I saw this awesome video the other day in an online Stroke Survivors group that I am part of. It was a person’s foot and their toes were lifting up and down just a little bit. They could be heard of the video excitedly narrating what was going on. For the first time, they could get some part of their foot to move! That video got ME excited. Videos like that reinforce what I already know to be true- the brain can change and the body can change for the better after a stroke!
There are some things that person can do to help change that little “spark” of toe movement into a “roaring fire” of more natural movement. When I am working with someone who is at this same spot in their journey of improvement after a stroke, there are a few things I give them to help “fan the flames”.
First, stretching is crucial at this time. Let me repeat: STRETCHING IS CRUCIAL TO INCREASE A SMALL ACTIVE MOVEMENT TO A BIGGER ONE. If you have read any of my blogs, you will see that this is a very common recommendation that I make. That is because it relates to how the body works. You see, our body movements occur with the most ease in the middle of their range of motion. When a person is trying to move a part repeatedly to the end of the range of motion that they have, it is too difficult and fatiguing. Let me explain.
Let’s look at the movement of the foot lifting up. (The medical term for that movement is Dorsiflexion.) We are going to look at “Sam the Stroke Survivor”. Sam’s more affected foot is stiff toward dorsiflexion. It can only lift up ½ of what his less affected foot can lift. Now, we know that naturally the body moves most comfortably in the middle of the range of motion. So, that means that Sam’s more affected foot could really only comfortably lift repeatedly through about ¼ range of motion. That is not nearly enough! More range of motion toward lifting/dorsiflexion is needed to walk on level surfaces, and certainly more to walk up inclines, up/down steps and curbs naturally.
The thing to be aware of is that if you are having that spark of movement, you want to create conditions that make it easiest to repeat that movement and try to increase it. So….stretch to increase dorsiflexion (and toe extension too).
Once you get stretching and increase the range of motion toward dorsiflexion, you can increase the spark by helping the foot to that end range, or having someone else help it to end range, and trying to hold it there. A holding muscle contraction is easier for us than a lifting contraction when we are trying to learn a movement.
I actually apply these same concepts for most any movement that I am helping a person increase. You can use them too.
If you are interested in more strategies and instructions for how to use them, sign up for the Walking and Balance Boot Camp. In this online program I teach you exercises and strategies that can help you with lots of the common problems that Stroke Survivors deal with when trying to improve their walking and balance after Stroke. Click Here to join the boot camp