am posting about this unusual condition because it's a misery for committed athletes and there's not a lot of consensus on what it is or how to treat it. I've had it for about eight years, and am finally turning a corner on recovery.
It first showed as occasional toe drag in left leg, and a foot permanently plantarflexed while pedalling. This progressed to increasing difficulty running (esp on treadmill and pavement) and then walking.
Despite this I raced triathlons throughout, consciously forcing the leg to hold a better position, and/or wearing a brace that kept the foot reasonably level.
Multiple exams by physicians -- including MS investigations, lots of MRI's (all clean), a peroneal nerve release (ineffective), suggestion of hip surgery (slightly torn labrum and impingement). A dystonia specialist suggested medication, which I wasn't interested in. Also strength training, rolling, etc. etc.
Here's what worked. A great, intuitive physiotherapist, who ordered complete cessation of running and biking (which, as it turns out, was ingraining the bad movement pattern -- 100% quad dominant on the left -- even deeper). Six months of 90-minute strengthening sessions, every other day, with leg lifts, squats, adductor work, single leg hip bridges, single leg deadlifts, and fast walking on a steep incline. BORING. But it worked.
What it taught was very interesting though -- a good third of the bad leg's/hip's musculature simply wasn't firing. If a muscle is deactivated, you don't realise it until it starts working again, and then you're like "what the hell is that and where has it been!" Much of the rest was locked into hyperactivity. I suspect the root cause was poor hip/core strength causing the quad to hyper compensate, a pattern that got ingrained (thanks to stubborn refusal to stop training) and eventually overwrote the code for good, natural movement. The right leg was enabling the bad movement by bracing, which further disrupted the pattern.
Long story short, it's now 80% better, and improving by the day. It's not possible to fix by doing the same old same old workouts and hoping to push through. It's a comprehensive reeducation. The deactivated bits must be lit up by repetitive movements without stress. Once the brain is convinced the hips are strong enough to trust with a normal pattern, it will find its way back to it.
Don't imagine this is relevant to many, but hope it may help some.
It first showed as occasional toe drag in left leg, and a foot permanently plantarflexed while pedalling. This progressed to increasing difficulty running (esp on treadmill and pavement) and then walking.
Despite this I raced triathlons throughout, consciously forcing the leg to hold a better position, and/or wearing a brace that kept the foot reasonably level.
Multiple exams by physicians -- including MS investigations, lots of MRI's (all clean), a peroneal nerve release (ineffective), suggestion of hip surgery (slightly torn labrum and impingement). A dystonia specialist suggested medication, which I wasn't interested in. Also strength training, rolling, etc. etc.
Here's what worked. A great, intuitive physiotherapist, who ordered complete cessation of running and biking (which, as it turns out, was ingraining the bad movement pattern -- 100% quad dominant on the left -- even deeper). Six months of 90-minute strengthening sessions, every other day, with leg lifts, squats, adductor work, single leg hip bridges, single leg deadlifts, and fast walking on a steep incline. BORING. But it worked.
What it taught was very interesting though -- a good third of the bad leg's/hip's musculature simply wasn't firing. If a muscle is deactivated, you don't realise it until it starts working again, and then you're like "what the hell is that and where has it been!" Much of the rest was locked into hyperactivity. I suspect the root cause was poor hip/core strength causing the quad to hyper compensate, a pattern that got ingrained (thanks to stubborn refusal to stop training) and eventually overwrote the code for good, natural movement. The right leg was enabling the bad movement by bracing, which further disrupted the pattern.
Long story short, it's now 80% better, and improving by the day. It's not possible to fix by doing the same old same old workouts and hoping to push through. It's a comprehensive reeducation. The deactivated bits must be lit up by repetitive movements without stress. Once the brain is convinced the hips are strong enough to trust with a normal pattern, it will find its way back to it.
Don't imagine this is relevant to many, but hope it may help some.