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Weak Calf Muscle

creccre Posts: 44
I have had back issues from getting hit from behind in a car accident years ago. I would be down for a few days and then be fine. I was extremely healthy and active. I snowboarded, skied, and spend 3-4 days a week at the gym. My gym exercises were limited after the accident and I had therapy, but I was in good relative health. No one could seam to give me a straight answer on my lower back “awareness” or pain. I wish I would have been able to get better answers before my latest problem. I am currently 33 years old. On March 25 2009 I woke up and sneezed. I felt it down my spine, and down both arms and legs, but it stayed in the left leg. After a few minutes I tried to get out of bed. I was done.
I got an MRI and have “disk herniation narrow based. The protrudes into the left lateral recess and displaces the nerve root. The herniation measures 1 cm in diameter”.
I went home that night and that’s when things became the worst. I tried to get up and my calf and thigh just kept tightening. I was shaking in bed trying to find a position to stop the pain and cramping. I relieved it by taking a muscle relaxer. I was on 6x the prescribed amount for the first 2 days. Within a week I was off them completely. I slowly made progress becoming more and more mobile. It was a slow process, but I could see small results each day. I remember looking at both my calf muscles a several days after. It was like they disappeared. Just 2 flabby areas of skin where muscles used to be. I remember my left calf muscle had no strength. I started the decompression table and chiropractic April 3, 2009. The goal was trying to suck the disk back in. From the first night my calf had no strength. I also got an inversion table at my house and hung upside down twice a day for 15 minutes on my non chiropractic days. I got a cane to help me get to the chiropractor on April 3rd. I also bought an on line guide to healing a herniated disk. It had a lot of great information which I used. It is almost a month later and I can walk on my own, but still have almost complete calf weakness in my left leg. I just realized that today when I was asked to stand on my toes. I could easily do it with my right leg, but not with my left. I have noticed that I am making progress with walking better. At first I could only walk for just under a minute. Now if needed I can walk for over 10 and am taking bigger strides.
Now that I realized just how weak my left calf muscle is we are looking at surgery. My left calf muscle has made a significant improvement in size and I am walking better this past week. I will be getting surgical consults for Percutaneous Laser Disc Decompression and microdiscectomy this week. While I am getting the surgical consults, I will be evaluating my left calf strength. I plan on deciding the best plan of action in the days to come. The main thing I need to figure out over the next few days is: is my calf getting better, worse or staying the same.
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Comments

  • Welcome to the board. Sorry for the reasons that you have found us.

    When you say "we", as in "we are looking at surgery," are you referring to a doctor and you? What type of doctors have you consulted with thus far?

    It sounds like you are slowly, but steadily making some improvement. It also sounds like you are doing your homework. Read all you can on your condition. The more you know, the better you will be able to communicate with your doctor. I would suggest finding a fellowship trained spinal specialist, if you have not already done so. This can be either a neurosurgeon or an orthopedic surgeon who has served a fellowship in the spine, and who devotes his practice to issues of the back and spine.

    If you decide to have surgery, you want to get it right the first time, so take your time in choosing a specialist that you trust and are comfortable with.
  • When I say “we” I am talking about me and my chiropractor. He is very knowledgeable and has helped many of my friends, when others could not. Having said that, “I” am doing all of the research I can to try to make this decision.
    I am slowly improving and would like to find a non surgical solution. The calf weakness is very scary. I don’t want to damage my nerves and not be able to walk correctly. As I said, this is VERY scary.
  • Usually most lumbar spine surgeries are elective. (Of course I am not talking about a trauma where the spinal cord is snapped -- I'm talking about lumbar issues.) The only time surgery is done on an emergency basis is when there is bowel or bladder involvement or foot drop. Numbness and weakness are not considered a medical emergency. Most people with a disk herniation or stenosis experience some muscle weakness and/or numbness. Most often, it goes away when the herniation is resolved and the nerve is no longer compressed. This resolution can happen through natural healing or through surgical intervention.

    To hurry this process along, a next step is to have some type of epidural spinal injection. It is fairly common to do this in a series of three. Often it is a gradual process to get the situation to resolve.

    I would suggest you find a spinal specialist to advise you about your muscle weakness and to be sure that you have no other issues than the disk herniation...something a chiropractor might not see.
  • I read through the thread pertaining to laser surgery and just wanted to add that with both the spinal compression like the DRX 9000 and with laser surgery, I have seen a number of posts from others that the results were not long lasting.

    Did you run a search on this board to see older posts on the laser surgery topic?

    Not all disk herniations can be treated endoscopically.
  • Thanks Gwennie.
    I sent my MRI results of to an institute in Tampa. I am a type A personality (very

    humbled at the moment). After my initial consult, I politely pushed a little bit

    and talked the nice lady into having a doctor call me with further questions. The

    doctor called back and was very good at answering all of my questions (not that she

    wasn’t also very good). My symptoms, calf weakness, nerve damage. He also spent a

    great deal of time explaining the differences between Percutaneous Laser Disc

    Decompression and microdiscectomy. That was something I wanted explained in depth.

    They made a very good first impression. They also sent me a full page of lumbar

    references.
    I am also in the process of having my MRI scans sent to New York for a different

    doctor to review. I will be asking the same questions. My goal is to figure out

    the best path next week. I will be talking to my chiropractor about this in length

    over the next few sessions we have.
    In the mean time I am already using the DRX 9000 decompression table 3 times a week.

    I am also doing chiropractic, massage, cold laser, and muscle stem. Today was an

    off day. I walked for 3 minutes while focusing on using my calf while walking. I

    plan on doing this every day without overdoing it. I am also using my inversion

    table 2-4 times a day on my non therapy days. I spend 5 minutes in the morning and

    evening lightly bouncing on my bouncy ball. I am also icing my back several times a

    day.
    I feel the tip of my third smallest toe, and my calf is a little soar from the 3

    minute walk. Other than that, just another day in bed with lots of liquids. I

    continue to see better movement.
  • I mailed my MRI scans off to NY yesterday. I have continued the decompression table, inversion table, Ice, Ice, Ice, massage, muscle stim, cold laser, and chiropractor. I am also doing some mild stretches now. I still have very little strength in my left calf, but am starting to use it more when walking. I walked, making a concentrated effort to use it, for 3 minutes on Thursday. We will see how I do today. I do notice that I am using it more and more when walking. I continue to gain mobility each day.
    Surgery seems very likely at this point, but I am holding on to the hope that I may be able to avoid it if I continue to see improvement and my calf strength comes back. I am hoping the therapy and decompression table will suck the disk off the nerve and the calf will respond. We will see.
  • In addition to my daily routine, I walked for 10 minutes yesterday using my calf. I noticed a SMALL improvement. My calf was a little soar later in the day. It was mild and the type of sourness you would get the day after your first day back at the gym. I did another 10 minutes this morning and plan another 10 minutes tonight as long as nothing starts to bother me. I am not using a cane at all, but carry it with me in the event my muscle cramps. I am clearly walking better today. I still don’t have near enough calf strength to stand on my left toes, but I do see improvement.
    I am not focusing on working out my calf excessively because I don’t think that is my problem. I am constantly icing, decompression, and inversion with the hope I can reduce inflammation and the herniation. It is a shot in the dark, but what else can I do?

    A week or two ago I noticed that once every day or so I would get a pin prick on the outside middle pad of my foot. This would usually happen when I was on the inversion table. It happened for the first time on the ball of my foot today once. I noticed the top pad of my foot near my three smallest toes seemed to be slightly puffy and tender yesterday. It was really tender, tingly and puffy several weeks ago when I first started walking with a cane. I keep feeling all of my toes and each pad of my foot and can feel everything fine. Not sure what that means. I will ask the chiropractor tomorrow and also ask the NY surgeon when he looks over my MRI this coming week. Mobility and range of movement continue to improve.
    I have some small glimmer of hope that this will continue and I may avoid surgery. If this continues and I am walking correctly again I am going to get another MRI to see where I am at. If I do get to that point the new goal will be, how do I strengthen the muscles and disks to prevent this from happening again or progressing into something worse.
  • Hi!, I am also buttling weakness but in my big toe (l4-l5 hernia).First few weeks after it went totally paralized (I was not able to move my toe up at all and had a slight drop foot) I did not see any improvement, but it did not get worse either. NOw 5 month after the insident, I can move it alright, but not against resistance. Drop foot is gone, but I still have drop-toe. However I do not feel that weakness anymore. It has been improving slowly, but I probably stay like this. I saw 3 surgeons and they did not recomeneded surgery due to some other disk issues that I have and due to the fact that I was imroving. Since it has been over a month since your injury you might as weel wait few more months to see your progress. I've been told that unless you do surgery immediatly, there is no difference if you do it after a month or 4 month or 6 months. I also told that surgery is only effective 50% in removing weakness. Sad...
  • I am still researching doctors and procedures. I am also working on getting a better definition of success regarding the weakness and the time line.
    As for my update. I had treatments yesterday. I have been driving to my appointments for a week now. No driving other than to and from appointments. I don’t want to aggravate anything. Still seeing better movement. My calf was a little tight yesterday so I skipped my 10 minute walk. Just normal walking around the house. The pad of my foot below my toes was a little tender/tingly last night and continues this morning. I am very cautious with it. No pricking of my heel or the outside pad of my foot just above it. All toes feeling almost identical. No pricking on the outside of the top left part of the 3rd toe. Now it is just an occasional feeling that it is there.
    On a slightly amusing note, the neighbors are probably starting to wonder about me. Every day they see me walking around my pool in circles, carrying a cane, followed by my two dogs. I use this area for my 10 minute walk to protect me from trouble. I would hate to be a block away and have an issue.
  • You certainly are doing everything you can to give yourself a very good chance of recovery without having to have surgery at the moment.

    I just wanted to tell you that I had sciatic pain (and a compressed nerve) for over 3 years. I had little feeling in my toes and I could not raise up on my toes. I had a fusion in Jan. 2008 and I can now stand on that leg on my toes. It has taken awhile, but I can not do it. I suffered no permanent nerve damage, even though the nerve was severely compressed for probably about 4 years.

    How are you feeling by now?
  • Xe-xe - pool in circles! You remind me of myself during the first month : I used walker and made trips from one end of the hallway to the other. It was fall/winter and I could not go outside. So, tell me more about inversion table - I am thinking about one.
  • I am guessing that my two separate 10 minute walks on Sunday may have been too much too fast. Maybe it is my sciatica nerve getting progressively worse. Not sure. I thought I was making good progress and am light years ahead of where I started. Everything else continues to improve and I am walking better. My calf was sour Monday and Tuesday. Yesterday I started taking my daily walk around the pool and realized this may be a bad idea. I was cautious. 3 minutes into the walk my muscles started tightening. I stopped immediately and went in, iced my back and relaxed. I am going to take it very easy for a few days and see where I am at. Tuesday night I could feel the pad on my foot right below the three toes acting a bit sensitive. No issues walking, just sensitive. That continues on and off. I had it a bit this morning, but once I started walking on it, it seems ok. Still very cautious. The outside of my calf is a bit soar. It is definitely the outside part of the muscle and not the nerve. My nerve down my leg has been tender, during massage and chiropractic visits, threw this whole thing. It is slowly becoming less tender. I am fairly sure I can tell the difference between the muscle and the nerve. The underside of my thigh is a bit tenderer than over the weekend. I believe that is the nerve. Simply relaxing and going to the chiropractor today. No walks around the pool.
    NY hasn’t received my scans yet. Following up with a tracking number. I found another back surgery institute that seems to be different than the others. They are in California. They don’t do an incision at all. The scar is supposed to be the size of a freckle and the surgery is supposed to be the least invasive. I sent my MRI off and will run thru the same list of questions with them.
    My main concern is getting worse, vs getting better. I don’t want to be letting my nerve die. If there is a REASONABLE natural healing path without surgery, great. If not or the risks are too great, I am all for surgery. It just bothers me that making the wrong choice could leave me in a worse spot than I am currently in.
    Anyway, that’s my update.

    Gwennie,
    I am glad to hear you got better after surgery. How long after your surgery were you able to raise up on your toes again?

    Metoo,
    I am not sure about the inversion table, chiropractic, decompression table treatments, any of it. I am reading as much as I can and trying to do the most logical things to help. I am DRASTICALLY better than when this first happened. I am not sure which things or if it all together is helping. I know that when I got on the decompression table the first few times (and still once in a while) some of my symptoms go away. The very light tingling in the feet for example. The calf usually relaxes if it is feeling a little aggravated laying on the triangle pad they put below my legs. I started slow on the inversion table. I can tell that I seem to stretch out about an inch or so by the time I get off. I can feel the end of the table above my head when I start, and a bit lower when I get to my 15 minutes. My first goal is to see if I can possibly get the herniation to reduce itself thru everything I am doing now. I am considering another MRI later this week or early next to compare. If I could somehow get to that point and continue improvement when walking, I would move on to other stretches and exercises to slowly strengthen my back. That is the plan at the moment.
  • My point in telling you about being able to raise up on my toes was to point out that my L5 nerve was BADLY compressed for about 4 years and I suffered no permanent nerve damage.

    Given the symptoms you describe, I think it is highly unlikely that you will damage the nerve by waiting. I think you have plenty of time to try all conservative methods.

    Also while reading about your walks around the pool, it occurred to me that you may be putting too much stress on particular muscles by repetitious use. Maybe this is comparable to walking around a track in one direction??

    Do you vary the direction you are walking? How tight are the corners you make when walking around the pool, etc.??

    Did you find this information?

    http://www.spine-health.com/wellness/exercise/exercise-sciatica-a-herniated-disc

    You could be doing this type of exercise now....
  • Cre -
    1) the pain you are describing is a nerve pain. I had (and still sometimes) have this pain, sometimes it feels like a sprain ankle (muscle) or on top of the sKin or deep inside. One of my DR said that it is all nerve pain. My PT said otherwise and he even taped my anckle, but in this case I whould belive a doctor.
    2) You are very early into recovery. My first 2 months were continious cycle of flare up and feeling better, then flare up again. I am 5+ month now and have monir flare ups every week or so, they are better next day. At the beggining they were longer. o not be discoraged!
    3) I can recommend to look at the Dr Bookspan website - google it. If anything , it is inspirational. I found it helpful for functional training.
    4) I am doing the first 3 excercises mentioned above every single day many times a day
  • Thanks for the info every one. I have had a long week and haven’t made any posts. The pricking pains intermittently continued and started in the pad of my heel. I was also noticing that the calf and thigh were acting up. Some of this could likely be attributed to doing too much with my walking too quickly.
    I believe my realization came in a couple of ways. After a few surgical consults I found out more about my MRI. My herniation is 1 cm. I have been informed that many people do operations with a herniation 3 or 4 mm. Even though my mobility was slowly increasing I seemed to be at a plateau. I was trying to slowly improve calf strength that was clearly caused by the pinched nerve. If it got any worse or progressed I could easily be forced into emergency surgery. I came to the realization that I needed to take further action on the cause and not the symptoms.
    I don’t like the odds and definitions of success on most of the surgeries. Even though Microdiscectomy appears to be far less evasive than normal back surgery, I am not comfortable with the definition of success. I also am not comfortable with the 20% chance of going back for another similar surgery in the years to come. I a scared of scarring and complications.
    I talked to the PLDD (Percutaneous Laser Disc Decompression) doctor who created the procedure in New York. Despite what some doctors have tried to tell me, this is nothing like a Microdiscectomy. There are other surgeons through out the US doing significantly different types of this procedure. This doctor in New York seemed very knowledgeable and told me that I should come see him. I seriously considered it. I would have tried this before the Microdiscectomy. I really was attracted to the minimal evasiveness of the procedure. I was also encouraged that this doctor actually developed this procedure. In my opinion, he is clearly the most knowledgeable regarding this procedure.
    I decided against the PLDD because of the 80-89 percent success rate. The size of my herniation concerns me. Since mine is larger than most, it seams my likely hood of success would be far less than a 3-6 mm herniation.
    I found a different type of surgery. One of the most upsetting parts of this process is the difficulty in finding information and the differences of opinions. It seems that everyone sticks to what they know and wont look outside there own box. I found a “Non Traumatic Discectomy” in Beverly Hills. The incision during surgery is not an incision at all. The scar is the size of a freckle. The procedure seems to be the least invasive and the smallest in size. They do not go thru the bone of the vertebrae. They gain access to the herniation without removing bone. It appears to have the least likelihood of complications and scarring. I was very impressed by the testimonials. There references were exactly what I have been looking for. I like the definition of success and there success rates. It appears to be my best choice.
    They reviewed my MRI last week. The surgeon answered all of my questions to my satisfaction. I flew out Monday. I completed my EKG, blood work, and consultation today. They will map my spine out and perform surgery tomorrow.
  • Surgery went well. They went in the first time (8am) and shot dye into different parts of my spine. They brought me back out and sent me out for a CAT scan. I was back that afternoon. Their morning surgery on a different patient went late so my 1pm appointment turned into a 4pm surgery. I think I was back out around 6 or 7. I am not sure to be honest. They said it went very well. They had no complications during surgery. I don’t have any signs of complications that I can see. My hips felt slightly sore last night. They are not sore today. I haven’t taken any pain meds. I iced my back 3 times last night. The tightness in my back is gone. I feel a bit different (not sure how much of that is mental). I can’t quite put my finger on it. I am still cautious walking. No pin pricking in the pads of my feet. My 3 little toes feel slightly different. They said I could have a few shooting pains down my leg, but I haven’t had any yet. I go in later this morning for my post evaluation. I am scheduled to fly home today. I hope this progresses and I continue to recover.
  • Post operation evaluation yesterday went well. No shooting pains. No pricking in the right foot. I do still have the occasional pricking on my 3rd smallest toe. That was the first thing I noticed when my back went out. I tried to stand up on my toes with my right leg and had some movement.
    Flew from LAX to ATL, spent the night in Atlanta and took my last flight to Panama City this morning. Actually made it thru the airport without a wheelchair on the way back. I was still walking very slow. Trying to take it very easy. Still no pain pills needed. They did put a spinal block in during surgery. I need to do more research to gain a better understanding of the spinal block.
    My goal is to take it easy and recover. I would really like to avoid reherniating my disk. I see a lot of posts here about multiple herniations and I am defiantly trying to avoid future problems if possible. They took 2 ½ inches of stuff out. I am icing 3-4 times a day and on the anti-inflammatorys. I will look into therapy next week. I do seam to be walking better, but I am not going to try to push myself in any way.
    I hope I continue to progress. I am going to make every effort to put myself on a path to the best recovery possible.
    I am a bit on the optimistic side. The surgery was very seamless. No stitches and just a bandage. It went just like their references said it would. I still haven’t seen the entry point for the surgery. They told me the bandage should come off on its own in the next week or so. I am keeping my fingers crossed that things continue to improve without any setbacks.
  • You are a man of ACTION. Not only did you decide what to do, but you flew across the country to get it done.

    I am sending my very best wishes for a speedy recovery. I hope this procedure works out well for you and solves your back problems.

    I will be interested in learning more about what you had done and how you even heard about the surgeon, etc.

    Take it easy now and give yourself a chance to thoroughly heal and recover.

    Cheers!

    Gwennie
  • You flew from LAX (my hometown) to ATL (my adopted town) and drove to panama City? Wow...you're brave or superman or something! I'm curious about 2 1/2 inches of "stuff"? What was it, where was it, was it calcified, how are you today? What constitutes a "non traumatic discectomy"? Is this a surgery using a laser? Where in L.A. do you live? I was born and raised there and still have many friends and too much family located in L.A. Sorry, I'm something of a curious cat!
  • I am trying to not get in trouble with the forum rules. I really like this site and have used this forum for support, and reference when talking to different doctors and surgeons. It makes it a lot easier to refer back thru time.
    From day one I was hoping that I could find some unbiased guide to the different types of surgery. I am not sure the best way to evaluate different procedures, but there has to be something better than what we currently have. It really bothered me that it is 2009 and surgeons still seem to need to cut thru bone to get to a herniated disk. HOW CAN THIS BE, IT IS 2009. Haven’t we made any technological advances? Turns out there are and some surgeons have been doing it for over 10 years.

    The neurosurgeon who does this procedure refers to it as “non traumatic discectomy”. If you do a Google search for that phrase you will find him as the first result with his office in Beverly Hills.

    I am by no means an expert. I am just the next guy with significant back issues trying to make the best choices. It is 3 days after surgery and I have no clue what is ahead for me. I am just thrying to make the best choices. From the research I did, I believe this surgery over the standard Microdiscectomy everyone else seems to be doing has every indication of being less invasive. We will see the true results over time.

    I can say that I have ecstatic about my results so far. Everything went exactly as their references said their procedure went. One of the hardest things for us is that we are all different. What works for one of us may not work for the next. I still believe there should be a better way to help us evaluate the best path.

    Gwennie,
    Thanks for the encouragement.

    Nancy,
    I had surgery in Beverly Hills. I had to fly to LAX from Panama City, Florida. I connected thru Atlanta. I flew back the whole way, I wanted to avoid the 6 hour drive from Atlanta to Panama City.
  • Took it easy over the weekend. Just normal walking around in the house. Spent most of the weekend just laying around. No pin pricks in any of the pads of my feet. I did feel a very light shock in my right second biggest toe once. That was kind of weird. My three smallest toes on my left foot seem a little better. I only notice a slight difference in feeling when I actually focus on it. I am clearly walking better. Icing 3-4 times a day for 20-30 minutes each time.
  • I had my 5 day post opp today. Doc’s seem happy. I had a little burning in the pad of my foot below my three smallest toes this morning. I also had a prick on my second largest toe on my right foot over the weekend (weird because the problem was in the left leg). I also had a prick on the right side of my left foot. Doc’s say those are signs that the nerve is starting to fire again and that it is a good thing. Continuing to see improvement in walking and mobility.
    I am going to start walking 15 minutes twice a day.
  • I hope that you will see your recovery very soon. You are so brave to travel and sit in that airline chair! Did you have someone travel with you? Or you did it all by yourself? Are you allowed to sit that long?
  • How do you do that? A phone consultation?
  • Metoo,
    I flew by myself. My girlfriend was about to open a yoga studio and I told her not to go with me. I have traveled extensively and knew how to get assistance out their. After all, I am 200 lbs and she is 100 lbs. How much help can she give me?
    I got pain pills and muscle relaxers for the flights. I made sure to book a seat that reclined relatively well. It got me thru.
    Gwennie,
    The post opp eval was a phone consult.

    Update:
    Walking better. Better mobility, I tried to do a calf raise with my left leg today. I did it with a little assistance from my upper body pushing against the counter. I start water therapy next week. Right now walking 15 minutes twice a day and taking it easy.
  • Glad to hear you are progressing!
  • I have been taking it easy. I start aqua therapy this coming week. No more pricks in my foot or sharp pains. I am not aware of any complications from surgery to date. The only reminence of the entry point is that it is slightly swollen when I run my fingers over it. My 3 smallest toes don’t feel slightly asleep any more. I can feel a difference in how the pad below my 3 toes feels when I am walking in the pool. Things are progressing well. I can not completely do a left calf raise on my own yet. I can do a partial calf raise. I am continuing to see small progress in my walking each day.
  • Woke up and 3 smallest toes on my left foot were slightly tingly. Been up for a few hours and they are. There was also a prick somewhere on my foot last night. Don’t remember where.
  • cre, one thing we all have to learn (and I am not very good at it) is to ignore occasional small pricks and pins and do not let them to spoil our mood. I think that you are recovering nicely and your pricks are just small reminders of the staff you had IN THE PAST. I am having funny feelings in my calf/foot every 2-3 days, they are are gone for a few days. I am thinking that I have to accept them as part of me. I think that once the nerve was damaged, full recovery will not be possible....Think about it - you have cut on a skin - you skin will have a scar forever.
  • Things keep improving. Still taking it easy. I started aqua therapy this week. Took a day off and went snorkeling with friends today. Walking pretty much normally. If I run on the sand I can tell a difference with my calf on my left leg. I am guessing that will also slowly improve. I CAN TO A CALF RAISE WITH MY LEFT LEG!!! It may seem like a simple thing. If this has happened to you , you know how great that is. There is still a difference between a left leg calf raise and the right, but I believe this will also continue to improve.
    Pad below my 3 smallest toes still seams a bit puffy from time to time. It is noticeable less and less. I don’t notice a difference in feeling in any of my small toes.
    All I need to do is keep improving and not do anything stupid to jeopardize my recovery.
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