A few weeks ago, something really fantastic happened to me. For several hundred meters, I could walk normal again and without a cane. This has not happened to me for the last 2-3 years. I always went out with a cane and got completely dependent on it. Perhaps more importantly, the muscles in my hips worked and I could feel their ‘rotational’ movement needed for the gait. It was as if I could control my legs as in the old days.
In a way the experience was really weird and came by complete surprise while I was not conscious at that moment about the physiotherapy session that I had had the previous day. In fact, the day before I had seen a new physiotherapist who had treated MS patients for over 20 years. He stretched my legs and hips. It was not really very much more than a few rather basic movements, mainly stretches.
In the morning the legs were quite stiff but that's not unusual. Later that morning, I went out of the house to go to the back of the garden, and already in the kitchen I felt that my legs were different. I put on my shoes, took the cane and got going. But 5 meters on or so - this came totally unexpected - I told my wife who happened to be outside: it feels different. And I threw the cane away and walked like a normal person to the back of the garden and then came back.
This made me realize that the nerve paths are still there, that in fact I still have full control over the muscles in my hips and legs. I guess now my main problem is the rigidity of the muscles that has held me back and seems to even worsen over time. Is this what is progression, at least in part?
The physiotherapist said that many years of neurodeficiency may have caused muscular stiffness and rigidity. When the agonist gets tightened, the antagonist on the other side has to relax. Now if the signals to relax falter or are too slow, or because of cross-talk due to demyelination, a situation will develop where muscles and/or antagonists get exhausted and/or stiff and remodel. This situation may be aggravated by tightening muscles that squeeze significant nerves (Scott’s above posting), thinner/weaker neuromuscular paths caused by the oxidative stress cycle (EBV B cells) and of course the neurological trauma in CNS and spinal from earlier MS relapses.
The last MRI of my head suggests things are stable so no (new) inflammatory activity. There may still be a bit of oxidative stress left over from EBV B cells but above 60 years of age that may be expected to wane with time as well.
The important thing now would seem to be to work on the muscles, to get the right physiotherapy and muscular treatments. Scott’s remarks on muscular treatments in above postings would seem very appropriate and are well taken. I know now what I have to work on.
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I share Scott’s view about muscular rigidity being collateral to MS. I know for us it feels like damage but I would not necessarily use the word damage as the phenomenon may be some sort of evolutionary compensatory mechanism in reaction to sustained nerve impairment. And with Scott, I think – and hope – that it is reversable.
Where the article in Scott’s above posting would seem to focus more on neurological health, I think that there is also an aspect of "muscular learning". Last night I saw a reportage on television called "The secrets of the human body" (you can find on YouTube). It was done by the BBC. It explained quite nicely how muscles of for instance tennis players adapt to the situation. I think that generally speaking there will also be some adaptation in elderly people where muscles get stiffer to compensate for the loss of... And for us there will be some 'compensation' for the many years of faltering signaling…
I would need to add another step (9) to the Skeleton to cover this new dimension of muscular blockage http://www.thisisms.com/forum/general-d ... ml#p251748
and with that I think we have a pretty complete picture of what is MS. It's now a matter of writing it all down.
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Post script June 2019:
I know now what happens. And it is repetitive. In other words, I can provoke this situation.
If I literally cool down my body the nerves start to work, I can even lift my foot and feel the rotational movements in my hip. And I walk almost as normal while normally my EDSS must be around 5-6 and I can only walk with difficulty with a cane.
In other words, if it gets really cold, the mitochondria are supplied by raw energy, ATP is produced and the synapses are 'charged'. And the muscles work as normal and almost instantly the spasticity seems to evaporate..