Podcast Summary: The MSing Link with Dr. Gretchen Hawley Episode 277: Your MS Questions Answered: Walking, Hip Weakness & Leg Pain Date: March 25, 2026

Episode Overview

In this special Q&A episode, Dr. Gretchen Hawley, physical therapist and multiple sclerosis specialist, answers real-life MS-related questions from her Missing Link program members. The episode covers practical advice and research-driven strategies addressing walking challenges, hip weakness, pain differentiation, neuroplasticity, adaptive devices, and symptom management. Listeners gain insights into MS-specific exercises, assistive technologies, and maintaining motivation during symptom flares—all delivered in Dr. Gretchen’s empathetic and motivational style.

Key Discussion Points & Insights

1. Addressing Uneven Walking Patterns

(02:30 – 17:30)

• Member Question: Weaker left leg “stays behind” when walking, feels heavy, and makes walking more challenging.
• Dr. Gretchen’s Insight:
  • Step-to vs. Step-through Gait: Problem often presents as a “step-to” gait versus a “step-through” gait.
  • Possible Causes:
    • Hip flexor weakness
    • Knee/hamstring weakness
    • Ankle dorsiflexion limitation
    • Tightness/spasticity in glutes, hamstrings, or low back
    • Neural adaptation (“learned” patterns due to MS)
  • Exercise Recommendations:
    • Hip flexion/marching exercises (seated, standing, or lying)
    • Hamstring curls/leg kicks for knee mobility
    • Ankle dorsiflexion exercises
    • Figure four and hamstring stretches to target tightness
    • Practice exaggerated step-through motions, using slippery surfaces as needed
    • “Single step” exercise to retrain full stride
  • Quote (10:57): “The more strength you have, the more forward your leg will come. That often requires more knee bend and ideally, ankle dorsiflexion. Strengthen your hip flexors and hamstrings—those marching and leg kick exercises make a big difference.”

2. Sagging Hip and Trendelenburg Gait

(17:45 – 23:40)

• Member Question: Right hip “sags” when walking with a cane on the left side. Is this hip weakness?
• Dr. Gretchen’s Insight:
  • Trendelenburg Gait: Typically reflects gluteus medius weakness on the stance leg side (often the “stronger” leg).
  • Recommended Exercises:
    • Seated clamshells
    • Side steps/kicks to strengthen glute muscles
    • Weight shifting and single leg stance (with support if needed)
  • Quote (19:50): “A lot of people assume the issue’s on the side that drops, but more times than not, it’s weakness on the opposite hip—especially the gluteus medius.”

3. Vibration Plate Therapy – Community Perspectives

(23:45 – 33:30)

• Member Question: Experiences with vibration plates for MS symptoms (balance, numbness, spasticity)?
• Dr. Gretchen’s Insight:
  • She’s not personally used it in clinical practice due to logistics, but many Missing Link members report:
    • Improved balance
    • Reduced numbness and tingling
    • Looser muscles and decreased spasms
    • Muscle soreness initially, so start slow
    • Improvements do not depend on long sessions—1–10 minutes can be impactful
    • Sensory overload possible; start with low intensity or use seated modalities if needed
    • Vibration balls or foot massagers can be a gentler alternative for some
  • Member Feedback:
    • “It does loosen up my spasms and decreases pain in legs.” (31:50)
    • “I tried vibration therapy at a clinic… it felt like sensory overload and triggered paresthesia, so I started smaller with a vibration ball.” – Amy (29:15)
  • Quote (27:05): “The science of vibration means your muscles do have to work, even just standing on it. It’s really good for balance and overall movement, and you don’t need long sessions to see benefits.”

4. Neuroplasticity’s Hope for All Stages and Lesion Types

(33:40 – 44:00)

• Member Comment: “Neuroplasticity always gives me hope. I just need to be patient with the baby steps.”
• Dr. Gretchen’s Insight:
  • Neuroplasticity allows the brain to strengthen existing neural pathways and form new ones—even years after symptoms or with spinal lesions.
  • Success is defined by effort, not visible movement: “The more effort you put in, the more likely your brain is to form new or stronger connections.” (41:10)
  • Visualization and focused effort can amplify neuroplastic change.
  • Applies not just to movement, but also to mindset, speech recovery, and more.
  • Research is strongest for brain lesions but applies logically to spinal lesions too; all neurologists and MS researchers she consults agree on this hope.
  • Quote (38:55): “If you can explain what neuroplasticity is, you really understand the possibilities—especially during flare-ups or seasons where movement feels harder.”

5. Differentiating Leg Pain Types in MS

(44:10 – 50:30)

• Member Question: How to tell the difference between neurological pain, muscle atrophy, and muscle shortening/spasticity?
• Dr. Gretchen’s Insight:
  • Neuropathic Pain: Due to misfiring neural pathways (often burning, stabbing, or dull, not tied to specific movements).
  • Muscle Atrophy: Noticeable shrinkage/weakness in certain muscles (e.g., smaller calf), best managed with strength training.
  • Spasticity: Muscle shortens and restricts movement—painful when stretching; best managed with stretching, sometimes combined with medication or targeted treatments (e.g., Baclofen pump, Botox).
  • Quote (45:51): “Spasticity is when your muscle contracts involuntarily, and if you try to straighten it, you might not be able to—or it’s painful. How you manage each kind of pain is very different.”

6. Assistive Devices: Thoughts on the Zine

(50:45 – 53:30)

• Member Question: Experiences or opinions on the Zine mobility device?
• Dr. Gretchen’s Insight:
  • Unique device that provides fall protection with a built-in seat and handrails
  • Useful for those needing to alternate between walking and sitting
  • Bulky compared to other mobility aids but offers safety and endurance benefits
  • Some Missing Link members use it for exercising and community events
  • Quote (52:01): "If you fall, the seat belt keeps you up, and the seat stays as is. It does prevent the fall...great for mixing walking with standing exercises safely.”

7. Additional Member Questions & Noteworthy Tips

(55:00 – 1:03:00)

• Symptom Exacerbation after Emotional Distress: Proactive or preemptive stretching/relaxation before distressful periods can help; keep a written list of what works for you for quick reference.
• Stretching the Biceps: Full elbow extension, with arm behind you or on the side of a chair can help; massage or vibration can assist if stretches don’t seem effective.
• Adaptive and Cognitive Exercises:
  • Use of “Bop It” kids' game for neuroplasticity/brain-challenge exercises; can be adapted for rest breaks and to encourage fun, focused repetition.
  • Quote (56:40): “It’s a brain game—a really fantastic way to work neuroplasticity. Try to beat your high score during your rest time between exercises.”
• Feedback on Missing Link Classes: New offerings include Zumba (well received) and an upcoming strength class using resistance (weights, bands, or cans).

Notable Quotes & Memorable Moments

• On Neuroplasticity:
  “Success is not how much movement you see. Success is how much effort you’re putting in. Every repetition truly, truly matters.” – Dr. Gretchen (41:10)
• On Using Assistive Technology:
  “If you fall, the seat belt keeps you up… I purposely tripped and it catches you. It does prevent a fall.” – Dr. Gretchen on the Zine (52:01)
• On Vibration Plate Therapy:
  “You don't have to use it for that long. One minute, up to five—people see improvements without needing a 30-minute session.” – Dr. Gretchen (26:25)
• On Neuroplasticity and Spinal Lesions:
  “Can new pathways be made after a few years? Yes—it just may take longer. Our brains are always capable.” – Dr. Gretchen (48:24)
• On Exercise Success:
  “Don’t think of success as the amount of visible movement. Think of it as the amount of effort you put in. That’s where the gains happen.” (57:55)

Timestamps for Key Segments

• 02:30 Walking difficulties & step-through/step-to gait
• 10:57 Hip/knee/ankle strengthening advice
• 17:45 Hip sagging & Trendelenburg gait
• 23:45 Vibration plate therapy – pros, cons, member experiences
• 33:40 Neuroplasticity explanation & hope for longstanding symptoms
• 44:10 Differentiating leg pain types
• 50:45 Zine mobility device discussion
• 55:00 Pain, stress & stretching strategies
• 56:40 “Bop It” for brain training and neuroplasticity
• 58:10 Feedback on classes & adaptive activities

Episode Tone and Conclusion

Dr. Gretchen’s supportive, empowering approach encourages listeners to experiment with new strategies, prioritize effort over outcome, and utilize community wisdom. Member contributions (with first names) enrich the episode, showing it’s a collaborative, positive community focused on real-world progress, hope, and adaptive living with MS.

For more resources, demonstrations, and to join future live Q&As, listeners are encouraged to explore the Missing Link program and its Facebook Community.

If you’re seeking actionable MS advice and genuine community, this episode is a vault of practical wisdom—perfect for MS warriors at every stage.