My husband was diagnosed with MSA-C about 2 years ago, although he had symptoms for a couple years prior. My question is, he has been falling every day lately and it seems his right leg just gives out. At first we thought it was his knee, as he's always had trouble with it due to his history of downhill skiing and working in construction. He tells me he doesn't think it's particularly his knee, but feels like the muscle from his ankle to his knee. He did go thru xrays a year or two ago, and all they found was arthritis. Has anyone experienced this? is this just the progression of the disease? or should we go to the orthopedic and have it checked out? I'm just not sure what to do, as spending money on an orthopedic doctor seems a waste if it is just 'the symptoms and progression' of his disease. Anyone have any suggestions or have experienced this?
Frequent falls when knee gives out - Multiple System A...
Frequent falls when knee gives out
Hello Andra,
You mention your husband's history of downhill skiing - I notice you live in Colarado. Some of our most memorable skiing was with friends who live in Aspen and we used to visit them every other year until Jackie came down with MSA-C.
Part of Jackie's early progression was falling to the right hand side. She would appear to lose her balance and topple over. Jax describes it as if her leg "just gives way". Over the years that feeling has been worse at some time than others and I am afraid to say we have just had to accept it as part of the disease.
Due to Jackie's acute loss of balance and difficulty of moving, she progressed quite early on to a wheelchair. That hasn't stopped us getting out and about and before Covid we travelled extensively. Sadly, we've had to miss out on our visits to Aspen and the downhill skiing since Jackie's diagnosis.
Take care, Ian
Thank you for your reply. It's nice to hear others progression to compare to. All though sad that we are coming, I know everyone's progression is different. My husband is insistent on getting an MRI of his lower back, as he believes it is a pinched nerve causing this. I guess we can always hope for the best.
Hubby has bad arthritis in both knees and if it would not be for this dreadful disease, he would have had replacements by now.
Yes they give way and he falls. First he had walking stick, then rollator, now Zimmer frame and mostly now he is wheelchair bound. We got a orthotics person looking at him and supplying with proper braces, but he prefers the pressure sleeve he can just pull on.
Sadly part and parcel of it all. welcome to the club
My mum has seen this as her disease has progressed I'm afraid, she often said her leg just did what it wanted! She like Jackie in Ian's reply now struggles with her mobility and increasingly her balance, leading to a lot of falls. That't the focus now - just making sure she asks for help, luckily despite a large number of falls every week she seems to get away with just bruising. Sadly she is looked after in a nursing home now and due to Covid we're not able to visit, she is though in a lovely specialist home who can deal with her symptoms well. Not an easy time for her or us.
My husband is increasing in his falls too. This week 3 times. Even though he has had a sporting history it does not seem to be related. WE think in our case that he is less aware of where his joints are in space and his coordination is worse. We are choosing not to seek orthopaedic help at this time. Unfortunately, adaptive devices for walking aren't helpful either for him. We are trying to change the house for him to have easier pathways. Can he tell you what it feels like before it buckles. I am finding it fascinating that when my husband describes things, it is very different than how I am interpreting his movement and his original shorter description and I find he has been spot on.
Thank you for your response. My husbands right leg seems to drag, for example, I always follow him up the 2 steps we have into the garage, just incase he falls backwards. I notice when he goes in, he will step up with his left leg, and then the right leg (foot) seems to drag instead of lift up. When he falls, he blames his knee 'giving out', but when I ask him to be more specific, he says he feels it is more what he feels from his ankle up to his knee. Unfortunately I think he is still in the denial stage about his disease, so I will go with him to the ortho doctor, and support him. I have ordered a walker for him , that has the seat. You mentioned walking devices have not helped? I was hoping the walker would assist him to walk as the cane he uses, he tends to trip over when he doesn't get it out of the way.
As a side note, I am an Occupational Therapist. So I think his could also be a sensory awareness of his leg. The reason my husband is not using the devices well is coordination and also he is having visual perceptual issues that affect him a great deal. He can't see past the walker/seat to the floor which is where he is trying to focus to help him walk because he cannot stabilize his gaze further away. He is also very resistant to using devices and has just recently accepted a cane. So your husband may do great and it may slow him down enough to control his leg. What happens if he consciously attempts to ascend the stairs with his weaker leg?
He refuses to use his right leg to lead with, as it tends to not be strong enough to support his weight, and is a guaranteed fall. Can i ask, the visual perceptual issues, has he had that long? My husbands symptoms seem to gradually appear and when the doctors told us what to expect, I always am shocked when he starts doing some of the things they say will happen.
Just the other night he was laughing at something on the TV, to the point that we all looked at him to see if he was ok. It was almost on over the top laugh that continued for quite a few minutes.
My husband says his left leg will not obey orders. This side has been difficult for a lot longer than diagnosis when we think back. He didn’t fall more subsided but is full wheelchair user now so fortunately no more falls.
Hi Andrashko, my husband describes the same thing i.e. his leg just gives out and he falls and I do think this is part of the condition. He was up until recently insistent it was his back and we had to go through a consultant for him to take on board that it was the MSA and not his back. He also drags one of his feet a little on his weaker left side, as you described so again I'm surmising this is the condition. I think it is unfortunately part of the progression of the condition, but I get wanting to check it out.
Take care and hope you're managing okay
All this is very familiar from when my husband started with MSA. He first noticed that he couldn’t set off to run a few steps and thought that it was coming from his back, then he started not quite walking in a straight line And so bumping into door frames. He always struggled with his left leg more. He was quite risk averse and so was happy to use his 4 wheel walker inside the house to keep independent, but was more happy to use a wheelchair in public. Then after a fall that shook him up he was in his wheelchair for all his mobility. It is very dependent on people’s own emotional make up as to how they deal with the diagnosis and progressing symptoms. Know how to approach things is the greatest skill. That 4 wheeled walker was provided by the physio and pushed out of sight in the garage because he couldn’t imagine ever wanting to use it, but after a fall whilst using his stick alone at home he was grateful for it to be retrieved so that he was independent again!
Thank you for your reply. At first, it was a challenge to get my husband to use a cane. After several hours of conversation, I understood that he was "embarrassed", to have to use a cane. My attitude was who cares what people think? After convincing him, he started using it. Now it has progressed to where a walker would be more beneficial, so he is not hesitant to use it, thankfully. I guess just the acceptance that this disease is actually taking over is what is the hardest to deal with. Again thank you for sharing your journey.
So yes I was wondering if he was consciously not using that right leg because he couldn't control it as well. I agree that personality does impact reluctance or agreement to using adaptive devices. Falls have no impact on my husband and we are now up to 5 since last Thursday. We will be returning to the PT who assessed him for his weighted vest and he is more open to her suggestions. Everyone at my husband's work apparently just hold their breath waiting for him to fall but since he works with his cousins, they are driving him and I don't want him to be stuck at home if there is anyway possible. I think he finds work very motivating and it structures his day well so we will see. My husband's visual perceptual issues have been noted by the PT since February ( 8 months) but we felt like there was something going on because his driving was impacted and he said he couldn't focus on things around corners.
No, I don't think he is consciously not using his leg. We discussed this with his neurologist this week at an appointment, and unfortunately we were told it is more of a problem between his brain and his movement. The will to move his leg is there, it's just that his body does not respond to the directions of his brain. My husband was told not to drive due to the fact that his response time is not connecting to when his brain signals a need.
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Since when does MSA have a silent A in its title?
