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Just Clumsy, or Something Serious?
Experts explain when being clumsy is
a sign of medical trouble, or just plain klutziness
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By Mathew Hoffman, MD
WebMD Feature
Feb, 2007 --
We've all done a pretty good
impression of Inspector Clousseau at one time or
another. Knocking over coffee cups, dropping keys,
tripping over rugs - sometimes life feels like a
slapstick comedy, and you're the star.
Can
klutziness be cured? If episodes of clumsiness
happen more frequently, how can you tell if it's
something serious -- or just a temporary case of the
fumbles? Our experts tell us what to look for (and
not trip over) as we explore this common problem.
Coordination: An Overview
As
clumsy as you may feel, you're more coordinated than
you think. It takes a genuine miracle of
synchronized muscles, bones, and nerves just to get
up and walk across the room.
"Coordination of the body is an extremely
complicated process that involves input from both
motor and sensory systems," explains Taylor
Harrison, MD, clinical instructor in the
neuromuscular division of the Emory University
department of neurology in Atlanta.
Here's how our body parts work together:
Our
eyes provide a constant stream of information about
our surroundings and our position in space.
The
brain and nerves are our command-and-control
"wiring," carrying the messages on how and where to
move down to the muscles.
The
cerebellum is the part of the brain that specializes
in coordination and balance. About the size of an
orange, it's located under the brain at the back of
the head. The cerebellum "talks" constantly to other
parts of the brain to maintain balance, posture, and
fluid movements.
Muscles and bones carry out the instructions
transmitted by nerves, creating movement.
Normally these systems work together, playing off
each other like an orchestra performing a symphony
in perfect tune.
"Problems in any of these areas may give rise to
problems with coordination," says Harrison. Some of
the most common culprits are:
-
Poor vision
-
Strokes or head injuries, especially to the
cerebellum
-
ArthritisArthritis
-
Muscle weakness
-
Inactivity
-
Infections or illnesses
-
FatigueFatigue and stressstress
-
Medicines
-
Alcohol and drug use
All
of these causes of clumsiness can be treated or
reversed completely, so it's important to eliminate
them as possible contributors. Your doctor can help
you with this.
Steps to Cut the Risk of Falls
Perhaps the ultimate in clumsiness is actually
losing your balance and falling down. If you or an
aging parent frequently trips or falls, take it
seriously. Falls can cause permanent disability, and
many are preventable.
According to the CDC, a few simple steps can reduce
the risk of falls:
1.
Begin a regular exercise program. Exercise increases
strength and balance. Your doctor can help you
design an effective program for your level of
fitness.
2.
Make your home safer by taking actions like these:
-
Take all clutter off stairs.
-
Turn lights on when you get up to use the
bathroom at night.
-
Tape down the edges of rugs with double-sided
tape.
-
Have handrails placed on all staircases, and put
grab bars in shower stalls.
3.
Ask your doctor to review your medicines. "Many
medicines have dizziness as a side effect, and this
can certainly contribute to falls or clumsiness,"
says Erica Duncan, MD, associate professor of
psychiatry at the Veterans Administration Medical
Center in Decatur, Ga. If you suspect side effects
from your medications, discuss this with your doctor
to confirm and see what alternatives are available.
4.
Have your vision checked. You may have a treatable
vision problem like cataracts or glaucoma -- or just
need a new prescription.
Clumsiness: When It's Serious
When
does clumsiness merit a trip to the doctor? The
answer is -- whenever you think there might be a
problem. We asked Harrison about three real-life
cases of clumsiness; all were patients of this
writer over the last three years. Their names have
been changed. Do you see yourself in any of these
common scenarios?
A
Keyed-Up Programmer
Dave, a 25-year-old computer programmer, felt the
heat at work. He said deadlines made him klutzy, and
he felt like he was knocking something over every
time he turned around. This also happened the last
time he had a big project due.
Diagnosis: routine life stress.
"It's important to remember that simple things like
lack of sleep, skipping meals, or stressful
situations might affect our dexterity," says
Harrison. Taking care of ourselves when times get
tough is the best medicine for this brand of the
butterfingers.
High Sugar, Clumsy Feet
Arvind, 52, has lived with diabetes for almost 15
years. Sometimes he controlled his blood glucose
levels tightly; other times, he let it slip. But
Arvind noticed more and more that he was tripping on
rugs and the edges of stairs. He also felt that it
was harder to keep his balance at night.
Diagnosis: nerve damage caused by diabetes.
"Peripheral neuropathy is a disease of nerves
associated with sensory loss in the hands and feet,
and can affect coordination," according to Harrison.
Tight control of blood sugar is essential for
diabetes patients to avoid this complication, which
can lead to serious foot ulcers.
A
Gardener's Growing Problem
Madeline, a 68-year-old woman, loves to garden.
Recently she felt her right hand get heavy and numb
while planting flowers. She said it felt like it
went dead on her. This lasted only a few minutes
before returning completely to normal. She
remembered an almost identical episode about a year
ago.
Diagnosis: transient ischemic attack (TIA), or
"mini-stroke."
"This is serious," says Harrison, because TIAs make
a "real" stroke more likely in the future.
"Identifying risk factors for stroke, like diabetes,
high blood pressure, and smoking," and treating
those risk factors, will reduce the risk of stroke,
adds Harrison.
Initial symptoms of stroke and TIA can be the same.
The
American Stroke Association lists these warning
signs of a possible stroke:
-
Sudden numbness or weakness of the face, arm, or
leg, especially on one side of the body.
-
Sudden confusion, trouble speaking, or
understanding.
-
Sudden trouble seeing in one or both eyes.
-
Sudden trouble walking, dizziness, loss of
balance, or coordination.
-
Sudden, severe headache with no known cause.
Call
for emergency medical help at the first sign of
those symptoms. Don't wait to see if they go away
and don't judge for yourself how bad they are.
Can a Klutz Be Cured?
While it's necessary to rule out medical causes of
clumsiness, the vast majority of people with
coordination problems are medically "normal." What
about the millions of us who are just tired of
bumping into walls and banging shins on coffee
tables? Can a normal (but clumsy) person improve his
or her coordination? In other words, can a klutz be
cured?
The
answer is yes, according to Jim Buskirk, a physical
therapist and co-founder of the Dizziness and
Balance Center in Chicago. "The same techniques that
we use to help people with strokes can be used to
enhance performance in people without disabilities."
Buskirk uses these techniques to help athletes like
members of the Chicago Wolves, a professional hockey
team, improve eye-hand eye-foot coordination. "A
lot of it is vision training," Buskirk says, as
"when athletes say in interviews, 'I'm seeing the
ball better.'"
The
key is exercises which give a workout to the vision
and balance circuits. They are called "vestibulo-ocular
reflex (VOR) exercises." Simply put, the VOR is made
up of the connections between your eyes and brain
that help you track objects. Eye-hand coordination
depends on the VOR.
VOR
exercises are proven to help improve performance in
brain-injured patients. In normal people, the
benefits, if any, are much harder to measure. A
physical therapist can provide tools or exercises
designed to develop the VOR, and methods are
available on the Internet.
Good
old-fashioned exercise may be the best cure for the
common klutz, says Harrison. "Individuals with
coordination problems may see improvement after
regular exercise in dancing, aerobics, or even yoga
or tai chi," which emphasize balance. "Experiment
with different activities before finding one that's
right for you," he adds.
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Source - WebMD Inc. All rights reserved. |
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