I always love having a good “aha!” moment, especially when it helps improve how I manage my ALS symptoms. Better yet is when I learn that what I thought was a symptom of ALS was actually an impostor, the result of something called “learned nonuse.” Here’s what happened.
As I wrote in my column “How I Shift Into ALS Manual Mode,” when I sit in a chair and want to cross my legs, I have to reach down with my hands to help lift one leg over the other. “You have weak hip flexors,” the physical therapist at my ALS clinic would tell me.
Hip flexors are a group of muscles toward the front of the hip. They help move or flex the leg and knee up toward the body, as you do when you march, step onto a curb, or cross one leg over the other.
Why were my hip flexors weak? Well, I thought it was just another part of having ALS. But recently I read how patients with neurological conditions like mine experience weakness in certain muscles that would normally be strong, simply because these muscles aren’t being called into movement.
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The slippery slope
Not using these muscles becomes a habit, so the muscles further weaken and finally atrophy to the point of not responding at all. That’s something I want to prevent for as long as possible.
It’s important to know that this type of atrophy is different from what happens in ALS from the death of motor neurons. Learned nonuse, or disuse atrophy, is from a lack of voluntary movement; for most of us, that happens because we’re sedentary. I’ll have to admit, I certainly am, since ALS has severely weakened my feet and lower legs.
My solution?
I decided to strengthen my hip flexors by following a strategy I used to accomplish 40 chair squats — by being willing to do just one.
While sitting, I’d raise one knee up off the chair, lower it, and do the same with the other knee. Mind you, I could only lift each knee about an inch. But I knew that was OK. I did two lifts on each side in the morning and two again later in the day. Every time I sat down, I’d do two sets of knee lifts. Soon I could do five lifts, and my knees went higher, too.
Feeling confident, I tried some knee lifts while standing with my rollator. This became my new routine: standing knee lifts plus sitting knee lifts.
The other day I called my husband over to watch and showed off how I could perform a seated knee lift so high my knee touched my outstretched elbow. He responded with a “Wow, that’s great. Keep at it!”
Crossing my legs? That’s easy-peasy now.
Of course, I can’t wait for my upcoming ALS clinic visit in March so I can demonstrate my new skill to my physical therapist. For me, this was another lesson in never assuming there’s no hope — and learning that you’ll never know if you don’t try.
Let’s strive to live well while we live with ALS.
Note: ALS 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 other 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 ALS News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to ALS.