Ms. Tight Legs

[mm247]

So I am in limbo land currently my next MRI is next week.
The tightness in my legs is crazy! My knees are not fully flexing during my "normal" gait pattern just enough to clear my feet off the floor. I also have better balance with my shoes off.
Does anyone have any treatments to suggest?
I am an OT, I went to PT and was just getting the cookie cutter treatments, not working on gait or balance at all.
My uppers seem fine at this point.

[Marco]

I would be frustrated with a physical therapist that was not "committed" to your physical needs and improvement. Can you call the medical provider and request a different therapist?

Are your legs heavy, tight, stiff or feel like cement? Do the muscles have hypertonicity, or clonus, experiencing any spasms? They may also be shortened, hyper/hypo, but they all mean essentially the same thing. You have spasticity and you do not have full access to your muscles. Spasticity is normaly painful, and will reduce your mobility, range of motion. The walking and gait abnormalities may be a symptom of foot drop, and you may benefit from an AFO. If your neurologist is unavailable, please consider seeing a podiatrist, or physical medicine and rehabilitation doctor for evaluation and treatment.


As you know, before starting a stretching or an exercise regimen, you should always consult a physician. The general guideline is to stretch what is tight and strengthen what is weak. Ideally, you are stretching 3x/day, and whenever immediate intervention is necessary for comfort.

There are a number of stretches commonly used for leg spasticity:

1. nerve glides
2. leg raises with ankle rotation exercises
3. knee-to-chest pulls
4. side-to-side leg movements
5. to work on your knee and potential foot drop you may consider stretches for the common peroneal nerve

If stretching alone is not working, you might consider adding a medication. Baclofen, Zanaflex, diazepam, tizanidine or clonazepam are all commonly used to treat MS-related spasticity.

Other documentation:
Spasticity & Mobility Problems
http://mssociety.ca/qc/Documentation/spasticity_web.pdf

Stretching for People with MS
http://www.nationalmssociety.org/Nat...ted-Manual.pdf

[mm247]

polo

I happen to be an occupational therapist so I know a little, like how to to put my clothes and shoes on differently.
Negative on the foot drop and clonus
My legs feel progressively heavier as the day goes on and hard to bend to get the full range of motion with walking. All my muscle strength tests out at a normal level. I am an OT so I let the PTs play with me and everything strength wise is fine
I will try all those exercises it's funny when you are the clinician telling someone else to do it, it comes right off the top of your head but when you are the patient it doesn't connect

[Marco]

I did read where you were an OT. I try to post complete details for others reading this post at a later date. I probably drive some people crazy, but I know for every one that posts in a thread, many others will read it.

More than anything, I hope you get relief for your spasticity. Extreme spasticity is what put me in a wheelchair, so I have a special axe to grind against it. I wish you well ...

[MS TOO]

"Ideally, you are stretching 3x/day, and whenever immediate intervention is necessary for comfort."

Whenever I see this advice, I wonder if anyone really has the time to do this? I know I don't. I am still working as I hope to retire on my own terms someday. I also do what I can to help with my share of chores around the house like some cleaning, meal prep, yardwork, etc. And having MS means it takes me a lot longer than it used to to do anything physical both at work and around the house.

Throw in that I don't sleep well with 6-7 hours of sleep being a good nights sleep. So I am usually tired, fatigued, behind on my work, struggling to even move and I can't imagine how in the world I could stretch 3x/day. The only way I could was if I were to stop working and go out on disability or hit the lotto so I could hire a cook and a housekeeper!

[Marco]

MS TOO - I'm sorry if I my post seemed unreasonable. I no longer work, but I do stay busy. What I notice is if I do not stress, my pain and spasticity levels are increased making everything harder. I am not a huge fan of exercising or stretching, but the repercussions of not stretching make it mandatory. I can do this while waiting on hold, sitting in a restaurant, or even during a television commercial. At work, I would use a portion of a break, waiting in an elevator or waiting in a conference room for a meeting to start.

Stretching only takes me 3-4 minutes each time. So in under 15 minutes/day, I can improve my quality of life. I also do breathing exercises to improve my breathing, help prevent MS hugs and reduce my stress level. I hope you find small ways to incorporate things to help you.