Walking the ‘tightrope’ as we age

The initial conversation with many of my older patients often starts with what challenges they face, their commitment to change and what activities exactly do they want to return to doing without feeling limited. This “tightrope” can be a big challenge because of the two things required to “walk it”: Balance and control of their walking, or as we call it in therapist speak, “gait.” Many people notice that subtle limitations may come about when they can no longer keep up with walking as part of their exercise routine or when walking socially with friends. Others may notice that they begin to lose trust in their steadiness when walking and have to revert to using a cane or walker. More significant is the loss of confidence that comes from feeling the effects of this new limitation; this can be devastating to someone who has lived an active lifestyle without much concern about safety limitations.

These challenges are not permanent, and in many cases they can be reversed with some focused effort. Seeking an appointment with a physical therapist can be a valuable “first step” to regaining lost confidence, improved balance and walking safety.

Commitment to change is something I speak on regularly at community centers, in clinics, the Council on Aging and various other settings. My experience with the many patients seen at home, in the clinic and in the hospital has provided valuable insight about those who actually “try” and those who just talk about it. This is another version of the “tightrope,” since it’s very easy to quit or avoid the peril we face when returning to those things we want to do: How much effort and determination is a person willing to give to obtain or regain abilities lost? Not an easy question to answer, but as a therapist and the client’s main “coach,” motivation can come from the rewards gained during each session. Gradually, the small successes reached day to day become bigger ones accumulated through trial and error, correction and encouragement. This process is often just as rewarding to the therapist as it is to the client.

Balance is a “three-legged stool”:

• Strength, coordination and stability of the trunk and lower body.

• Functioning of your inner ear apparatus (your internal balance sense).

• How you perceive your surroundings through your senses (mainly touch and sight).

If any one or more areas of the above systems is limited or impaired, the “stool” becomes wobbly and may not remain steady. Your balance will become more notably difficult to control.

Walking or gait is a “fall” interrupted by well-timed steps.

Just remember, walking is all about timing, coordination and predicting where the next best place is to put your foot to prevent that “fall.”

When we walk, we have developed amazing timing and control that came from years of practice from childhood. As this skill declines through limitations, it can be some of the most frustrating issues we face as we age since we have been literally practicing it our whole lives.

So this is the order I suggest you follow if you are noticing challenging physical limitations in your own life or someone you care about:

• Identify your fears and concerns about where you are missing out or losing abilities.

• Understand that change is possible, but it does not come without commitment.

• Seek out a physical therapist to be your guide and help you walk that “tightrope.”

• Take inventory regularly of your progress and challenges.

• Look for places, supportive people and opportunities to maintain or build upon your progress.

• Have an annual checkup with your physical therapy doctor just as you would with your regular physician.

“Tightrope” walking is all about commitment, balance and walking – just as in life. So get out there and do it!

Dr. Gregory Redmond is a physical therapist in private practice and co-owner of Eberhardt Physical Therapy, Nutrition and Wellness in Shreveport, La., with his wife, Shelly Marie Redmond, a registered dietitian and creator of Skinny Louisiana. Dr. Redmond also owns Redmond Therapy Services, a home health agency consulting company providing physical, occupational and speech therapy services throughout Northwest Louisiana.