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7 Surprising Reasons You Wake Up Tired

7 Surprising Reasons You Wake Up Tired

When you can’t sleep, you know it. But what about when you can, yet you wake  up feeling tired and achy or you’re groggy again a few hours later? What’s that  about? All too often, it turns out, the problem is one that doesn’t keep you  awake but does sabotage your sleep in more subtle ways, so the hours you spend  in bed don’t refresh and revitalize you the way they should. Here are seven  signs that you have a sleep problem that’s secretly stealing your rest.

1. You sleep poorly and wake with a bad taste in your  mouth.

What it’s a symptom of: “Morning mouth” can be a  signal of gastroesophageal reflux disease (GERD) or asymptomatic heartburn.  Recent sleep studies have shown that up to 25 percent of people who report  sleeping poorly without a diagnosed cause have sleep-related acid reflux. But  because they don’t have obvious heartburn symptoms, they’re unaware of the  condition.

How it interrupts sleep: Acid reflux causes the  body to partially awaken from sleep, even when there are no symptoms of  heartburn. The result of this “silent reflux” is fitful, uneven sleep, but when  you wake up digestion is complete and you can’t tell why you slept poorly.

What to do: Follow treatment suggestions for  heartburn, even though you aren’t experiencing classic heartburn symptoms: Don’t  eat for at least two hours before hitting the sack, and avoid acid-causing foods  in your evening meals. (Alcohol, chocolate, heavy sauces, fatty meats, spicy  foods, citrus fruits, and tomatoes all contribute to heartburn and acid reflux.)  Some doctors also recommend chewing gum before bed, because it boosts the  production of saliva, which neutralizes stomach acid.

Certain medications, particularly aspirin and other painkillers, are hard on  the stomach and esophageal lining, so don’t take them just before bed.

Sleep studies have shown that sleeping on the left side reduces symptoms, and  sleeping on the right side causes them to worsen because acid takes longer to  clear out of the esophagus when you’re on your right side. If you prefer to  sleep on your back — a position that can increase reflux — elevating your head  and shoulders can help.

Losing weight can do wonders to banish heartburn and acid reflux. And if all  else fails, try taking an over-the-counter antacid.

2. You toss and turn or wake up often to use the  bathroom.

What it’s a symptom of: Nocturia is the official  name for waking  up in the middle of the night to use the bathroom. The National Sleep  Foundation estimates that 65 percent of older adults are sleep deprived as a  result of frequent nighttime urination. Normally, our bodies have a natural  process that concentrates urine while we sleep so we can get six to eight hours  without waking. But as we get older, we become less able to hold fluids for long  periods because of a decline in antidiuretic hormones.

How it interrupts sleep: For some people, the  problem manifests as having to get up to use the bathroom, and then being unable  to get back to sleep. Once middle-of-the-night sleeplessness attacks, they lie  awake for hours. But for others the problem is more subtle; they may sleep  fitfully without waking fully, as the body attempts to send a signal that it  needs to go.

What to do: Start with simple steps. Don’t drink  any liquids for at least three hours before going to bed. This includes foods  with a lot of liquid in them, like soups or fruit. Lower your coffee and tea  consumption; the acids in coffee and tea can irritate the bladder. Don’t drink  alcohol, which functions as a diuretic as well as a bladder irritant.

Go to the bathroom last thing before getting in bed and relax long enough to  fully empty your bladder. It’s also important to get checked for conditions that  cause urination problems. Guys, this means getting your prostate checked.  Inflammation of the prostate, benign prostatic hyperplasia (BPN), and prostate  tumors can all cause frequent urination. In women, overactive  bladder, urinary  tract infections, incontinence,  and cystitis are common causes of urinary problems.

Diabetes  can also cause frequent urination, so if you haven’t been tested for diabetes  recently, see your doctor. Certain drugs such as diuretics and heart medications  can contribute to this problem; if that’s the case, talk to your doctor about  taking them earlier in the day. A prescription antidiuretic can cut down on  nighttime urination if all else fails and there’s no underlying issue.

3. Your jaw clicks, pops, or feels sore, or your teeth are wearing  down.

What it’s a symptom of: Teeth grinding, officially  known as bruxism,  is a subconscious neuromuscular activity. Bruxism often goes on without your  being aware of it; experts estimate that only 5 percent of people who grind  their teeth or clench their jaws know they do it until a sleep partner notices  the telltale sound or a dentist detects wear on the teeth. Jaw clenching is  another form of bruxism, except you clench your teeth tightly together rather  than moving them from side to side. Jaw clenching can be harder to detect than  grinding, but one sign is waking with pain or stiffness in the neck.

How it interrupts sleep: Bruxism involves tensing  of the jaw muscles, so it interferes with the relaxation necessary for deep  sleep. And if you’re fully grinding, your body is engaged in movement rather  than resting.

What to do: See a dentist. If you don’t have one,  dental schools often offer low-cost dental care provided by students supervised  by a professor. A dentist can look for underlying causes, such as problems with  your bite alignment, and can prescribe a mouth-guard-type device such as a  dental splint. If jaw clenching is your primary issue, there are specific dental  devices for that.

Experts also suggest giving up gum chewing during the day, because the  habitual chewing action can continue at night. Some people who grind their teeth  have experienced relief from botox injections to the jaw muscle. Others have had  success using a new biofeedback device called Grindcare, approved by the FDA in  2010.

4. You move all over the bed or wake tangled in the  covers.

What it’s a symptom of: That kind of movement  indicates restless  leg syndrome or a related problem, periodic limb movement disorder  (PLMD).

How it interrupts sleep: Doctors don’t know exactly  what causes these sleep movement disorders, but they do know they’re directly  related to a lack of deep, restful, REM sleep. The restlessness can prevent you  from sinking into deep sleep, or a muscle jerk can wake or partially rouse you  from deep sleep.

What to do: See a doctor to discuss your symptoms  and get a diagnosis, which may also involve looking for underlying conditions  related to restless leg syndrome or PLMD. Diabetes, arthritis,  peripheral neuropathy, anemia, thyroid disease, and kidney problems can all  contribute to restless leg syndrome and PLMD. Make sure to tell your doctor  about any medications you’re taking; a number of medications, including  antidepressants, antihistamines, and lithium, can cause restless leg syndrome as  a side effect.

You can also try making dietary changes to make sure you’re getting enough  iron and B vitamins, particularly folic acid, since iron and folate deficiency  have been linked to restless leg syndrome. Red meat, spinach, and other leafy  greens are good sources of both nutrients, but you may want to take supplements  as well. If your doctor diagnoses restless leg syndrome or PLMD, medications  used to treat Parkinson’s can relieve symptoms by eliminating the muscle jerks.  Your doctor may also prescribe medication to help you sleep more deeply, with  the idea of preventing the involuntary movements from keeping you in light  sleep.

5. You wake up with a dry mouth or horrible morning  breath.

What it’s a symptom of: Mouth breathing and snoring  both disrupt sleep by compromising breathing. Look for drool on your pillow or  in the corners of your mouth. If you have a partner, ask him or her to monitor  you for snoring, gasping, or overloud breathing.

How it interrupts sleep: Mouth breathing and  snoring can interrupt sleep because you’re not getting enough air to fully  relax. Severe snoring — particularly when accompanied by gasps or snorts — can  also indicate a more serious problem with obstructed breathing during sleep.

What to do: Train yourself to breathe through your  nose. Try snore-stopping nose strips, available over the counter at the  drugstore, or use saline nasal spray to irrigate your nasal passages. Experiment  with sleep positions; most people have a tendency to snore and breathe through  their mouths when sleeping on their backs. Use pillows to prop yourself on your  side, or try the tennis ball trick: Put a tennis ball in the back pocket of your  pajama bottoms (or attach it some other way), so it alerts you when you roll  over.

If you typically drink alcohol in the evening, try cutting it out. Alcohol, a  sedative, relaxes the muscles of the nose and throat, contributing to snoring.  Other sedatives and sleeping pills do the same thing, so avoid using anything  sedating. Alcohol also can trigger snoring in two other ways: It makes you sleep  more deeply initially and is dehydrating.

Losing weight — even just ten pounds — can eliminate snoring, studies show.  If none of these solutions work, consult a doctor to get tested for  sleep-disordered breathing conditions such as apnea.

6. You sleep fitfully, feel exhausted all the time, and wake with a  sore throat or neck pain.

What it’s a symptom of: Obstructive  sleep apnea is a disorder defined as breathing interrupted by intervals of  ten seconds or more. A milder sleep breathing problem is upper  airway resistance syndrome (UARS), in which breathing is obstructed but  stops for shorter intervals of under ten seconds. The number of people who have  sleep apnea and don’t know it is astounding; experts estimate that 20 million  Americans have sleep apnea, and 87 percent of those are unaware they have the  problem. One mistaken assumption is that you have to snore to have sleep apnea.  In fact, many people with apnea don’t snore.

How it interrupts sleep: Obstructive sleep apnea  results when the throat closes and cuts off airflow, preventing you from getting  enough oxygen. UARS is similar, but it’s usually tongue position that blocks air  from getting into the throat. Blood oxygen levels drop, and when the brain knows  it’s not getting enough oxygen, it starts to wake up. This causes fitful,  unproductive sleep. Weight gain is a major factor in sleep apnea, because when  people gain weight they end up with extra-soft tissue in the throat area, which  causes or contributes to the blockage.

What to do: See an otolaryngologist, who will  examine your nose, mouth, and throat to see what’s interrupting your breathing  and how to fix the problem. It’s also important to have your oxygen levels  measured during sleep. Your doctor will likely recommend using a Continuous  Positive Airway Pressure (CPAP) device, a mask that blows air directly into your  airways. Studies have shown CPAP masks to be extremely effective in treating  sleep apnea. Another mask called a BiPap (Bilevel positive airway pressure  device) works similarly but has dual pressure settings. Airway masks only work  if you wear them, so work closely with your doctor to choose a model that’s  comfortable for you.

Other options include oral appliances, which change your mouth position by  moving your jaw forward to open up the throat, and surgery, which aims to remove  the excess tissue from the throat. Newer, minimally invasive outpatient surgical  treatments include the Pillar procedure, which involves using permanent stitches  to firm up the soft palate; coblation, which uses radiofrequency to shrink nasal  tissues; and use of a carbon dioxide laser to shrink the tonsils.

7. You get a full night’s sleep but feel groggy all the time or get  sleepy while driving.

What it’s a symptom of: This signals circadian  rhythm problems or, more simply, getting out of sync with night and day.  Irregular sleep patterns, staying up late under bright lights, working a shift  schedule, using computers and other devices in bed, and having too much light in  the room while you sleep can disrupt your body’s natural sleep-wake cycle.

Why it interrupts sleep: The onset of darkness  triggers production of the hormone melatonin, which tells the brain it’s time to  sleep. Conversely, when your eyes register light, it shuts off melatonin  production and tells you it’s time to wake up. Even a small amount of ambient  light in the room can keep your body from falling into and remaining in a deep  sleep. The use of devices with lighted screens is especially problematic in  terms of melatonin production because the light shines directly into your eyes.  This light is also at the blue end of the spectrum, which scientists believe is  particularly disruptive to circadian rhythms.

What to do: Try to get on a regular sleep schedule  that’s not too far off from the natural cycle of night and day — and preferably  the same schedule all week. (Experts recommend 10 p.m. to 6 a.m. or 11 p.m. to 7  a.m. every night, but that’s just a general outline.) If you struggle with not  feeling alert in the morning, go outside and take a brisk walk in daylight to  feel more awake; you’ll find that it’s much easier to fall asleep the following  night. This is also a trick experts recommend to help night owls reset their  internal clocks. Force yourself to get up and get into bright light one or two  mornings in a row and you’ll be less likely to get that “second wind” and burn  the midnight oil or experience nighttime sleeplessness.

As much as possible, banish all screens (TVs, computers, and iPads) for at  least an hour before bed. Reading is much more sleep-inducing than looking at a  lighted screen, but make sure your reading light isn’t too bright and turn it so  it doesn’t shine in your eyes. Remove night-lights; if you need to get up in the  middle of the night, keep a small flashlight next to your bed, being careful to  turn it away from you. Check your bedroom for all sources of light, however  small. Does your smoke alarm have a light in it? Put tape over it. Use an alarm  clock without a lighted dial, or cover it. If your windows allow moonlight and  light from streetlights to shine in, install blackout curtains or shades tightly  fitted to the window frames. Don’t charge laptops, phones, cameras, and other  devices in your bedroom unless you cover the light they give off.

(Leesa recommeds rubbing Lavendar essential oil on the soles of your feet before bed!)

By Melanie  Haiken, Caring.com  senior editor

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5 Surprising Signs of an Unhealthy Heart

5 Surprising Signs of an Unhealthy Heart

We’ve all read the signs of a heart attack listed on posters in the hospital waiting room. But what if there were other, earlier signs that could alert you ahead of time that your heart was in trouble?

It turns out there are. Researchers have done a lot of work in recent years looking at the signs and symptoms patients experienced in the months or even years leading up to a heart attack. “The heart, together with the arteries that feed it, is one big muscle, and when it starts to fail the symptoms can show up in many parts of the body,” says cardiologist Jonathan Goldstein of St. Michael’s Medical Center in Newark, New Jersey. Here are five surprising clues that your heart needs checking out. Any of these signs — and particularly two or more together — is reason to call your doctor for a workup, says Goldstein.

1. Neck pain

Feel like you pulled a muscle in the side of your neck? Think again, especially if it doesn’t go away. Post-heart attack, some patients remember noticing that their neck hurt and felt tight, a symptom they attributed at the time to muscle strain. People commonly miss this symptom because they expect the more dramatic acute pain and numbness in the chest, shoulder, and arm. Women in particular are less likely to experience heart pain that way, and more likely to feel twinges of pain and a sensation of tightness running along the shoulder and down the neck, says Margie Latrella, an advanced practice nurse in the Women’s Cardiology Center in New Jersey and coauthor of Take Charge: A Woman’s Guide to a Healthier Heart (Dog Ear, 2009). The pain might also extend down the left side of the body, into the left shoulder and arm.

Why it happens: Nerves from damaged heart tissue send pain signals up and down the spinal cord to junctures with nerves that extend out into the neck and shoulder.

What distinguishes it: The pain feels like it’s radiating out in a line, rather than located in one very specific spot. And it doesn’t go away with ice, heat, or muscle massage.

. Sexual problems

Having trouble achieving or keeping erections is common in men with coronary artery disease, but they may not make the connection. One survey of European men being treated for cardiovascular disease found that two out of three had suffered from erectile dysfunction for months or years before they were diagnosed with heart trouble. Recent studies on the connection between ED and cardiovascular disease have been so convincing that doctors now consider it the standard of care to do a full cardiovascular workup when a man comes in complaining of ED, according to cardiologist Goldstein says. “In recent years there’s been pretty clear evidence that there’s a substantially increased risk of heart attack and death in patients with erectile dysfunction,” Goldstein says.

Why it happens: Just as arteries around the heart can narrow and harden, so can those that supply the penis. And because those arteries are smaller, they tend to show damage much sooner — as much as three to four years before the disease would otherwise be detected.

What distinguishes it: In this case, the cause isn’t going to be immediately distinguishable. If you or your partner has problems getting or maintaining an erection, that’s reason enough to visit your doctor to investigate cardiovascular disease as an underlying cause. “Today, any patient who comes in with ED is considered a cardiovascular patient until proven otherwise,” says Goldstein.

3. Dizziness, faintness, or shortness of breath

More than 40 percent of women in one study published in Circulation: Journal of the American Heart Association, reported having experienced shortness of breath in the days before a heart attack. You might feel like you can’t breathe, or you might feel dizzy or faint, as you would at high altitude. If you can’t catch your breath while walking upstairs, vacuuming, weeding the garden, or doing other activities that previously caused you no trouble, this is a reason to be on the alert.

Why it happens: Not enough blood is getting through the arteries to carry sufficient oxygen to the heart. The heart muscle pain of angina may also make it hurt to draw a deep breath. Coronary artery disease (CAD), in which plaque builds up and blocks the arteries that feed the heart, prevents the heart from getting enough oxygen. The sudden sensation of not being able to take a deep breath is often the first sign of angina, a type of heart muscle pain.

What distinguishes it: If shortness of breath is caused by lung disease, it usually comes on gradually as lung tissue is damaged by smoking or environmental factors. If heart or cardiovascular disease is the cause, the shortness of breath may come on much more suddenly with exertion and will go away when you rest.

4. Indigestion, nausea, or heartburn

Although most of us expect pain from any condition related to the heart to occur in the chest, it may actually occur in the abdomen instead. Some people, particularly women, experience the pain as heartburn or a sensation of over-fullness and choking. A bout of severe indigestion and nausea can be an early sign of heart attack, or myocardial infarction, particularly in women. In one study, women were more than twice as likely as men to experience vomiting, nausea, and indigestion for several months leading up to a heart attack.

Why it happens: Blockages of fatty deposits in an artery can reduce or cut off the blood supply to the heart, causing what feels like tightness, squeezing, or pain — most typically in the chest but sometimes in the abdomen instead. Depending on which part of your heart is affected, it sends pain signals lower into the body. Nausea and light-headedness can also be signs that a heart attack is in progress, so call your doctor right away if the feeling persists.

What distinguishes it: Like all types of angina, the abdominal pain associated with a heart problem is likely to worsen with exertion and get better with rest. Also, you’re likely to experience repeated episodes, rather than one prolonged episode as you would with normal indigestion or food poisoning.

5. Jaw and ear pain

Ongoing jaw pain is one of those mysterious and nagging symptoms that can have several causes but can sometimes be a clue to coronary artery disease (CAD) and impending heart attack. The pain may travel along the jaw all the way to the ear, and it can be hard to determine which it’s coming from, says cardiovascular nurse Margie Latrella. This is a symptom doctors have only recently begun to focus on, because many patients surveyed post-heart attack report that this is one of the only symptoms they noticed in the days and weeks leading up to the attack.

Why it happens: Damaged heart tissue sends pain signals up and down the spinal cord to junctures with nerves that radiate from the cervical vertebrae out along the jaw and up to the ear.

What distinguishes it: Unlike the jaw pain caused by temporomandibular joint disorder (TMJ), tooth pain, or ear infection, the pain doesn’t feel like it’s in one isolated spot but rather like it’s radiating outward in a line. The pain may extend down to the shoulder and arm — particularly on the left side, and treatments such as massage, ice, and heat don’t affect it.

By Melanie Haiken, Caring.com senior editor

15 Things Your Walk Reveals About Your Health

15 Things Your Walk Reveals About Your Health

 By Paula Spencer Scott, Caring.com senior editor

Walk into an exam room and a trained eye can tell a lot about you in seconds: Your stride, gait, pace, and posture while walking can reveal surprising information about your overall health and well-being.

“Many physicians are keenly aware, when they see someone walking down the street, what their diagnosis might be, whether their underlying health is good or bad, and if not good, a number of tip-offs to what might be wrong,” says Charles Blitzer, an orthopedic surgeon in Somersworth, New Hampshire, and a spokesperson for the American Academy of Orthopedic Surgeons.

Find out what the following 15 walking styles may signal about your health.

Walking clue #1: A snail’s pace

May reveal: Shorter life expectancy
Walking speed is a reliable marker for longevity, according to a University of Pittsburgh analysis of nine large studies, reported in a January 2011 issue of The Journal of the American Medical Association. The 36,000 subjects were all over age 65. In fact, predicting survival based on walking speed proved to be as accurate as using age, sex, chronic conditions, smoking, body mass index, hospitalizations, and other common markers. It’s especially accurate for those over age 75.

The average speed was 3 feet per second (about two miles an hour). Those who walked slower than 2 feet per second (1.36 miles per hour) had an increased risk of dying. Those who walked faster than 3.3 feet per second (2.25 miles per hour) or faster survived longer than would be predicted simply by age or gender.

A 2006 report in JAMA found that among adults ages 70 to 79, those who couldn’t walk a quarter mile were less likely to be alive six years later. They were also more likely to suffer illness and disability before death. An earlier study of men ages 71 to 93 found that those who could walk two miles a day had half the risk of heart attack of those who could walk only a quarter mile or less.

Simply walking faster or farther doesn’t make you healthier — in fact, pushing it could make you vulnerable to injury. Rather, each body seems to find a natural walking speed based on its overall condition. If it’s slow, it’s usually because of underlying health issues that are cutting longevity.

Walking clue #2: Not too much arm swing

May reveal: Lower back trouble
“It’s really amazing the way that we’re made,” says physical therapist Steve Bailey, owner of Prompt Physical Therapy in Knoxville, Tennessee. As the left leg comes forward, the spine goes into a right rotation and the right arm moves back. This coordination of the muscles on both sides is what gives support to the lower back, he says.

If someone is walking without much swing to the arm, it’s a red flag that the spine isn’t being supported as well as it could be, because of some kind of limitation in the back’s mobility. Back pain or a vulnerability to damage can follow. “Arm swing is a great indicator of how the back is functioning,” Bailey says.

Walking clue #3: One foot slaps the ground

May reveal: Ruptured disk in back, possible stroke
Sometimes experts don’t have to see you walk — they can hear you coming down the hall. A condition called “foot slap” or “drop foot” is when your foot literally slaps the ground as you walk. “It’s caused by muscle weakness of the anterior tibial muscle or the peroneal muscles,” says podiatrist Jane E. Andersen, who has a practice in Chapel Hill, North Carolina, and is a past president of the American Association for Women Podiatrists.

A healthy stride starts with a heel strike, then the foot slowly lowers to the ground, then it lifts from the toe and slings back to your heel. But with drop foot, muscle control is lost and the foot can’t return slowly to the ground. Instead, it “slaps” the ground.

“This could be a sign of a stroke or other neuromuscular event, or of compression of a nerve,” Andersen says. A ruptured disk in the back is a common cause, since it can compress a nerve that travels down the leg. A rare cause of drop foot is simply crossing your legs, Andersen says, if the common peroneal nerve is disrupted from the pressure.

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Walking clue #4: A confident stride (in a woman)

May reveal: Sexual satisfaction
Your stride and gait don’t always indicate bad things. A study conducted in Belgium and Scotland, reported in the September, 2008, Journal of Sexual Medicine, found that a woman’s walk can reveal her orgasmic ability. Women who have a fluid, energetic stride seem to be more likely to easily and often have vaginal orgasms, researchers said. They compared the gaits of women known to be orgasmic (defined as by penile intercourse, not direct clitoral stimulation) with those who were not.

What’s the connection? The theory is that orgasms contribute to muscles that are neither flaccid nor locked. Result: a freer, easier stride, researchers found, as well as greater sexual confidence and better self-esteem.

Walking clue #5: A short stride

May reveal: Knee or hip degeneration
When the heel hits the ground at the beginning of a stride, the knee should be straight. If it’s not, that can indicate a range-of-motion problem in which something is impairing the ability of the knee joint to move appropriately within the kneecap. “Degenerative changes in the knee sometimes need to be addressed by manual therapy to stretch out the tightness and improve that range of motion,” Bailey says.

A similar cause of a short stride is lacking extension, or good range of motion, in the hip. By taking shorter steps, the walker doesn’t have to extend as far. “Unfortunately, that compensation puts more stress on the back,” Bailey says. “In older people, a big issue in the back is having enough space for the joints and nerves as it is. When you don’t have a lot of hip extension, there’s not a lot of room to play with, and it can cause back pain and neural issues, such as drop foot.”

Walking clue #6: Dropping the pelvis or shoulder to one side

May reveal: A back problem
Muscles called the abductors on the outside of the hips work to keep the pelvis level with each step we take. So while we’re lifting one leg and swinging it forward, and standing on the other, the abductors keep the body even — unless those muscles aren’t working properly, Bailey says.

What happens then is that the body compensates. In a common walking pattern known as the Trelendenberg gait, as the heel strikes the ground on the unaffected side, the pelvis drops on that side to try to reduce the amount of force the muscle has to produce on the other side. Sometimes the compensating is so pronounced that the whole shoulder dips as well.  The ultimate cause of the weak abductors is often a back problem, Bailey says.

Walking clue #7: Bowlegged stride

May reveal: Osteoarthritis
“Think of the classic image of the old, slow, bow-legged cowboy,” says orthopedic surgeon Blitzer. “He probably looks that way because of arthritic knees.” Eighty-five percent of people with osteoarthritis (OA), the wear-and-tear form of the disease associated with aging, have a slightly bowlegged walk, he says. Bowlegs (also called genu varum) happen because the body can’t be supported adequately; the knees literally bow out.

Rickets or genes can also produce a bow-legged walking style, but these causes are more commonly associated with kids than grown-ups, and they can be outgrown or corrected with braces.

Walking clue #8: Knock-kneed appearance

May reveal: Rheumatoid arthritis
Rheumatoid arthritis (RA), the kind that’s an inflammatory disease, produces a knock-kneed walk, where the knees bend in toward one another. “About 85 percent of people with rheumatoid arthritis are knock-kneed,” Blitzer says. In knock-knee (genu valgum, or valgus knee), the lower legs aren’t straight but bend outward. This can create a distinctive, awkward-looking walk where the knees are close together and the ankles are farther apart. Sometimes osteoarthritis can also result in knock-knees, depending which joints are affected.

Walking clue #9: A shortened stride on turns and when maneuvering around things

May reveal: Poor physical condition
Balance is a function of coordination between three systems: vision, the inner ear, and what’s called “proprioception,” which is the joints’ ability to tell you their position. The joints can do this because of receptors in the connective tissue around them. But the quality of the receptors is related to how much motion the joint experiences. “It’s the old use-it-or-lose-it,” Bailey says. “When you’re active, you lay down more receptors in the connective tissue, so your proprioception is better.”

That means you have better balance. And it’s why someone with balance problems is often frail or in poor physical condition. “If you have trouble balancing, you have a shorter stride, and it’s especially noticeable on turns or when you’re maneuvering around objects. You also have trouble going up steps, which requires balancing on one foot for a longer amount of time,” Bailey says. “You do much better on straightaways.”

Blitzer encourages frail patients who need canes and walkers but avoid them because they “don’t want to look old” to set aside their pride and use them. “Better to use adaptive devices and continue to be active than to be sedentary, which is a vicious cycle that makes you more sedentary,” he says.

Balance problems can be also be related to peripheral neuropathy, a kind of nerve damage caused by diabetes, Andersen says. Other common causes include alcohol abuse and vitamin deficiencies.

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Walking clue #10: A flat step without much lift

May reveal: Flat feet, bunions, neuromas
Flat feet are obvious at a glance: There’s almost no visible arch (hence one of the condition’s names, “fallen arches”). But other conditions can also cause a flat walk. When the person takes a step, the foot flattens even as the heel is lifting off the ground, when it would normally be going into an arched position. The heel may also shift slightly to the inside when it comes up, and the toes may flex upward.

These kind of movements are attempts to create better stability where there isn’t any because of a painful bunion (an abnormal enlargement of the bone or tissue around the base of the big toe) or a neuroma (a nerve condition) in the foot. The most common neuroma, called Morton’s neuroma, is extremely painful thickening of the nerve between the third and fourth toes. The stepping pattern changes in order to protect what hurts.

Walking clue #11: Shuffling

May reveal: Parkinson’s disease
Shuffling — bending forward and having difficulty lifting feet off the ground — isn’t an inevitable aspect of aging. It’s a distinct gait that may indicate that someone has Parkinson’s disease. The person’s steps may also be short and hesitant.

“Shuffling is one of the most common manifestations of Parkinson’s, a neuromotor dysfunction in a neuromuscular disease,” says Blitzer. Along with tremors, it can be an early sign of the disease.

People with advanced dementia, such as is caused by Alzheimer’s disease, may also shuffle as a result of cognitive trouble — the brain and musculature don’t communicate well. But by the time this happens, memory loss and problems with thinking skills are far more obvious.

Walking clue #12: Walking on tiptoes, both feet

May reveal: Cerebral palsy or spinal cord trauma
Another distinctive gait owing to an underlying condition is “toe-walking.” The toe reaches the ground before the heel, instead of the other way around. It’s related to overactive muscle tone, caused by stretch receptors that fire incorrectly in the brain. When the toe-walking happens on both sides, it’s almost always because of damage high in the spinal column or brain, such as cerebral palsy or spinal cord trauma.

Note: Sometimes toddlers walk on tiptoe for a while as they’re getting the hang of it, but this doesn’t mean they have a palsy. If you’re concerned, mention it to the child’s doctor, who will assess for other signs of a problem.

Walking clue #13: Walking on tiptoes, one foot

May reveal: Stroke
Doctors assessing toe-walking look for symmetry: Is it happening on both sides or only one? When a person toe-walks only on one side, it’s an indicator of stroke, which usually damages one side of the body. When polio was still a scourge in the U.S., affected people often had one withered extremity and one-sided toe-walking was more common.

Walking clue #14: A bouncing gait

May reveal: Unusually tight calf muscles
One unusual stride is a gait that causes the walker to literally bounce a bit. Specialists can see the heel-off, the first part of a normal step, happen a bit too quickly, because of tight calf muscles. Women are the most vulnerable, because of chronic high heel use, podiatrist Andersen says.

“I’ve seen women in their 60s who have been told to exercise — sometimes for the first time in her life because a doctor is ordering it for a health issue — and she can’t because she can’t comfortably wear a flat shoe,” she says. “The same thing can happen much earlier in life, too, such as with a 25-year-old who’s been wearing stilettos since she was a teenager.”

Walking clue #15: One higher arch and/or a pelvis that dips slightly

May reveal: One leg is shorter than the other
Limb (or leg) length discrepancy simply means that one leg is shorter than the other. Experts can spot this in several different ways. One is by looking at the foot while you take a step, says podiatrist Andersen; one foot will have a higher arch and the other will look flatter. The flatter foot usually corresponds to the longer leg, she says.

Also, because the shorter leg has to go a bit farther to get to the floor, the pelvis may drop down slightly in the stride, adds Bailey. “If you pull up the shirt you can often see changes to the lumbar spine — a horizontal crease along the spine on the side with the longer leg, because the spine is bending in that direction.”

You can be born with limb discrepancy or get it as the result of knee or hip replacements, if limbs don’t line up perfectly after healing. But unless the discrepancy is three-quarters of an inch or more, Blitzer says, studies indicate it probably won’t cause health problems. Shoe inserts usually can make up for a quarter-inch discrepancy; surgery is sometimes recommended for larger differences.

by Caring.com

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