Down

I don’t care who you are or where you came from, going downstairs and downhill is harder than going upstairs or uphill.  This is because the muscles that control that motion are working very differently.  The same muscles control the action of ascending and descending something, but descending is harder.  Ever hear the expression “same shit, different day?”  Well, here it’s “same muscles, different action.”

eccentric

It’s kinda blurry but I really like that picture.  It’s from here.

My mom says when her knee is hurting it hurts worse going downstairs.  That’s because she using the quadriceps muscle eccentrically.  When I climb stairs, it’s much harder and feels much less stable descending stairs.  That’s because I’m using the quadriceps muscle eccentrically.  If you don’t have a brain injury and tore your ACL or something, going downstairs will be harder.  If you have perfectly uncompromised muscular and neurological systems, going downstairs and downhill will be harder.  It might seem like it should be easier to walk or run downhill because of the momentum but you have to control the motion with eccentric contractions and they’re hard.



Categories: Brain stuff, Health, Recovery, Rehab, Stroke stuff

Tags: , , , , , , , ,

14 replies

  1. My OT told me that if I couldn’t do concentric contractions, ecctrentric contractions would help me recover concentrically also. I haven’t been able to find any research that supports that idea yet.

  2. Arghh, eccentric not ecctrentric

  3. My new job is in a 9 floor building and the elevators are not always easily available. I hate the stairs, especially walking down. The suggestion is to take the elevator up and walk down stairs. Phooey on that idea but it most certainly is not considered acceptable to stand around for 15 minutes waiting for the elevator to have room when I am supposed to be working. I had no idea this would be such a huge issue when I took the job.

    I complained about my sore leg and even sorer knee to my beloved Tai chi teacher/ alias rehab physiotherapist and she said that it would be good for me – just focus on stepping straight on each step and no twisting my knee. ( What I was really wanting was sympathy) My “weak” leg had a screwed up knee before I got sick and poor gait screwed it up the rest of the way.. and now all the abuse has damaged my “good” knee too.

    • I went to a museum once (post-stroke) and the lady at the front desk said the fastest way to explore is to go to the top floor and take the stairs down. No, it’s not faster for me honey.

  4. Thanks for that explanation, Amy – I’ve often wondered about it. I’ve been meaning to write and ask you why it’s harder to walk while carrying something – even something light. I keep forgetting and getting distracted, but this post reminded me, because I’m finding it extra tough to carry anything while going downstairs. I normally walk pretty “normally,” except if I change direction – then I wobble and stagger and probably look drunk. But if I’m carrying *anything*, no matter no lightweight, then I revert to some sort of limping even on flat ground, like I did right after my stroke. I’ve been wanting to ask you about that. I hope this is related and not a hijack of the thread or a misplaced comment. If I have to track that down, I’ll get sidetracked and never get back here, so please either pardon my error or tell me where to go. ~Cheers

  5. When I was coming off my cane after my accident, going down stairs was scarier than going up them. Like you said, different movement of the muscles. Now with an AFO going down is twice as hard as going up because the brace doesn’t like it.

  6. Linda, my “good” knee is wrecked, too: arthritis, bone spurs, torn meniscus, and previously-torn ACL (which makes my knee inherently unstable). Doc said it’s the arthritis that’s causing the pain, swelling, and near-collapse on the stairs. A patella replacement (or worse) is in my future. Just like your tai chi instructor, my PT said I have to stop twisting the joint.

    • I am stuck in a WICKED traffic jam. OMG I wanna get home and take a nap so badly.

    • yeah.. stupid knees. Years ago I had a large unusual cyst in my weak side knee that was partly under my knee cap. The knee healed up badly and off to the side, ligaments were damaged, broken floating bits of cartilage and now arthritis too. Dr. says let him know when I give up and want a knee replacement but at the same time I am now considered a really bad surgical risk so I am hanging in there as long as possible. I do have a honkin big knee brace but that actually screws up my gait even more and then the rest of me hurts too.

      • My physiatrist recommended a honking big brace for my unaffected knee, but I haven’t bothered. Too much other stuff to deal with. I just try to strengthen my affected knee more so that, in the event I have surgery on the other, I’ll have at least ONE leg capable of being the “good”” leg. Haha!

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