Does your leg feel “heavy”? Is it hard for you to lift it off the ground when you are walking? Or worse, does it drag (on the ground) because you are unable to lift it? You are not alone. It is a common “problem” that happens with many neurologic conditions. So, what exactly causes the leg to feel heavy? And more important, how do you fix it?
Lots of different things can cause this “heavy” senstion. Therefore, before I dive into the “fixin’ it”, it is critical to know what is causing it.
What Causes a Heavy Leg?
There are three things that might cause a leg to feel heavy.
#1 Extensor Spasticity
This is an involuntary muscle action that causes the leg to straighten out. Sometimes this is also referred to as an “abnormal movement pattern”. An abnormal “extensor” pattern means that when the knee straightens the hip extends and the foot points down. It is abnormal because these movements happen together (involuntarily).
If the leg goes into this pattern it makes it very difficult to bend the knee and bring the leg forward during walking. This might cause the sensation that the leg is heavy.
#2 Damage to the Nerve-Muscle Connection
Damage to the neurologic system can also cause a diminished connection between the brain and the muscle. This lack of connection can also cause the leg to feel heavy because the muscle is not getting the correct signals at the correct time. The “nerve signal” to the muscle can be delayed, “jumbled”, or absent altogether. Without a clear and accurate signal, the leg will not do exactly what you want it to do when you want to do it. Hence causing the leg to feel heavy.
Although this gives the appearance that the muscle is weak, IT IS NOT MUSCLE WEAKNESS.
I hear this ALOT! (even from well meaning healthcare professionals). “the muscle is weak”. Muscle weakness means there is a problem with the muscle. Therefore many will resort to “strengthening” tactics. And as many of you know, “3 sets ot 10 reps” is not the best way to regain a “brain-muscle” connection You need to handle this with strategies that facilitate neuroplasticity. But I digress. ??♀️
#3 Post-Stroke Edema
If you have suffered a stroke, you may have something called post-stroke edema. This can also cause the sensation of a heavy leg. The extra fluid in the leg can sometimes make it feel heavy.
So, now that you know what may be causing your leg to feel heavy, how do you fix it?
What are the best exercises to fix a heavy leg?
Motor Control Retraining
When your leg feels heavy due to extensor spasticity or “leg weakness”, the answer is motor control retraining. Motor control retraining is a way to strengthen all the areas of the brain that are necessary to perform a specific movement. In the case of a heavy leg, the goal is to re-learn how to bend the knee and bend the hip.
Hip and knee flexion exercise: Progression 1
Start laying on your side with the involved leg on top.
Bring the leg forward bending the knee and the hip.
Hip and knee flexion exercise: Progression 2
Lay on your back with the involved leg as shown in the picture. (leg with the duct tape)
bend the hip and the knee and bring the leg up toward your chest: pay attention the knee does not “flop out” to the side
Fix a Heavy Leg by adding a “purposeful movement”
Evidence shows that the best way to get permanent positive brain changes after a stroke is when you perform “purposeful or meaningful activities”. That being said, I never end a session with a “motor control activity”. So, how do I end most sessions? Well, that is a no-brainer……..walking.
Performing gait training (walking) at the end of each session is CRITICAL because it is something that has both purpose and meaning. I can’t remember a time someone told me their dream was to be able to lay on a mat and bend their knee. ?Hence, it is not really purposeful or meaningful.
I like to break “walking” down into small pieces and work on each component (each movement required to take a step). Here are a couple of the key movements to work on if your leg feels heavy or gets stuck on the ground: The best way to do this is to break walking down into pieces (all the movements that make up taking a step).
Here is a video where I explain this in detail:
Physical Therapy to fix a Heavy Leg
It is always best if you can work with a physical therapist. A physical therapist can provide appropriate manual cues at the right time to retrain these movements in standing. It is also important that you look for a neurologic physical therapist. A board certified neurologic physical therapist has special training and experience with the BEST strategies to facilitate normal movement patterns for those who have had a neurologic injury.
At Orlando Neuro Therapy, this is our specialty. We only have physical therapists board certified in neurologic physical therapy.
Don’t live in Orlando? no problem. We also offer 1 and 2 week intensive programs for those who travel from out of town.
Call today if you would like to learn more about our programs.