Fixing Foot Drop

For someone with "foot drop," the front lower leg muscles are too weak to lift the foot upward at the ankle. The foot hangs downward instead of lifting upward to take each step. Gait is altered and the front of the foot may slap the ground with each step. Fixing foot drop involves fixing three things - stopping the original cause, strengthening the (several) secondary effects of the weakened and tightened muscles, and retraining gait to normal. Common treatment options of braces to hold the foot up, canes or walkers to steady walking, drugs for the pain of whatever is causing it, reductions in activity, and certain surgeries, may all interfere with recovery and create new, and even more serious problems. Healthy treatment can be done without surgery, drugs, inactivity, or bracing.

One common surgery fuses the ankle so that the foot can't hang down. The foot can't move any other way either, causing new gait disturbance, and limitations in moving for health or fun. When foot drop comes from a herniated disc reducing nerve conduction, surgeries may remove the disc. However, discs are needed for healthy spine dynamics. Surgical spine fusion, even more drastically limits healthful movement, and ultimately health itself.

Interchangeably called drop foot, it is not a disease by itself, but the result of something else. Foot drop can follow a herniated disc that presses on nerves that exit the lower spine. It may also come from an injury directly to the peroneal nerve behind the knee. Certain diseases of the nervous system such as multiple sclerosis, Parkinson's, and amyotrophic lateral sclerosis (ALS) may reduce signals to various nerves.

A disturbing and increasing number of foot drop cases come from back and knee surgery. Someone undergoing surgery for a herniated disc or a knee replacement may wake with foot drop when nearby nerves were damaged or accidentally cut during the surgery. Such "side effects" are regularly called unavoidable surgical risks. It is important to change understanding of medical practice so that it is understood that adding new problems is not healthy and so, isn't "health care." Tragically, surgery itself for disc trouble is nearly always unnecessary.

As foot drop continues, lack of stretching in back of the leg that would have naturally come with each step from lifting the foot results in Achilles tendon and other structural tightness. Tightness can increase until that alone restricts lifting the foot.

Reader Sylvia wrote me several notes of her success reversing the components of foot drop. She first wrote in August, after finding the post of Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier. Her photos walking with a cane and needing to ride in a golf cart are above, left.

In Sylvia's case, her physician told her that a herniated disc was preventing the nerve down the leg from conducting enough to the front lower leg muscles (usually the tibialis anterior), which lifts the foot. Sylvia wrote,

"The specialist orthopedic surgeon I was referred to fortunately said he would not operate and my subsequent follow up visit has resulted in him telling me to go away as I am no longer in pain although I still have no dorsiflexion (upward lift of the foot). If in a year I still have drop foot I should discuss again with my doctor. Not very helpful…Thankyou for the wonderful work you have done putting this web-site together Best Wishes from England.

Sylvia"

When a disc is involved, the first thing to do is to stop the reasons for discs pressing outward, such as bad bending and sitting, and use good bending and sitting instead. If it is slouching so that you have too much inward curve of the lower spine, and that is pressing on the nerve, or it pushes the disc which then pushes the nerve, then you stop that habit, so it can heal. Stop the source. Surgery is not necessary. This is explained more in the post Cauda Equina - Result Not Cause. Then you exercise the shin muscles that have weakened, and stretch the calf and Achilles and bottom of the foot, which has tightened. You also need to practice balance and gait.

Reader Ivy began corresponding in the comments of the post to tell Sylvia her specific events to first stop the disc herniation, which was pressing and constricting nerve conduction.

By October, Sylvia has done much to reserve several causes and results. She was walking without a cane (right) and wrote,

"Hi Jolie and Ivy
"I really appreciate your support and enthusiasm. My badly herniated disc obviously impinged on the nerve causing the nerve damage. I know this is from years of bad posture. I have come a long way already but not too far in the lunging and balance areas yet.

"At the weekend I was seen to be dancing at my son's wedding and I realised that non-one would believe I am usually slapping along.

"Instead of wearing my usual flat shoes or bare feet I had some new ankle strap 2 inch heel sandals for the event. The strap helps to keep the shoe on and the height of the heel was just right to keep me on my toes ! So I have decided to find a dance class to supplement my pool and land exercises as I have rediscovered I love dancing !

"I am going to Florida for a couple of months and should be able to find some dance action there. I'm going to try and toe walk on the sandy beach too.

"In the meantime I will keep on trying to change my bad postural habits! Best wishes. Sylvia"

Sylvia and I also corresponded. She send a photo of her happy and healthy at her son's wedding (below, right), with this update:

"Dear Dr Jolie,
"I have received the books today... Now I have no excuse for not stretching and correctly at that !

"I can't wait to get back in the water and see how my ankles are - they are probably quite stiff so will need some work.

"I have printed the Inspirational Ivy page with the pictures of her exercising and keep it in my purse as a constant reminder that my condition will improve. Everyone here whom I haven't seen for two months whilst in the UK, is telling me how much better I'm walking. I tell them what I'm doing and if they have any problems refer them to your web page. Best wishes for now."
Sylvia

We will be hearing more wonderful things from Sylvia.

Posts with specifics to try:

• Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier
• Cauda Equina - Result Not Cause
• Fix Disc Pain Without Surgery
• Studies Say Back Surgery Not Needed
• The Cause of Disc and Back Pain
• Disc Pain - Not a Mystery, Easy to Fix - When you stop bending wrong many times each day, which pushes discs outward many times each day, damaging forces will stop, and can heal.
• Changing Thai Massage to Be Healthier Part I - Avoid Pressuring Lower Back Discs

Labels: disc, fix pain, footdrop/dropfoot, gait, impingement, injury, Parkinson, readers inspiring story, surgery

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Rocky Movie Computer Fight Simulation

The 2006 Sylvester Stallone movie Rocky Balboa featured a scene where a computer simulation estimates the outcome of a hypothetical fight. Can computers do that?

In this movie, Stallone's heavyweight boxer character Rocky has retired. In one scene, Rocky is watching ESPN news, and is startled by a broadcast. It features a computer simulation depicting a fantasy fight, and predicts the outcome of how Rocky would have fought in his prime against the movie's present-day heavyweight champion Mason Dixon, spurring his return to the ring. A real pro boxer plays Mason Dixon's character - Antonio "Magic Man" Tarver is a southpaw from Florida, and former light heavyweight world champion.

Computer generated fights that generate real probable outcomes in real time 3-D are not yet possible outside the movie industry. What can real computers do?

An actual "fantasy fight" computer simulation was done in 1970. It was the SuperFight between Muhammad Ali and Rocky Marciano. Rocky (Rocco) Marciano was heavyweight champion of the world from 1952 to 1956. Muhammad Ali was three-time World Heavyweight Champion in the 1970s. Marciano and Ali fought in different eras and never fought an actual bout.

To make the SuperFight, probability formulas were entered into a computer. No drawings, just numbers. Ali and Marciano met in real life on a filmset to film numerous short segments showing possible parts of a fight. Marciano was already retired 13 years and wore a toupee. The short segments were then spliced together to match the already done computer outcome to make a movie that looked like a real fight or computer-generation of one, but was not. The predicted outcome had already been generated by computer, but the fighters and movie were the real people, not computer generated. The outcome may or may not have reflected actual ability of the fighters or the real outcome.

In the mid 1980s, I was investigating which differences in human movement determined injury potential and athletic performance. In one study, I wanted to know what made the difference between the punch of a black belt martial artist and the same punch by an athletic person without training.

In present day, a camera can be hooked directly to a computer, which picks up the locations of the person's joints at each point in time, generating a computer image of the person as they move in real time. Software automatically calculates, draws, and records the image on the screen.

Back when I did these studies, we didn't have any of that. I did it all manually. I filmed two subjects using 16mm high speed filming. An athletic man who had never done martial arts was subject #1. My husband Paul, who had earned his black belt a few years before that, volunteered as subject #2. I put markers over the center points of their major joints, and bands around joints which initially faced the camera but would rotate during the punch, so that the joint center would still be determined. Both executed a front reverse punch with their dominant arm. (Paul had to use traditional hyperlordotic position to match the untrained subject, rather than healthier neutral spine position, just for this comparison. We have done other studies comparing my neutral spine adjustment and found it to be a stronger punch - try it here.)

After waiting a week for film developing, I went into a darkened lab and used a film projector to throw the image of each of the thousands of frames, one by one, against a large computer digitizing tablet hung on a wall. I then digitized each joint point of each projected image, in each frame, of both subjects, frame by frame, with a digitizing Graf-pen. I sent data points from each frame by (300 baud acoustic coupling) modem to a text editor on a mainframe in another building at the University's new computer center. I wrote my own FORTRAN programs to generate data summaries and used packaged International Mathematical and Statistical Libraries (IMSL) cubic spline programs and subroutines for data smoothing. This was all to get each knee, hip, ankle, shoulder, wrist, elbow, neck and other filmed joint points into a computer to see exactly where and how fast they moved. Projecting each frame against the wall also allowed me to trace the subjects' outlines to make series of line drawings of their punch, and to make stick figures showing joint center placement. Here are some data and the actual drawings I made:
























































Not long after, with improvements in automating this process, action video games were flourishing. I was invited to a computer-generated imagery (CGI) development studio to be their "movement representation figure." They put the dots on my joint centers and filmed me using high-speed 3D computer graphics modeling as I did martial arts and tumbling moves. Not just one punch, painstakingly done, but jumping, spinning, flying all over the studio, and up and down walls.

The software automatically generated a mathematical, "wireframe" 2-D representation of my three-dimensional form. From it they animated a wild female warrior action figure for their fighting/mission genre arcade and video gameplay. They also used skeletal animation for when I would morph (on-screen) into various animal forms. I never got royalties but it was fun.

More:

• This is a big fun topic. For more, click the label "martial arts" under this article.
• I can write more about motion capture analysis of various sports if anyone is interested.
• Learn how to adjust to neutral spine for a stronger punch without lower back pain.
  
• The Great Muhammad Ali has been diagnosed with "Pugilistic Parkinson's syndrome" of tremors, muscle rigidity and slowness - with the possibility, still not fully determined, if due from the damage of a boxing career. See Rocky IV and Head Injury.

Labels: computer, injury, lordosis, martial arts, movie/media fitness, neutral spine, Parkinson, speed

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Healthy Mother's Day

Neolithic groups (stone age) worshiped the mother. Ancient Germans worshipped the virgin Hertha holding her child. Scandinavians worshipped virgin Disa holding her child. In ancient Egypt it was Isis with infant Osiris. In India, Devaki had Krishna (also by virgin birth). In Asia, Cybele and Deoius. Chinese holy mother Shing Moo held her child in arms. Christian missionaries to Tibet, China, and Japan found that holy mothers depicted with splendid light around their head and holding a divine child had been worshiped long before they got there.

In Rome, the goddess was Demeter, meaning Earth Mother, wearing wreathes of braided corn in her hair. In ancient Greece, Demeter was called Ceres, the great mother with baby at breast. From her name "Ceres," we get the word "cereal" (grains), "which made man different from wild animals."

In the spring in ancient Greece, celebrations were held in honor of Rhea, the Mother of the Gods. Christian Europe celebrated the spring festival of "Mother Church" who (they believed) would protect them from harm. During the 1600's, England celebrated "Mothering Sunday" on the 4th Sunday of Lent, honoring the mothers of England. All cultures worshiped the divine, the Mother, who gives life and food, compassion and love.

So. How to celebrate this Sunday on Mother's Day? I'm in favor of some goddess worship, probably involving some rocks and food and chocolates and compassion and love. Not so original, but time tested and universal:

• Visit Mom (or a Mom) and give her a massage (if she wants one). Neck, hands, feet, back. Good for circulation for giver and receiver. Touch can be healthy. Ask her stories.
• Teach her a Nice Neck Stretch
• Make her (and you) something healthy to eat. For light teas, try cinnamon, cloves, grated orange peel, or ginger in hot water.
• For a cold treat without unhealthy junk food, mash a frozen banana with crushed raw walnuts or flax seeds. Use a food grinder or get free exercise by mashing them yourself in a bowl. It will taste like creamy ice cream. Flax seeds and walnuts have been found to be effective to help bone health as vegetarian sources of omega-3 (n-3) fatty acids. Raw walnuts (as part of a general low fat and cholesterol diet) have also been found to have a beneficial effect to decrease cardiovascular disease risk, among other benefits. This treat has fiber and is non dairy, both associated with lower breast cancer risk.
• Goddess worship often is helped with chocolate. The primary chemical in chocolate is theobromine. "Theo-" means God and "broma" comes from a word meaning food. The theobromine in chocolate was named for "food of the gods." Theobromine is an antioxidant, weak diuretic, stimulant, and mood booster, opens breathing airways, and relieves coughing. Dark chocolate has more theobromine than lighter chocolate, with flavonoids and phenolics, plant substances that are good for the heart. People who get a kind of vascular headache called migraine do better not to eat chocolate. For others, get plain cocoa, unsweetened, not junked up with sugar. Add the unsweetened cocoa to the frozen mashed banana and walnuts for a healthy sweet wonderful treat that tastes better than you would expect. For exotic flavor and more health benefit, add fresh grated ginger root.
• Sit outside in the air and sun to have your tea and frozen banana. Warnings on the dangers of overtanning are important for preventing skin cancer for people who work outdoors, who over-tan for cosmetic purposes, and a few other populations. Another group to consider is those spending too little time outdoors. Sunlight exposure and the Vitamin D it makes your skin produce, is increasingly documented as crucial to bone density, healthy immune function, positive mood, sound sleep at night, relief of symptoms of rheumatoid arthritis, fibromyalgia, MS, Parkinsons, polycystic ovary, diabetes, and other health issues. A nice massage and tea and chocolate outside in the sunlight could be made into a wonderful Mother's Day. Nice excuse to buy a hat.
• Make Mom (or a Mom) some homemade healthy skin lotion. Commercial products have preservatives, dyes, and chemicals. Try combinations of grape seed oil, tea tree oil (very small amount), vitamins C and E, ginger, honey, tea, fresh aloe, and fragrances from oils, fruit, flowers like lavender, or leaves like mint. (Don't wear citrus oils like lime out in the sun.)
• Help out at a woman and child shelter. Or help at a men's shelter to help the guys get back on their feet to help their own families.
• Celebrate Mother Earth - go out and pick up litter. It's good exercise. Bend right.
• Make a trip to look around a home improvement center to see about some do it yourself solar projects, even if only to replace a few lights.
• Go do gardening for your mother, or your mother Earth. Lift and bend right, reach right, carry in healthy ways.
  
• Do some cooking, shopping, vacuuming, and cleaning for Mom (or a Mom). Water their plants. It's good exercise for you and a nice thing for them.
• Be good to each other - all the children of Earth.
• Follow the advice of the unknown who said, "The most important gift a father can give his children is to love their mother."
• If that doesn't work, take the advice on the side of aspirin bottles: "Take two aspirin, and keep away from children."

Labels: arthritis, circulation, diabetes, digestion, fibromyalgia, fix pain, green fitness, holiday, massage, nutrition, osteoporosis, Parkinson, spirit, stretch, sunlight, upper back

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