I left Wyoming three weeks ago. Now I'm in our new home in Connecticut. I spent the past few days hiking amid myriad 300-year old fences. Three years ago I found there was a problem while attempting a marathon. My balance was off to the point of bending at the waist and falling on my hands. Yesterday and again today I had the same symptoms but milder. What was similar for both events was very hot August weather. In Wyoming it was 70 degrees and no clouds and 10% humidity. Today on the walk it was 80 degrees and quite humid. I tried Sinemet 3 years ago but never felt that it helped. Maybe I didn't give it enough time? I think I need to find a new neurologist. The business of falling forward bent at the waist makes me think of weak lumbar muscles. I've been told strengthening lumbar muscles means abdominal exercises. Not sure what one has to do with the other. Any ideas?
Why do I fall forwards? : I left Wyoming... - Cure Parkinson's
Why do I fall forwards?
Hi Kaypeeoh. There is only one reason I can think for our problem is your posture, as you indicated. You must stand erect in order to walk properly. You may also find that your knees are bent when you walk. The knee of the front leg should be straight before the heel touches the ground. Your head should be facing forwards, not facing the ground a few feet ahead of you.
You can practice standing erect wherever you are and become conscious of not being erect.
Yes! your back muscles need strengthening!
I know this is an old post but wanted to let you know that your suggestion to keep leg straight was helpful! 😊
Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease | 2017 pmc.
In this prospective observational study, we investigated the implications of falling direction to predict the mechanisms of recurrent falls in PD patients.
Although there was no difference in demographic data, parkinsonism, or frontal lobe function, forward fallers showed more severe falls and tended to fall during walking or turning, while non-forward fallers usually fell during sitting/standing or turning. Additionally, forward fallers revealed higher score on a freezing of gait (FOG) questionnaire.
Logistic regression analysis demonstrated that FOG was associated with falling forward, while balance impairment, akinetic-rigid subtype, and neuropsychiatric symptoms were associated with falling into the other directions. Our results indicate that FOG and balance impairment are two major mechanisms for recurrent falling in PD patients, and falling direction is an important predictor for these mechanisms.
nature.com/articles/s41598-...
12 cite Youn 2017: Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease.
This sounds like momentum issue, suggesting the freezing during motion lives you unable to exert the imperceptible but definite backward force needed to keep your upright balance between/backward momentum when decelerating. The deceleration could be caused by simply having less dopamine and the momentum, being forward motion, overwhelms the gradually decreasing ability to keep yourself upright and in balance well you are in forward motion. If we ran backward as often as we do forward perhaps the same problem would be gradually revealed.
Ever see a Segway scooter? The other day I saw my granddaughter on a small version of it without a stick in the middle, just two feet of scooter, actually pointed laterally, not in line with her direction of movement but actually perpendicular to her forward movement. Pretty amazing. If you never saw a Segway before, it's pictured in the movie Paul Blart Mall Cop. It illustrates the forces involved and how the micro adjustments are continuous and ever-present, even though unseen. The adjustments are made in response to continuous changes in departure of the Ryder/scooter system from the vertical, detected by continuously sensing on board gyroscopes, which signal the wheel motors to make little contrapositive, very quick increase or decrease (functioning like dopamine in muscles would) of backward or forward torque or power to leverage the body's orientation back toward true vertical as your roll. If you had wheels instead of legs, it would take a lot less contrapositive energy by your muscles to change your momentum along with your changes and balance, to keep you vertical as you run or during deceleration.
An implication might be to increase your medication or the frequency of it, and another implication might be to go slower on your marathons or walk instead of running, or maybe take up biking since your muscles aren't in anything near as much as a forward momentum during biking, you're almost sitting up right and a bike keeps you up as long as you can preserve your lateral balance. You can screw yourself up big time by falling, depending on your age and how fast you are moving when you fall. Just guesses. Another guess might be to run shorter distances, because even a marathoner is going to experience muscle fatigue, and it may be that there is a point at which further fatigue or sodium lactate make it harder for muscles, gradually depleted, to maintain backward pressure of that continuous forward momentum weight. Wondering if your falls happen early or late in your runs, if my hypothesis is correct then later in your runs is when you would see more of your falling forward. Another solution: jog more run less, or at least run slower. run your marathons in stages interspersed by walking so that your muscles can recover a bit and bring they're need to push backward back within their ability, some sort of exhaustion of dopamine or simply that freezing thing... Kind of a period Of refractory recovery.
Also again, why the heck would someone leave Wyoming? Progressive dementia? (for those lacking a sense of humor or perspective or proportion, that's a joke)
Nice commentary. I need and use a rollator, and its brakes. Controlled falling forwards is how I think of my mobility wit the rollator.
I wish researchers/clinicians could solve the problem regarding “festination”. My husband constantly falls forward and refuses to use his Parkinson specific walker. Yes, core strength is the answer.
Good luck and run/walk many marathons!
Why would you move to Connecticut when you can live in Wyoming?
Where in Connecticut, Kaypeeoh?
North Stonington, CT.
I wuz hijacked. Because of PD I had to sell our veterinary practice. My wife Ellen negotiated the sale getting twice what I thought the practice was worth. In the same time-frame our daughter was being treated for Non-Hodgkins Lymphoma at Dana Farber cancer center in Boston. She survived surgery and chemotherapy and is back at work. But while staying here Ellen found and bought a house. She says she texted me constantly about the house but I have no memory of that. Is selective memory a sign of PD?
So I'm stuck here. MarionP et al suggest I need to restart Sinemet. Before doing that I need to find a neurologist maybe in Boston.
I had surgery for Haglund's Deformity three months ago and am feeling okay. I want to get back to training, hopefully losing the 30# I've put on since the PD diagnosis.
Yesterday I spent three hours hiking on frikkin picturesque New England roads while wearing a Slendertone Abdominal Muscle Trainer. S'posed to mimic ab crunches. Today my lower lumbar muscles are sore. But not my abs. So maybe JP is right.
I have that problem, of falling forward, also! I’ve had freezing episodes, and I’ve hurt myself, several times, falling forward. I seem to lose my balance, if I lean too far forward, and a couple times, I fell flat on my face, resulting in a big hematoma on my forehead, two black eyes, and a concussion. So, I really have to be careful walking. Uneven ground can be perilous for me, so hiking is something I don’t do much, anymore! I was diagnosed with PD, 5 years ago.
Abdominals? YES ! Actually the Pilattes, yoga, and many other exercise types all include Abdominal ( CORE ) exercises for front and back muscle groups. They are not just the exercises for a so called' six pack '. 2 simple ones are very similar.and simple but have to be done slowly to maintain form and safety.
#1 lay on your back, knees bent, feet comfortably flat on the floor. Now slowly contracts the muscles from the anus to the bottom of the pelvis, you will actually be you should and then the abs up to your diaghaphm. Now hold everything for 30 seconds then relax and repeat. Set of 5 to start
#2 assume position #1 and contract and hold. Now do a pelvic curl of the pelvis and lift just your pelvis toward the ceiling to start , then keeping your back straight (FLAT AS POSSIBLE) lift you butt as high as possible, if correct you lwell have a slight arc in the lumbar region
In both exercises your head should be on the floor.
Hope this helps. Sounds like you are quite fit already.
No, just the opposite. The exercises resemble crunches...or reverse crunches? I'll add them to the planks tonight.
Thanks,
kpo
Do your kegels!................hang in there........
Corrected a few late night comments. Should read easier now.
kaypeeoh, are you noticing any subtle changes yet?
FYI, it took me about a month to be definite about the change process. .
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