Lots of stroke survivors have issues with their arm “drawing” up when they walk. They find that their elbow bends, their arm draws into the stomach and the wrist and hand get tight. This position can be uncomfortable and frustrating for many people. And, while the arm is the thing that is tight, sometimes it is the way a stroke survivor is moving that can lead to the tightness.
There are a few things that I like to look at as initial reasons that this might be happening.
Toes are curling: I have given you some information about ways you can start to loosen the toes (see below). That is because I know that curled up toes not only get in the way of your progress toward more normal walking, they also can contribute to your arm being tighter. Why? It may be due to the fact that a foot where the toes are curled is uncomfortable to stand on. And, our whole body reacts to painful stimuli, even if it is just a small amount. However, walking a small amount= repeated painful stimuli dozens-even hundreds of times- has a big effect. If you are working with a healthcare professional on your recovery, are they taking off your shoes and looking at your foot? They should be looking at what your foot is doing and devising ways to help you work to stop this from happening.
Hip hiking when you walk- Hip hiking happens when people aren’t lifting the foot or bending the knee to take a step forward. Our brains are good at finding ways to “make things happen”. If the foot is not lifting and/or the knee is not bending, the brain says “hey we need to get this leg through somehow, pull up your hip and swing that leg through”. So you pull up, or hike your hip, and get that foot/leg forward. In these cases, when the foot isn’t lifting a brace to help with this makes a big difference. And, while I do have an opinion on the most beneficial design of the foot brace, it is a topic for another blog. If you are not allowing the knee to bend in order to take that step forward, you may be encouraging that hip hike also. But, what does hip hiking have to do with your arm? There is actually a very large muscle group that has some attachment at the pelvis (that is the top of your hips where you can rest your hands) and to the arm bone that makes up the shoulder. So, your brain uses this muscle to help “ hike the hip” and in order to do this, it has to clamp down into that bent position to do it.
Trunk twisting is not happening- You may not know it, but it is natural for our spine and our middle- the trunk- to twist slightly when we walk. This twisting is part of what creates a natural arm swing. When our trunk is stiff and unable to naturally rotate, it stiffens up the arm.
So what can you do to improve the looseness in your arm when you walk. Well you can start with determining if you are having toe curling when you stand on your foot. And then, start a process to improve this. Also, if you have avoided using an ankle foot orthosis, reconsider discussing this with your rehabilitation healthcare provider. Choosing a foot brace that can help with your progress can make a big difference. And, keep that trunk loose and twisting. In the coming weeks I will be sharing video on these 3 topics to help you get a jump on loosening your arm when you walk.
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