At age 64, Mary Miller feels like she's just learning to walk.
The Medford resident quickly bounced back from hip-replacement surgery in December but recently "felt wobbly." An April workshop at Rasa Center for Yoga and Wellness showed Miller how to put her best foot forward.
More than mere walking, "gait therapy" is a system for moving the body that stretches, strengthens, improves balance, eases pain and ultimately prevents injuries. Certified therapist Jamie Elmer knows better than most the unexpected benefits of changing one's stride.
"I was in constant pain every day," says Elmer of lower-back aches that sometimes kept her in bed for a week. "I feel like this work completely saved me from surgery."
Ten years ago, a yoga instructor told Elmer, now 33, to seek out physical therapist Sherry Brourman in Santa Monica, Calif. Brourman, in 1998, published "Walk Yourself Well," a 312-page manual of the techniques she developed in response to her own unexpected and debilitating back pain. Squeezing her stomach and back muscles together, while shifting her weight slightly forward, dulled Brourman's stabbing sensations and over time stabilized her spine enough to heal.
Like most gait-therapy patients, Elmer says she was deeply skeptical of how altering the way she walked could possibly alleviate pain. The lifelong dancer walked into Brourman's office like the consummate ballerina: toes pointed out at an extreme angle, hips thrust forward and lower back tightly compressed.
"Most people are pretty surprised at some of the habits they have," says Elmer, including herself in that category.
Walking out of the session with new rules for strolling and standing, Elmer went on to study for about two years with Brourman, transferred the lessons to her yoga and Pilates students and became the first gait therapist Brourman certified.
Courses now are held around the world, and Brourman has certified nine other therapists.
"For the amount we walk in our everyday life, we focus on it so little," Elmer told Rasa workshop participants by way of introduction.
About half of the 18 participants were training toward yoga certification, but the rest related their pains, past surgeries and concerns over minor skeletal deformities that nevertheless could have major consequences years down the road.
Miller suspects that years of turning her right foot out while walking likely contributed to arthritis in that hip and her recent joint replacement. Also a lifelong dancer, Miller says a dance-related injury could have originated the overcompensation on her body's right side.
"The body will compensate in amazing ways instead of using muscle effort," says Elmer.
The most common method of compensating is locking the knees while walking and standing. Every workshop participant displayed this joint-dependent habit to some degree, says Elmer. Knowledge of or proficiency in yoga usually has no correlation to a proper walking gait, she adds.
"Most people lock their knees when they walk, she says. "Most people don't use their feet efficiently. Most people don't use their core."
Locking the joints not only lets muscles off the hook, it wears away at bone and connective tissue. So Elmer spent the first hour of the two-hour workshop showing participants how to bend their knees through their strides and lengthening the distance between their feet, all while feeling equal weight on the inner and outer balls of the feet and the center of the heel.
"A lot of people don't have any awareness in their feet," says Elmer. "How we use our feet is going to affect how everything else is working."
If one's foot doesn't adequately compress onto the walking surface, she explains, the absence of momentum means muscles struggle to lift it up. She advises clients to envision "1,000 little suction cups" on the sole of the foot gripping the floor. Knees are bent midstride in a "little lunge," she adds. Proficient walkers really do have a slight "spring in their step."
Some people need to stretch their calves or Achilles tendon to extend their stride while others need to strengthen their inner thighs, says Elmer. The foot's placement behind the body while walking is just as important as its placement in front, she adds. A proper gait should include the most brief moment when one's weight is borne entirely on a single leg.
"We want to find just that split second of balance," says Elmer. "It's hard for people to find that middle ground."
Centering the torso on the hips was participants' task for the second hour. Elmer uses the image of a bowl for the pelvis with a second bowl, representing the torso, set upside down over it.
Yoga poses that "open" the chest or "heart," pressing the chest forward, actually compress joints in the lower back, says Elmer, while jutting the hips forward weakens muscles that should be supporting the spine. Back-bends are beneficial in the context of practicing yoga, but the human body shouldn't be perpetually in one, says Elmer.
Walking backwards is a good way to take pressure off the lower back and knees, she says. Walking on tiptoe helps strengthen the foot's arch. Bending the knees just a few inches rather than at a 90-degree angle works muscles around the joint.
With gait techniques, these exercises can be practiced in five-minute increments several times per day to set one's feet on the path to wellness.