How can I stop tripping all the time?
March 17, 2019 6:40 PM   Subscribe

I have a problem where every few weeks I will trip and cause a minor sprain to my left foot. Help me fix my coordination issues.

It all started about four years ago when I was walking down a grassy hill. I tripped and rolled inward on my left foot, such that the outside of my ankle moved closer to the ground. This caused significant pain to where I was limping throughout the day and the next. A few days later, my relatives visited from out of town and I felt I should take them around, even though I still had some foot pain. During these daylong outings, had some pain and a minor limp, but thought perhaps the movement would be good for it or something. I realize in retrospect that this is probably wrong. After that, the foot pain became a dull, chronic pain. At this point, I saw a couple of podiatrists. After maybe a year and a half, I did find someone who was able to help me. He prescribed orthotics and strengthening/weighted calf raises. Eventually, the chronic pain went away.

However, I still have this issue where every so often I will trip and roll inward on my left foot again. For example, it happens while walking down grassy hills in a hurry, while walking up/down steps while distracted, while walking on a bus which suddenly lurches forward. When it happens, the pain usually lasts for a couple hours to overnight. I’ve brought this problem up with the podiatrist, but he doesn’t seem to have an answer other than to keep doing the calf raises.

Although it’s hard to remember, I think I’ve always tended to roll on my feet. I guess in the past, it just hasn’t really hurt as much and after a few minutes it would recover. Now, perhaps because of the injury, it seems every time it happens, it’s a minor calamity.

I was wondering if there’s anything I could do to stop myself from tripping all the time? At the moment, I’m just going to try to be more careful and watch my step, but I feel I can only do so much (eventually I will get caught off guard). Is there anything else I can do to either improve my coordination, balance, or strength to stop the trips?
posted by strekker to Health & Fitness (22 answers total) 5 users marked this as a favorite
Maybe try tai chi? From NPR:
Researchers don't know exactly how tai chi works to restore balance. UCLA psychiatrist and brain scientist Michael Irwin says it may work by literally re-training areas of the brain that control movement.

"There's a memory component of our nerves, and they're receiving signals from our body all the time that are integrated by the brain," Irwin says. "And it may be that what happens with tai chi is that it's bringing awareness of the brain to these areas of the body" — thereby strengthening those areas of the brain.
posted by Little Dawn at 6:54 PM on March 17, 2019 [1 favorite]

I think you need a physical therapist, not a podiatrist. Improving strength, coordination, and balance is exactly what they do.
posted by wintersweet at 6:54 PM on March 17, 2019 [23 favorites]

Physio can help a lot with this so that's my top recommendation.

If that's not an option here's a few things.

Knowing where your body is in space and being able to adjust is called proprioception. There are exercises online to increase that, but many many activities will help including dance, zumba, any martial art, yoga, etc. - things where you do activities where you feel where your body is and move it deliberately through movements that require both sides, various joints, etc. When you hurt your foot you probably adjusted for both pain and a lack of range of motion and over time, not moving your foot and ankle the same way as much caused a kind of blind spot there for you.

Yoga or martial arts will help with balance too, as will lots of other things but those are two I'm familiar with.

For building stability in the foot and ankle, after I broke my leg, my physiotherapist got me up on a bosu ball (it's that little sort of half ball that people do sit ups on) and also recommended walking barefoot on sand and other mildly unstable surfaces to build up the small muscles again.
posted by warriorqueen at 6:55 PM on March 17, 2019 [2 favorites]

Did you ever get it imaged? I had a torsion fracture in my ankle from being knocked over on a snowboard, and the X-ray I got a week later didn't see it. I saw a podiatrist, they gave me some exercises, etc.

It healed, more or less, and I ran and played basketball on it for a year or so. I noticed it would periodically get really sore and I'd have to restrict activity for a few days or weeks.

Finally I went to an orthopedist, got an MRI, and turned out I had a talus fracture that X-rays couldn't see bc position. I had it scoped, spent two months on crutches, another two months in PT, and after a while, my range of motion returned and the pain went away forever.

TL;DR go see an ortho and get good imaging so you can see what's actually wrong and get going on it.
posted by toodleydoodley at 7:09 PM on March 17, 2019 [5 favorites]

Hi, I have this issue!

Things that have helped:

always flats, never heels;

shoes with a good, grippy surface on the sole;

knee-high boots;

shoes with good ankle support;

prescription (made from a plaster cast of my foot) orthotic inserts;

seeing a physiotherapist for treatment and exercises;

buying new shoes more often than I "should" have to - my feet turn inwards, which means my soles wear very unevenly, and there's a point where that means that I'm more likely to stumble/trip/fall. So now I replace shoes when the leather looks fine, but the sole is really uneven.
posted by Murderbot at 8:52 PM on March 17, 2019 [3 favorites]

I used to roll my ankle like that quite a bit, but got it under control when I made a point of slowing down anytime I couldn't be totally sure of my footing. I still walk very fast on a nice flat sidewalk, but if there's ice, or hills, or I'm paying attention to something else, I let myself take a little more time. The amount of time you'd save by always going at full tilt is negligible, but gaining fully functional ankles is worth it. It does mean that you have to pay a little closer attention to your surroundings, and be more in the moment physically. I know that this is exactly he action you said you are already taking, but wanted to confirm that it really does make a difference.
posted by 5_13_23_42_69_666 at 9:41 PM on March 17, 2019 [1 favorite]

I had the same issue for decades and well remember the horrible crunching feeling and the pain.

For the last few years I've done a 20-minute general exercise routine most days (either yoga or an old callanetics tape from the 80s), and now the ankle-rolling thing hasn't happened for years. I also seem to be less clumsy.

Yes, and as mentioned above, try not to rush.
posted by Grunyon at 3:13 AM on March 18, 2019 [1 favorite]

I have had a similar issue with repeated rolls/sprains. The two types of doctor who can help are a physical therapist and/or an orthopedist. I decided to try a physical therapist first, and that worked to my satisfaction; the PT gave me exercises to do at home with a resistance band and balance cushion that improved my strength, coordination, and balance. These have been incredibly helpful for me in preventing rolling and reducing ankle pain.

The other thing I'd recommend looking at is your shoes. For me, something about the way that I walk wears away one side of the sole before the other, which becomes a self-reinforcing cycle -- my foot tips a tiny bit and wears away one side of the sole, which makes my foot tip even more, which wears out that side of the sole even more, etc. This puts my foot in an increasingly tipped-over position with every step and makes me more likely to seriously roll/sprain my foot. Check out your soles; if they're worn in this way you can get them replaced by a cobbler, or just replace the shoe with one that has a wider base.
posted by ourobouros at 3:19 AM on March 18, 2019 [1 favorite]

Agree with everything above, but a simple step that you can take to build ankle strength is to balance on one foot, then the other, while you are brushing your teeth, putting on makeup, doing dishes, etc. I would talk to a doctor first, but this is a good, lifelong habit to get into if you have weak ankles. It really helps keep your baseline strength up.
posted by backwards compatible at 4:54 AM on March 18, 2019 [2 favorites]

I have used some of these and find them useful: How to Fix Bad Ankles (slnyt). I also found this Wikihow post but I haven't tried them. Probably a good idea to consult a physical therapist before using them.
posted by Botanizer at 4:58 AM on March 18, 2019 [1 favorite]

Once you sprain an ankle once it's more at risk for future sprains it's like tearing fabric and sewing it back together its still going to be weak at the tear. You need to go to a PT to build up strength in your ankles again.
posted by sockymcpuppeterson at 6:16 AM on March 18, 2019 [1 favorite]

Nthing the PT recommendation.
Also, I found barefoot shoes really helped with this. I haven’t rolled my ankle once since I switched; there’s no heel to fall off of. I like Soft Stars flats, sandals, and chukkas, but there’s lots of brands.
posted by john_snow at 7:01 AM on March 18, 2019 [1 favorite]

Maybe some mindfulness excercises. Because I figure most times I trip, I wasn’t really being mindful of the situation at hand and my behavior in it.
posted by SaltySalticid at 7:06 AM on March 18, 2019 [1 favorite]

Definitely talk to a physical therapist (or if for some reason you have easier access to a sports medicine or orthopedist, you can start there). You might end up with an ortho referral in the end.

If there's no treatable defect in an orthopedic sense, I know several people with those sub-clinical kind of long-term nagging pains who have gotten relief from Alexander or Feldenkrais technique exercises. You can youtube rabbit-hole that to see if one or both appeal.

Additionally, just on the generic tripping front: my clumsiness gets worse when I need new glasses. Even when you're not specifically looking down you are "reading" the ground in front of you in tiny little ways, and the older you get the harder it is to see the ground.
posted by Lyn Never at 8:03 AM on March 18, 2019 [2 favorites]

You can definitely talk to a physical therapist and see if that would work for you! I also had this issue and the thing that helped me the most actually is working with a personal trainer. My balance and proprioception and vestibular sense and pretty much everything has improved when I started personal training, especially doing Pilates. I haven't fallen like that in probably a year and a half at this point. Good luck!
posted by fairlynearlyready at 9:17 AM on March 18, 2019 [1 favorite]

For what it's worth: I had a friend who was having balance problems (tripping and falling even at home), her doctor told her to stop shoving Q-tips so far into her ears, she stopped, and her balance gradually improved over the next couple months.
posted by rada at 9:39 AM on March 18, 2019

This was me for a couple of years, only because of other issues the pain usually lasted about a week. I finally tried wearing an ankle brace for about nine months, because I theorized that the regular twists made it so it could never 100% heal. And it seemed to work! No issues since then.
posted by metasarah at 9:42 AM on March 18, 2019 [1 favorite]

>I’m just going to try to be more careful and watch my step, but I feel I can only do so much (eventually I will get caught off guard).

After close calls on both 4 wheels and 2, I adopted a technique that makes it harder for me to be caught off guard. Should work when walking.

Telling myself to pay attention and be more careful didn't work. What worked was telling myself to do those 2 things until I reached a target such as past the next intersection. After reaching the target, I immediately picked another target. I believe this worked for 3 reasons. First was the time between picking a target and reaching it was short enough that I could pay attention without my mind wandering. Second was reaching each target without mind wandering was a small reward. That motivated me to continue picking targets. Third is when picking targets it became obvious to pick ones past any risky situation, which was all the motivation I needed to pay attention and be careful.
posted by Homer42 at 11:44 AM on March 18, 2019 [1 favorite]

I would have it looked at by a doctor, in case there is any remaining issue. Tai chi, dance, or other regular conscious exercise is extremely helpful with balance and coordination. I do participatory International Folk Dance, which is welcoming to newcomers, and in most dances you are holding peoples' hands, so that helps, but any dance will help.
posted by theora55 at 11:52 AM on March 18, 2019

Maybe try walking zen meditation... but basically it's just take some time out of the day to walk slowly and mindfully as to slowly pick and place your feet and shift your weight. Go ahead and take 2 minutes to go from the couch to the bathroom sneaking around slowly like a cat and being mindful to never be off balance and almost not moving at all. It's harder than it sounds. Practice slow, learn fast.

But basically it's just PT and balance excercise and mild strength training and locomotion control. Practice.
posted by zengargoyle at 5:11 PM on March 18, 2019 [1 favorite]

Please see a neurologist as well. That might be a sign of a neuromuscular disorder.
posted by iStranger at 7:14 AM on March 19, 2019

Response by poster: Many thanks to all of the good advice. I will be rereading all of it and trying to do as much as possible. It does give me hope to hear the other people have faced this problem and overcome it. I will definitely go see a PT, and if I can without too much trouble, an orthopedist as well. I agree with the idea that probably my movement patterns have subconsciously changed to where I am using (or not using) the ankle/foot in a way that exacerbates the weakness. I’ve certainly intentionally tried to avoid doing things like dance to avoid the chronic foot pain I used to have and because I felt they were “risky”. But maybe it’s a case of “if you don’t use it, you lose it” (in terms of the foot/ankle strength). So I think it’s time to get back into things like that, along with more structured strengthening.

In the meanwhile, I am definitely going to take on board the tips about walking more carefully. I notice older people (like my mom) tend to be a lot more careful about how they move so as to not put themselves at risk. Although I’m relatively young (in my 30s), I think I could use a bit more of that attitude.
posted by strekker at 8:15 AM on March 19, 2019

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