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  • Increasing hamstring strength for walking.

    Firstly, I think this forum is awesome, wish I discovered it a long time ago. You guys are a wealth of info.

    My question is this. I have an incomplete sci @ c6-7. Right leg is good, but left has many deficits. I am attempting to strengthen my hamstring muscles and seem to have come to an empass. I can lay prone and do leg curls with 10 lbs. of ankle weights. I can do seemingly endless reps, up to 100. However, my abilitly to raise my ankle behind me as I walk is not improving. That is probably a terrible description, but thats the best I can explain. So, as I walk, I am still needing to raise my left hip. I can raise my leg in front of me when climbing stairs etc. I dont understand this. Any suggestions on a particular exercise or any suggestions at all are greatly appreciated.

  • #2
    This is a very simple answer to a complex question. There is more than one hamstring muscle. It appear that the lower muscle that helps raise the foot (leg curl) and works with the knee extensor is working but the upper part of the hamstring closer to the glutes which helps the the hip flexors and backward swing of the leg itself may not be working.

    I have the opposite problem. My upper hammys are strong and my lower are bad. They move but and I can do a sitting leg curl but not prone.

    It is hard to know if you have atrophied and need to isolate on straight leg hammy exercises or if the innervation is screwy which may be out of your control.

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    • #3
      Not that I have the answer, but what you folks are talking may help me more and yet more to look at. I not walk in 10+ years and in hospital 5+ years from auto accident with tons of issues. However, I dropped all professional therapy and doing my own. Rebuilding from a ton of atrophy - probably like dead. But what you say here, I am definitely looking into.

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      • #4
        SCG, hamstrings have been a hard comeback for me. It's been almost three years and I'm finally getting useful response from them. When exercising this area, it's very easy to cheat. I managed to bypass the hams for a long time and use upper glutes to do the job. I went back to PT and learned some ways to isolate the muscles that really needed to be worked. That helped a lot. Are you able to get any PT? Even a single session on this topic could help you get started. There's also a member of this forum who is a n SCI PT. See her thread at the top of the exercise forum...Ask a PT. She may have some good advice for you.

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        • #5
          Here's a video of showing how we strengthen an SCI patient's hamstrings using biofeedback and an instrumented treadmill at our clinic VIP NeuroRehabilitation in San Diego

          http://www.youtube.com/watch?v=4nPOsQWpBBM

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          • #6
            SCG - I am the PT Thanks Truly!

            It actually does not sound like a hamstring weakness to me... from the way you're describing it, I am thinking it may be more weakness in your calf or your pelvic stabilizers. Walking is a complex function that requires muscles to work in a synergy for it to be smooth. You have the strength to lift your foot against gravity with a weight on it when your pelvis is stabilized by the floor, right? That is what makes me wonder about weakness here.

            Also, when it comes to gait analysis, that knee flexion in the swing cycle is driven by the calf pushing off the floor - not by the hamstrings. Which is what made me question your gastroc-soleus strength.

            I think your exercise is great! But it may not bring the solution you're looking for. Hope that helps!
            Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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            • #7
              Truly, your "isolate" is exactly what I have been doing from abdomen down to toes on each leg. Therapy never took this approach. They were always "make the entire thing work" approach, which was total failure due to massive atrophy. Once I figured isolate, THINGS started working. Now got down to toes. Your "cheating" statement is VERY true. Need to be extremely careful you are not doing that. I cannot believe all that works once ankle a foot are in the process.

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              • #8
                rimtrhmiles - must admit that as I read and try to understand what you are saying, I don't succeed. I often get the message that if you beleive that if you just work very hard , you can bring function back despite having SCI. It sometimes sounds like "mind over matter". I must admit that I don't fully understand your posts but I recognize your optimism which is a wonderful coping mechanism to have.

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                • #9
                  arn, I was told here your eyes at times have input to brain "directly" ahead of actual execution. They are a sort of "follow the leader" type thing. I have gotten a lot of things working lying on bed with eyes closed and not worry about physical body execution. More so a "let's see if mental execution is correct WITHOUT eye input." I also did this in H2O water therapy 1+ years ago lying on back supported simply by a foam tube at lower back. She moved legs through walking execution. I had eyes closed. In a few weeks, she had me walking with zero assistance doing that. Another HUGE key thing here was she had me transferring upper body weight from correct side at correct time in order to execute which leg should support and which leg should step. Mentally I was always trying to step with the supporting leg for a VERY long time instead of the stepping leg. This also requires correct transition/location of your upper body weight.

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                  • #10
                    I not know if mind over mater. I was in hospital 5-1/2 years with tons of problems from auto accident. Was really disgusted with therapy. What they wanted to do and what I wanted to do never matched. That a huge problem. I told them get lost and went home. I started almost 2+ years ago with approach of be a baby again and simply work from top of body to the bottom. Should I get stuck? Maybe "leaped" too far forward so back up and work from there. This is working. I have things working all the way down to toes in each leg. Need build strength. But it appears I have a lot of things working. Do not know what may be missing.

                    Originally posted by arndog View Post
                    rimtrhmiles - must admit that as I read and try to understand what you are saying, I don't succeed. I often get the message that if you beleive that if you just work very hard , you can bring function back despite having SCI. It sometimes sounds like "mind over matter". I must admit that I don't fully understand your posts but I recognize your optimism which is a wonderful coping mechanism to have.

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                    • #11
                      If I might respectfully disagree with SCITotalFitness...although the initial knee bend may be driven by the calf during toe off, the hamstring contracts to hold that bend through the swing phase and then assists with deceleration of the leg before heel strike. It then co-contracts with the quadriceps during stance phase. As you can see the hamstring plays a significant part in forming the proper gait.

                      I would suggest a test for loaded/standing hamstring function: stand at a bar and have someone stabilize your pelvis by grasping it in both hands on each side, making sure to hold the front and the back with the fingers and thumb, respectively. Now try to raise your heel to your butt making sure to keep your upper leg (femur) perpendicular to the floor. If you can do this, even half way, the problem would be hip stability during gait. If you cannot, you definitely have hamstring weakness when in an upright posture and loaded.

                      To strengthen in this position will require some assistance. I would suggest standing at a bar with someone stabilizing your femur (from drifting forward) and raising your lower leg so it is parallel to the floor, you then try to hold your leg up so the foot does not fall to the floor. I have a feeling you will find this to be very challenging.


                      Eric Harness, CSCS
                      Founder/President
                      Neuro Ex, Inc
                      Adaptive Performance and Neuro Recovery

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                      • #12
                        Try using emg biofeedback to monitor the muscles contractions

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                        • #13
                          My hamstrings are one of my weaker areas as well. I've found a seated leg curl machine helpful, but even more so is working out in the water. I have access to a under water treadmill, that helps me work on my gait (try not to hitch my hip); I also work with a step in the water, up, down, up, down...I've been able to go from the deeper part of the pool to the shallower end, and from a shorter step to a taller one, but I have to keep at it; we seem to regress rather quickly!

                          there are a lot of pool exercises that will help you strengthen without overworking your muscle, then you can transfer that training gradually to land based exercises.

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                          • #14
                            That regress goes insanely fast if not keep at it. Any amount I lose from not keeping at it takes me X times more to get back to where I just was. That, for me is a mental curveball in the process. Pisses me off.

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