Leaning foward when walking

[jsully]

Whenever I walk by a mirror or window, I can't help but notice that I lean forward when I am walking. I try to remind myself to pull my shoulders back, but this doesn't seem to help much. Has anyone else had this problem????? How long does it last???? I don't feel I will ever be "normal" until I can walk upright. Please help!
Thanks,
Janet

[JamieAnn]

Hey Janet,

Just curious if you (or any other people with recent surgeries) are in physical therapy. I would imagine that would help the leaning forward issue, but regardless I'm just curious if it's something most people do or not. My surgery is in late September.

Thanks

[titaniumed]

Janet
I have had that feeling a few times. Its way too early to come to any conclusions as to any possible sagittal imbalance issues....all your muscles have to heal....

Surgeons have to build your lordosis and kyphosis shape into your construct. They also have to re-shape your scoliosis curves, so it’s a 3 dimensional correction. Many surgeons will use a Jackson table.
http://www.mizuhosi.com/jacksonSpine.cfm

I will feel the forward lean every once in a while, but not often...

Ed

[VMosch]

Hey Janet! I am almost 16months post op and I still notice myself bending forward, especially in photographs. (grrrrrr) Anyhow, I was naive enough to think that I would automatically stand "straight" right out of surgery, I guess I was thinking the rods would hold me up..LOL. My doctor says my xrays look good and correction was GREAT, sooo, now its a matter of getting my muscles and muscle memory whipped into shape.
Good Luck!!

[jsully]

No PT yet, just walking and swimming. Of course when I take long walks, I use a walker which does not help things. I feel not just this way sometimes. It is all the time and I am concerned.

[Susie*Bee]

Janet-- I sent you a PM earlier... don't know if you saw it. I find it interesting about the walker. Practically everyone mentions getting one, but my surgeon does not let you have one, because he says it causes people to bend forward... I did get to have a cane for help going up and down stairs. (And I used it a little on longer walks for security, although he didn't know that-- and took it with me in crowded places as a "prop" so people would know not to crowd in around me!)

[pint47]

My surgery was March 25th and I still walk leaning forward. I have been off my walker for about a month. I use two quad canes now and think it is helping some- my Dr said he thought i was leaning forward because of the walker. I have just been approved for aqua therapy. Hope that helps. Also my Dr is trying to get surgery adding a concrete like substance in the vertibrae above my fusion to straighten my upper back so i don't lean forward as much. this has not been a quick fix to my problem but I do have a lot less pain in my back and groin.

[CHRIS WBS]

Its way too early to come to any conclusions as to any possible sagittal imbalance issues....all your muscles have to heal....

No it's not. Just ask Naptown who said she could not stand up straight while still in the hospital following her first surgery. I would definitely let your surgeon know about your forward lean.

My surgeon highly discouraged walker use and said it can cause kyphosis in a healing spine.

[Back-out]

"HEADS UP" - on impoperly used walkers!

No it's not. Just ask Naptown who said she could not stand up straight while still in the hospital following her first surgery. I would definitely let your surgeon know about your forward lean.

My surgeon highly discouraged walker use and said it can cause kyphosis in a healing spine.

Great comment, Chris. Super helpful. Don't know why others haven't reported similar advice from their surgeons. Sometimes I think they (surgeons) feel their job is planning and executing the surgery and thereafter it's up to other providers (and the patient) to take it from there - with minimal, if any - guidance. Even (especially) with opiate meds too, things seem much too laissez-faire with many doctors (I think loads more education needs to be part of prescribing such pain meds).

The ultimate success of the surgery can hang on just such pointers/rules, though - especially vital during the immediate post-surgical healing period when the spine is fusing in its final shape. It's not just "no BLT" but posture itself that must make a huge difference in avoiding PJK problems such as Linda has been posting about. (And I myself am in such bad habits now!) Count me as another who thought the surgery itself would make me stand and sit upright - without effort.

This makes perfect sense - but we should be hearing it from the surgeons. Have others of you gotten such directions about walkers? I see they've been unfavorably mentioned several times in this thread alone. I was counting on mine after surgery, and yet now that I think of it, I am sure I'm walking with much more of a tilt since I started using mine (pre-surgery) . Walker height matters a lot too. (Nb. this was just realized trial and error. No one ever measured me or adjusted it after I got it!).

I think this deserves its own thread - to highlight the importance of this issue. Everyone deserves a "heads up" (haha - NOT!) about the risks of improperly used walkers. It can create a feedback loop, which worsens the problems leading one to reach for walkers (and shopping carts) in the first place!

(Gives me a lot of respect for your surgeon. Also to feel all the more, how much one must think for oneself - and seek out such opinions).

[Susie*Bee]

Great comment, Chris. Super helpful. Don't know why others haven't reported similar advice from their surgeons.

You must have missed it-- look two posts above Chris', from me... I just said it too. My surgeon doesn't allow walkers. I will go back and highlight it somehow... There, I don't think you can miss it now.

[jenparker]

Me too!

I had my surgery at the end of January of this year. I was sent home with a walker but realized after a few times around the block that I was leaning forward. I am close to your age (38) and a nurse. I decided that I would keep walking but my whole focus would be on standing up straight because I've seen too many fusion patients walk forward for the rest of their lives.

I didn't listen to my music on my walk but tried the entire time to pull those muscles in my legs and gluts straight. It was tiring. It felt like I was pulling taffy--maybe lying in bed after the surgery for so long had made the muscles tight. But, now I don't have to think about it as much.

Good luck. It's good that you are noticing this sooner than later (as least in my opinion). I wish the doctor's or PT's would address this sooner.

Jennifer

[Singer]

I used a walker whenever I was out of bed for three months -- and with a severely weakened leg, there's no way I could have walked at all if I hadn't used it. I also used (and leaned heavily on) a cane for a good three months after that. I have no problems with leaning forward. I did have a lot of physical therapy, however -- including gait training, to lengthen and balance my stride. It helped immensely.

[Doodles]

I still have the same feeling. It seems my head juts out. I try to compensate but know I don't always do well. I had a walker for about 3 months but only occasionally used it the last 2. Janet

[Back-out]

You must have missed it-- look two posts above Chris', from me... I just said it too. My surgeon doesn't allow walkers. I will go back and highlight it somehow... There, I don't think you can miss it now.

Sorry, SusieBee! Indeed, you did - and well said too.

I posted in haste after being left with a strong impression of the dangers of walkers, and Chris' comments were just the most adjacent.

I am struck by the fact that both your surgeons are in Chicago. It must be an integral part of their training/teaching - I picture memos being passed around and perhaps research links too. I wonder why other surgeons aren't coming up with like rules. As you comment, most folks comment on being "issued" walkers and without any words of warning, much less rules.

Again, this puzzles and dismays me. Why do surgeons have so little apparent regard for their handiwork (if not their patients) that they neglect this important finding? Or is is possible that the walker rules (as for me) are based on "common sense" rather than any organized studies showing the risks?

Sometimes when a negative effect seems "obvious", no studies are done as scientists believe it unethical to have a control group (using walkers) subject to a harmful influence.

So the learning curve is "Darwinian" - attached to self-education as through this (invaluable) group and comments like yours. (Not just in this thread, either! )

IMO this and other advice shown to have been missed by posters either through mis-communication or neglect. should be collected in a reference section. A glossary too! (Another example is the no NSAIDS during healing rule which " sacket " only learned of here - he was misled by a slip-up when he left the hospital. )

We can't count on David Wolpert's book for everything! (Wonder what he has to say post-surgical walker use).

[Back-out]

PATENTS - ideas. Venture Capitalists, anyone?

BTW I am adding this to my "ideas for Patents" folder - I toss in notions as needs are called to my attention, especially after searching for a product that doesn't exist. (Dammit! Many have already been marketed and made others a mint...)

This one is easy (though I have a complex version too, involving sophisticated circuitry).

Easy: Something to wear either around the neck or atop the head, It would sound a bell or other alert , when the head tilts at an angle beyond a set-point. Kind of a "level" (think carpenters' bubble type) triggered alert to replace ye old "book on head".

(Maybe, for that matter, a driver alert already manufactured would work - designed for long distance truckers especially. Wakes them up when their heads start to nod.).

Complex: More effective and with more general efficacy, would be a posture trainer I've been thinking about for a LONG time. Would be a long vest (light) with pressure points, attached to a circuit map "drawn" by an orthopedic specialist according the patient's needs. It would buzz (or give a mild localized shock) when the patient's posture goes out of alignment at given points. To accompany PT and exercise.

I'd call it the "Parent" or "Posture Minder". In memory of how my dad used to run his finger down my back when he caught me slumping around the house as a teenager ("Posture!" he'd say, catching me off-guard. I'd jump)

But, of course, the extra attentiveness would only last moments...Hence in the immortal words of parents everywhere, I "grew that way" )
Note that although I believe scoliosis for many is a deeply ingrained pattern with genetic, neurological, musculo -skeletal, etc. roots, I also believe early posture training can do a lot to compensate. How many West Pointers/Marines have scoliosis?