Heel, Toe: Walking with Mindfulness
(Graphic by Jean Mellano)
“Mindfulness isn’t difficult, we just need to remember to do it.” — Sharon Salzberg
The ability to walk is something many of us, myself included, have always taken for granted. Now that I have Parkinson’s disease (PD), something that used to come as a matter of course to me is starting to deteriorate. PD has adversely affected my left side more than my right side. I find myself tripping more, since I tend to drag my left foot.
Walking now requires my conscious thought
Going for a walk is now more of a mindful task than an exercise for me. I find it much more therapeutic to focus on how I walk and be in the present moment than to think about the future and how my PD may progress. With each step I take, I concentrate on repeating to myself, “Heel, toe.”
My stride analysis
When there was snow on the ground, I decided to compare my walking steps when I did not focus on saying “heel, toe” with those from when I did. My footprints in the snow were very telling, so I took a photograph. On the left side of the photo are my steps when I was not thinking about my stepping patterns. You might notice that both feet show a bit of a drag in the snow. On the right side of the photo, as I moved forward, I really focused on flexing both of my feet and having my heel strike first. There are no signs of drag on either foot.
Am I putting too much thought into this?
Years of training to improve as a dancer and a cyclist have made analysis of my body movements come quite naturally to me. Whether it was improving my pedal stroke for more cycling power or perfecting my balance to do pirouette turns, I learned to be mindful and to be in touch with how my body was performing. Now I must use that skill to help myself be more attentive when I walk.
My neurologist says I tend to overthink things. I believe our greatest strengths can also be our greatest weaknesses. Sometimes, I do overthink, to the point of getting paralysis by analysis. However, I believe that mindful analysis of my PD symptoms (including my walking technique) is critical in helping me to create different ways of doing things that at one time (before PD) used to come as second nature to me.
“Do not dwell in the past, do not dream of the future, concentrate the mind on the present moment.” — Unknown
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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.
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Comments
James Mourlas
Dear Jean,
It is so true that among the many little "side" issues of PK --and LBD--which my wife had--are these annoying little physical changes that slowly creep into one's everyday life--such as the walking issues you describe. And the the other "biggie" is the tendency for everything to get smaller--whether it is small steps--small writing--small--(low) speaking----
At the Rock Steady Boxing program --where I volunteer- (designed for PK patients) we concentrate a lot on making things BIG--big steps--big voices--big breaths--
I commend you on your focusing on "Heel Toe"--I'm not a doctor but I believe this extra effort and concentration will slow the degradation down--maybe stop it all together! Fight back!--that's all you can do--God Bless all--Jim
Thank you James for your comment and the work you do with RSB. I have been taking RSB classes now for over a year and LOVE it.
Perhaps you might enjoy some articles I have written about RSB:
http://parkinsonsnewstoday.com/2018/08/21/parkinsons-rock-steady-boxing-mental-push/
http://parkinsonsnewstoday.com/2018/09/04/parkinsons-battle-continues-rock-steady-boxing-classes/
http://parkinsonsnewstoday.com/2018/09/18/parkinsons-disease-battle-complacency/
http://parkinsonsnewstoday.com/2019/01/08/parkinsons-reflections-one-year-rock-steady-boxing-comraderie/
http://parkinsonsnewstoday.com/2019/02/26/rock-steady-boxing-parkinsons-disease-left-room/
Alan McDaniel
Thank you for your article. Any idea on the what's and how's to get insurance to cover RSB therapy? Insurance does recognize and cover LSVT therapy? I really want to do RSB but, cannot afford the fees. Thank you again.
Alan, I am not a tax professional, so I can only tell you what someone in my class recommended. If your dr. writes a letter indicating medical necessity for RSB, perhaps you can deduct your mileage and class fees as medical expenses on your tax return but you need to check with your accountant. Have you tried getting your dr. to write a letter to your insurance company? RSB is the best thing for people with PD. It is a form of P/T
ART DUBOW
John Pepper deserves credit for teaching these techniques with PD patients. ART
Thank you Art for your comment. My PT's have always stressed heel, toe with me. My challenge is staying focused and being mindful. It seems my brain still goes 85 MPH and my body is more like 30MPH LOL.
Alan Tobey
Heel and toe are the two contact points, but you also need to pay attention to direction of motion. One former neurologist (whom I fired, we had many issues) looked at my mildly dragging foot and told me to concentrate on lifting the foot vertically so it stayed above the dragging zone as long as possible during the step. This was bad advice: lifting engages the lower abdominals, which pull on the upper abs, which pull the shoulders forward. Result: this exaggerates the forward stooping we don’t want. Instead I learned to concentrate on moving my foot backward on first contact, and focusing effort there. This had the opposite effect: force was transferred more strongly to the back muscles, which pulled back my shoulders and straightened my spine while reducing foot impact. It took quite awhile and deliberate attention — thousands of steps at each of dozens of sessions — until it became much more automatic, what I have named a “mindfulness circuit.” I have quite a collection of these ready to deploy, and creating new ones gets easier and easier. With enough it feels like I’ve shifted much more to automatic pilot, the ultimate goal of the mindfulness road.
Alan, great food for thought. Mindfullness is so important. Having been on 'autopilot' for most of my life. It is a challenge for me to focus and try to re-learn something I have always taken for granted in the past
Ern Shivers
Yes can relate I've done similar for years but my condition has changed so that now i have to concentrate as well on uncurling my toes as they search for better grip in my shoes as i walk. This helps to maintain a more steady gait.wonder if any else has this side effect?
Ern,
Thank you for sharing. Jeez, this disease always finds new ways to challenge us!
James Mourlas
Dear Jean
I read all the RSB articles--thank you for sharing--you should be proud of your accomplishments. I would have liked to have been there to see you break the wooden board!
I enjoy working with everyone at our RSB--they have such grit and determination--it's truly amazing -and they are so appreciative of the volunteer's efforts--I often hear--"I love you Jim"--or the names of the other volunteers-- shouted out as part of the voice strengthening we encourage them to do--always with a big laugh---there is a wonderful feeling of camaraderie and a universal attitude that we my be stuck with this thing but we are not going down easy--I am so proud of these folks and so pleased to be a part of this program--I think it helps me as much as it helps the PD folks.
I encourage anyone who is not enrolled in RSB to get involved--join up!--
God bless all of you--and keep your chins up! Never forget there are people who love and admire you.
Jim
Thank you James for taking time to read my articles. I cant say enough good things about RSB. Your comment: " camaraderie and a universal attitude that we my be stuck with this thing but we are not going down easy" sums it up very nicely. I think RSB is the best thing to happen to PwP. Stay tuned for some of my future articles about Fighting Back..
AJ
Ern,
I have awful toe curl issues first thing in the morning. It is debilitating, until the first dose of Stalevo kicks in. I am 53 and was dx 11 years ago.
My new Neuro has put me on Stalevo CR for overnight. Haven't tried it enough to report on it yet.
Carol
Yes! I find my toes on my right side clenched and “gripping” the floor and have to consciously relax them. It feels like the purpose is better balance.
Jerry Boster
Aloha Jean,
I am convinced mindfulness of walking is very important. When I was diagnosed 6 years ago at age 47 after a 29-year Navy career, one of my symptoms was a hunched posture and the beginnings of the Parkinson's shuffle. So over the past 2-3 years I have consciously worked on a daily basis to have a normal gait. Recently I had a partial knee replacement due to all the wear-and-tear from my Navy career. When I started PT, the doctors and therapists were astounded at how I was ble to walk properly from the beginning. At 4 days after surgery, they said I was at the normal patient 4-week mark. And my progress has continued to consistently to be ahead of the norm. I am firmly convinced it's because I purposely and with mindful forethought have worked to walk as normally as I can. You styory just confirms what I felt was true. Great job and keep it up.
Cheers, Jerry
aloha Jerry, Do you live in my favorite place in the world; Hawaii? My late husband and I would return to Kauai every year for over 20 years..
Thank you for sharing your story. I am happy to hear your mindful walking has helped you both with your PD symptoms and your surgery recovery.
I believe those of us with PD must remain as active as we can and continue to MOVE. My challenge is remaining mindful LOL.
Amy Lindberg
Jerry, hey shipmate! Ever stationed at CLNC ( <1987) re: water contamination?
Lorna Romeo
On my daily walk, I repeat over and over - head up, shoulders back, swing those arms, take longer strides, and don’t forget to breathe!
Lorna, keep on walking, I think exercise is the best thing for us. Who would have thought walking, something I always took for granted, has become more of a mind exercise than a physical exercise.