Thank you so much for the responses! I'm glad it's normal to have to figure out walking. A physical therapist came to my home twice a week for the first three weeks after I got out of the hospital. It was very difficult to do the exercises because of pain but definitely beneficial. He wanted to make sure I didn't just stop moving because of the pain and I was glad for the encouragement. I think it made a big difference. He stressed the importance of walking so I walked up and down our hall any time I couldn't stand lying still in pain, often in the middle of the night. I walked super slow though.

The therapist told me that the wrong way to walk was putting one foot right in front of itself, so both feet move forward on a parallel path. I would know I was walking the wrong way if my head bobbed back and forth, like a metronome. He said that puts more strain on the body in the long run. He said the best way would be to put one foot in front of the other. That's the way I used to walk, right up to the day of surgery, but now I find it hard to do. During the three weeks of therapy, I moved at a turtle's pace using a walker. I used the walker for the first six weeks I think.

I got on the treadmill today for the first time and lowered the speed to just .5 mph. That ended up being too slow so I raised it to 1mph. I walked between .7mph and 1mph for 30 minutes. I was only going to walk for 15 minutes but was reading a book so I just kept on going. I don't hurt more than usual tonight but tomorrow will tell. I know I'll have to take Tylenol tonight. But at one point, I noticed the shadow of my head, bob bob bobbing back and forth like a metronome. @_@ I'll have to get back on the thing tomorrow and concentrate more on where I put my feet. Me oh my.

Ed, I'm glad you told me about the ski poles. That gave me the courage to get on the treadmill because I thought holding the two stable arms of the treadmill would be a bit like ski poles for stability. I had put away the walker and haven't walked as much since then. Getting on the treadmill worked because I had something to hold! Thank you!

I've had my husband drive me places perhaps half a dozen times since my surgery in October. Each time I come home, it takes me a full week for my pelvis to stop aching; the roads aren't that bumpy here but the pain is still bad. I'm really anxious to get my body back in shape so I can at least get out of the house more, hoping walking helps. I don't know how you all work at jobs outside the home so soon after a surgery like this. I'm 54 now and I'm SO glad I did not wait getting surgery.

[LindaRacine]

Hi...

I also feel like my gait is all wrong. I'm 2 years postop, and really haven't seen much improvement (although I am a lot faster than I was in the first 3-6 months). I think gait problems are more the norm than the unusual in long fusions to the sacrum.

--Linda

[jrnyc]

i do not know why i never thought of this happening...
and i am guessing it doesn't happen with fusions that stop
in thoracic area...?

jess

[rohrer01]

This problem makes a whole lot of sense since there is no movement allowed in relation to the hips and spine. However, when I noticed my lower curve progression happening, I also noticed a change in my gait. I have been able to adapt since I'm not fused. Once in awhile, though, my gait feels funny and my curves are all thoracic. I have noticed as of the last couple of years that my hips are no longer even, so there may be some minor compensatory lumbar involvement. I think it would be hard to get used to not being able to compensate for the new changes. You'd think that it would be okay for those who are bothered badly by it to use a shoe lift. What would be the harm in that? I would think that evening out the legs would cause less stress on the actual hip sockets, saving one from eventual hip replacement surgeries. Just my thought on the matter.

[Susie*Bee]

In my case, my PT for leg and arm strength, which included gait work, began at 6 months post-op and lasted 8 weeks, but I continued doing it at home all year-- plus I did PT for core strength at 11 months. At 6 months, for gait work, he had me work very slowly on the treadmill (1 - 1.5?) rings a bell, I think, with my head held centered and my body not pitched forward at all- and yes, JuliaAnn, holding the arms for stability. Another thing I remember needing to do was to look in a mirror for awhile to make sure I was holding my shoulders evenly. (Not on the treadmill-- just standing on the floor.) After 20-30 or more years of being crooked, your muscles have to relearn where "right" is. It felt all wrong to me when I had my shoulders even! That was not the natural place my muscles wanted to go. As far as gait went, I had become an old lady by then with a short gait and needed to stretch out my stride and relax and even out my steps. I think I was favoring my right side. Plus I was looking down as I walked... (don't want to trip on something!) PT for some people is really worth it. Others don't need it. I definitely needed it-- especially to build back my strength and to help with those problems.

[amelot]

Gait problems, too! Any more specific advice?

I'm so happy to see this thread! I thought I may be the only one after seeing all the success stories. Basically, I would describe my gait for the first 4 months post-op as "toddler with a very wet diaper." Now, I'm down to toddler with dry diaper but I still feel and look very awkward unless I use my walker or for short distances my cane. And 5 months post-op I'm so tired! And achy! Maybe because I got off all my pain medicine and my muscles are having to work harder to learn their new roles, but it's still frustrating.
The advice about walking one foot in front of the other should be very helpful--thank you.
I do have to wear a 1/2" lift in one shoe.
Does anyone have any further advice? Specific gait exercises?
Pam
61 and much straighter!

[JuliaAnn]

I'm so happy to see this thread! I thought I may be the only one after seeing all the success stories. Basically, I would describe my gait for the first 4 months post-op as "toddler with a very wet diaper." Now, I'm down to toddler with dry diaper .....
Pam
61 and much straighter!

Oh Pam, this made me laugh! What a perfect description and yes, that was me too!

In my case, my PT for leg and arm strength, which included gait work, began at 6 months post-op and lasted 8 weeks, but I continued doing it at home all year-- plus I did PT for core strength at 11 months. At 6 months, for gait work, he had me work very slowly on the treadmill (1 - 1.5?) rings a bell, I think, with my head held centered and my body not pitched forward at all- and yes, JuliaAnn, holding the arms for stability. Another thing I remember needing to do was to look in a mirror for awhile to make sure I was holding my shoulders evenly. (Not on the treadmill-- just standing on the floor.) After 20-30 or more years of being crooked, your muscles have to relearn where "right" is. It felt all wrong to me when I had my shoulders even! That was not the natural place my muscles wanted to go. As far as gait went, I had become an old lady by then with a short gait and needed to stretch out my stride and relax and even out my steps. I think I was favoring my right side. Plus I was looking down as I walked... (don't want to trip on something!) PT for some people is really worth it. Others don't need it. I definitely needed it-- especially to build back my strength and to help with those problems.

Thank you, Susie*Bee for posting this. Very helpful! The other day I looked in the mirror and was alarmed to see me tipping back into my old posture, even after surgery. It didn't occur to me that my muscles might be fighting to go back to the position they have held for over 50 years. Ever since I read your post, I've been holding myself up straighter and it feels right, the way it should. I'll just have to retrain. When I walk, I've been concentrating on putting one foot more in front of the other. It is really hard but this is only the first week of really making an effort and it's starting to pay off already. I'll just keep at it.

It does help that I walked that way before surgery so I'm just learning a new balance on the upper part of my body. I know I'll never be able to walk fully like I walked before surgery. I'm ok with that. I just don't want to waddle. The day of surgery, Dr Hey told my guys that I would be able to "run softly and ride a bike." I'm really looking forward to that. I haven't ridden a bike in years because I was too twisted to the left.