THHE CLINIC: After a Stroke, Blood Flow Problems?

QUESTION:

I am a 44-year-old brain stem stroke survivor, very fit before my illness. Most of my deficits are involuntary (such as balance problems), and not muscle-control related. I am running again but at about 45 minutes into the run, I experience cramping in my left foot and lose control of my left ankle and foot. Is this what is known as spasticity? Is there anything I can do to reduce this? I’d like to be able to run longer, and I certainly can’t see myself giving up running.

Jay Smith
Annapolis, MD

ANSWER:Muscle spasticity during exercise is not uncommon in your situation, and may represent blood flow problems triggered by the running. Most neurologists would probably caution you about running, which is vigorous exercise, but as a runner I appreciate your addiction. Before asking you to abandon the exercise, I advise you to take a treadmill stress test—not to evaluate your heart, but your blood pressure, during running. If it is aberrant, taking an appropriate medication might spare you complications and be helpful to alleviate your symptoms.

Ron Lawrence, MD
Santa Barbara, CA

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