In my daily outpatient clinics, I often encounter elderly patients who complain that they cannot lift their feet when walking, their movements become clumsy, and sometimes they even stumble. This may seem like a small problem, but there may be a variety of health challenges behind it. Too often, patients and families mistakenly believe that this is just a part of aging and that they don't pay enough attention to it.
Just last month, a 74-year-old retired teacher, Mr. Li, came to my office. With a look of confusion and uneasiness, he told me that he had been "smearing oil on the soles of his feet" lately, and that walking a few steps was like stepping on an ice rink. Mr. Lee's case is not unusual, but there is something unique behind each case. Through a series of detailed examinations, we found that his problems were due to peripheral neuropathy, a common complication of diabetes. After the diagnosis is confirmed, we develop a targeted treatment and rehabilitation plan.
Medical explanation: why can't you lift your feet
First of all, peripheral neuropathy is one of the very common causes. This condition usually affects the nerves in the feet and lower legs, resulting in impaired nerve conduction. For example, diabetics often experience such problems because high blood sugar damages nerves for a long time. Nerve damage causes the muscles in the foot to receive signals that weaken, making it impossible to lift the foot.
Secondly, muscle fatigue or degeneration is also an important factor. As we age, muscle mass and strength naturally decrease, which also affects the lifting of the feet when walking. Sometimes, this condition can be related to a lack of exercise or chronic diseases that directly or indirectly affect muscle function.
In addition, arthritis, especially degenerative arthritis of the knee or hip, often causes gait changes in older people. Pain and stiffness in the joints limit the amplitude of movement, which in turn affects the normal lifting of the foot when walking.
Finally, the effects of stroke sequelae or other central nervous system diseases cannot be ignored. This type of disease can lead to a decrease in muscle control on one side of the body, which directly affects the ability to walk.
Diagnostic process: How to determine the specific cause
First, the most basic thing is to take a detailed medical history. Doctors ask people when they begin to have difficulty walking, whether their symptoms worsen gradually or appear suddenly, and whether they are accompanied by pain or other sensory abnormalities. This information helps your doctor make an initial determination of the nature of the problem and possible causes.
Next, a physical examination is an indispensable step. The doctor will check the strength of the legs, muscle condition, reflexes and sensation. In particular, an examination of the feet and lower legs can help doctors determine whether muscle weakness or nerve dysfunction is present.
Neuroelectrophysiological studies are a key tool for further diagnosis. This includes nerve conduction velocity testing and electromyography, which can help doctors determine the location and extent of nerve damage, especially if peripheral neuropathy is suspected.
If doctors suspect a central nervous system problem, such as the sequelae of a stroke or a brain lesion, imaging tests, such as an MRI or CT scan, may be needed. These tests can provide detailed information about the condition of the brain and spinal cord to help confirm the diagnosis.
Blood tests may also be requested to rule out or confirm certain causes, such as diabetes, thyroid dysfunction or other metabolic disorders, which can affect nerve function and muscle strength.
Practical advice: Ways to improve your gait
Physiotherapy and rehabilitation
Physical therapy is the first option to improve gait. Regular professionally supervised rehabilitation can significantly improve muscle strength and coordination, and reduce symptoms.
Professional assessment: First, a comprehensive assessment by a physiotherapist identifies the specific factors that affect gait.
Customized training plan: Based on the results of the assessment, the physical therapist will design a personalized training plan for you, which may include strength training, balance exercises and gait training.
Keep practicing: Practice every day, gradually increasing the difficulty and duration.
Dietary modification and nutritional supplementation
Proper diet and nutrition are essential for nerve and muscle health.
High-nutrient foods: Increase foods rich in B vitamins, antioxidants, and omega-3 fatty acids, such as green leafy vegetables, fish, nuts, and whole grains.
Avoid sugar and processed foods: Reduce your intake of sugar and processed foods, which can exacerbate inflammation and affect nerve function.
Self-monitoring and preventive measures in daily life
Small changes in everyday life can also bring big benefits.
Safe home: Make sure your home is barrier-free, remove carpet and electrical wiring that can cause falls, and install handrails and non-slip mats.
Appropriate footwear and aids: Wear comfortable, well-supported shoes and use crutches or walkers if necessary.
Regular check-ups: Visit your doctor or therapist regularly to adjust your treatment plan as your symptoms change.
With the implementation of the above measures, not only gait can be improved, but also quality of life will be improved, making every step more robust and confident. These measures require the joint efforts and persistence of patients and families, and the effects will be felt over time.