When I was 24 I decided to go to school for physical therapy. I was bored and thought well I’ll go do this…. A few years after I finished that up I thought, just to mix it up a little, I’ll have a stroke at the age of 30 and completely F up my life. In school I learned this phrase…”up with the good, down with the bad.” This is how I was taught to teach people with a bum leg to go up and down steps. Up with the good – lead with the “good” leg going up stairs, then bring up the “bad” leg to the SAME step. Down with the bad – go down steps leading with the “bad” leg, then the “good” leg follows to the SAME step. This works perfectly for a sprained ankle or broken leg, not so much with a hemiparetic leg with severe ataxia and an intention tremor.
It’s the down with the bad that was my problem. That first year I had pretty much zero control over my right leg(bad leg). Going down is harder anyway and combine that with severe ataxia and uhhh(insert profanity here). Well, now I have complete control over my right leg. But I didn’t then and I couldn’t “lead” with it if someone offered me a zillion dollars to do so. So for the first year the whole “up with the good, down with the bad” thing didn’t work for me.
So what did I do? I led with my left leg(good leg – opposite of what I was taught) going down steps for about a year until I had the strength and control to do it the “right” way. I also held on to railings for dear life.
But that’s totally the PT in me talking, not the stroke survivor. I don’t think there is a “right” way to do things after a stroke. There are things that you should know to make it easier to get around but there is no “right” way. Do what you can, when you can.

Categories: Health, Recovery, Rehab, Stroke stuff

Tags: , , , ,

36 replies

  1. Thanks Amy, so basically it took you one year to have control over your right leg. My husband Luis, has an intentional tremor when he tries to walk. I read on one of your posts that strengthening his torso would help him control his tremor. In his therapy, he began a using “steps”. His whole body started shaking, was this due to the effort he was doing? It was almost as if he was doing therapy for the first time.

  2. thank you heaps, finally someone who knows what they are talking about!, the bit about POB balance actually works, just got to practice more. Why didn’t I get explained this before by the PT’s?

    • You didn’t have it explained like this to you before because they’ve never been through it and didn’t know that explaining it out thoroughly helps. Personal experience is the shit.

  3. “The good goes up to heaven, and the bad goes down to he’ll,” is what my PT taught me. Down with the bad has been he’ll for my arthritic “good” knee.” I WISH I could have done it the opposite way. I can try today. Thanks, Amy!

  4. But you didn’t explain that walking is just a series of controlled falls.

  5. You probably help a lot of people with your experience from different sides of the fence.doctors haven’t been through it,so I sure would try it your way. BIG GREG!

    Sent from my iPad


  6. I’m telling you, you should become a physiatrist or a program director somewhere. Actually, you should just open up your own facility! Or just move to California and work at CNS where zack went. From what I can see, it seems to be similar to that crappy Chicago place… Only helpful, actually!

  7. There is one in Texas too.

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