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Weakness in Calf Muscle

TedCTTedC Posts: 10
Hello everyone,

About 2 months ago, I had a pretty severe backpain accompanied by pain in certain areas in one leg. MRI showed a badly ruptured L5/S1 disc. None of the oral pain medications worked, PT made it slightly worse and I was sleepless for many nights. Finally, I was given an injection in the back, which worked like a magic. Now it has been 2 weeks of pain-free nights.

However, I notice substantial weakness in my calf muscle in the affected leg, along with some numbness along the side of the feet. I can stand on my toes, but cannot walk on tippy toes. I am walking with a small limp and running is out of question. Based on what I could learn from internet, this is a classic S1 nerve compression. I brought this up with my neurosurgeon and asked him if surgery needed to be done before weakness became permanent. He tested strength (or resistance) by pushing against the toes and legs and said that the weakness is mild. He said surgery may or may not resolve the weakness, but since I am pain free now, there is a good chance I would eventually gain strength. He does not want to operate unless I have foot drop or loss of bladder control or numbness in genitalia.

My question is, does anyone here have gained strength in the calf muscle over time? Does the numbness go away too? Right now, I am doing simple stretching and core-strengthening exercises recommended by my doctor.

I would greatly appreciate if someone could share their experiences (good or bad)

I am a 30 yr old male, physically fit.


  • But I would have to agree with the NS that you can get back the strength over time but what type of PT are you currently doing. The ruptured L5-S1 needs to heal and that takes time but to quicken the pace you need to help it along through PT.

    You may want to suggest to your doctor if you should have an esi (epidural). In my case they waited too long and the rupture got worse and I eventually got to a point of walking with a cane. If I would have had the epidural earlier and a proper diagnosis I would be much further along. You are lucky to have the proper diagnosis very early in the process so I suggest you move more quickly than I did.

    I am now at a point where I can walk for 3 miles and lifting weights. You need to get the PT exercises going and the epidural will allow you to do them. Also I am sure he gave you some meds to help in allowing you to be more mobile also.


  • Thanks for reply, jsirabella! I am very encouraged by your recovery.

    I saw a GP first, who asked me to take some pain killers, anti-inflammatory drugs, and muscle relaxants for a week and then take PT to get better. The pain subsided a bit for a week, but came right back (probably became worse) when I did PT (about 8 sessions spread over 3 weeks). This is when I saw an ortho, who took X-ray and MRI, and put an esi. So I had the esi shot after nearly one month of very severe pain. It did not see immediate relief with the injection, so on the third day of injection, I saw a NS (I had to beg and pull some strings to get an appointment so early). The NS asked to wait for a week to allow the ESI start to kick in, which it DID big time the very next day - the pain was gone just like that. I hope it stays that way - it is only 3 weeks since the injection.

    My NS gave me a pamphlet containing exercises for strengthening the back. He did not say anything about going for PT and I am actually scared of going to PT after my bad experience with them. But I must say, the exercises recommended by my NS are pretty much same as those taught by PT. I think I must had a pretty bad muscle spasm or/and inflammation while I was going to PT. ESI took care of these problems and now I can do these exercises pain-free.

  • I wish my story was like yours and would have been if my first ortho did not give me a diagnosis of pirformis syndrome. This gave me months of the wrong direction and a slow descent into pain and immobility.

    I needed 2 esi injections as per the PM to undo the nerve stewing for too long. PT is PT, meaning you do not have to have a PT specialist to do PT. I was given a pamphlet from my PM, went to a PT person to make sure I had proper form and did the rest on my own. This site has some wonderful exercises you should incorporate.

    You are also lucky that your NS knew to wait and not rush to the knife. Usually they seem to lean in that direction but he knew you were too early in the process.

    So do not loose the steam and stay on your lucky streak and do some of the exercises the doctor said and do plenty of walking. This may be over in several months for you with continued PT and some changes...just be patient and I really doubt you will not get the calf muscle strength back.

    Just keep in mind now that while the nerve has been calmed this is a condition you need to keep in mind for the rest of your life. You must continue to do the core exercises, some prone, yoga type exercises into the future. And most important do not over do it in lifting, bending and such.

    I am sure you much rather put your pride in check than go through this pain again!


    Two things, try not to sit too much especially if you work in an office environment, work and stand, also an important exercise is the mini-cobra. A must to move that bulge off that nerve!!

    Also I am a big believer in strontium and calcium. Calcium is just basic you should try to take a supplement daily.
  • Thank you for your encouraging words. But I still think I am not out of the woods yet. After all, ESI is not a permanent solution - as soon as the steroids are consumed in killing the pain, there is a good chance the inflammation could come back again. As you rightly pointed out, this is a condition that I need to watch over for the rest of my life. A ruptured disc is a permanent damage and you will never know when it is going to act up again.

    I am regularly doing the exercises. I will definitely check on the exercises listed in this forum, as you suggested. I feel better while walking compared to sitting, and my job requires quite a bit of both (depends on the day). I had always wanted to yoga, but I would like wait out for a while to make sure the pain is not coming back.

    I will definitely look into the supplements. Thank you for the great suggestions!
  • Ted,
    I recently completed my surgery to fuse my L4-L5. I had this L4 fracture since Nov 2001, it wasnt diagnosed until Feb 2007. From the summer of 07 to this last summer of 09. During that time I had 2 nerve blocks and a pars injection. My left leg got weaker and waker over that period of time. I was able to walk but could not do a single left leg squat. My calves and ankles lost so much muscle mass that my boots were laced as tight as they would go adn are still loose. The right and left side of the boot used to have about an inch in between them when laced up 3 years ago. After the last month of walking I am seeing a big change in the look of the left leg muscles and I am getting stronger.

    Keep up with the core excersises, they are the true key I believe. I startedto swim about three years ago and it was a great helper.

    Good luck to you,
  • I'm very interested to hear how your surgery went and how your recovery has been.
    I may need to have a lamenectomy with stabilisation via fusion surgery. I really trying to avoid it by doing lots of walking and core stability exercises.

    It sounds like your spondylolisthesis has slid further since your surgery. Is that correct? Did the surgeon try to pull it back into alignment during the operation?

  • Mark,

    Your recovery is truly inspirational. I am keeping up with the core exercises. I have not lost any muscle mass (yet), but it is more tender than the other side. I love to swim, but I am afraid of swimming in public pools these days (after I learnt that 10-20% of the people pee in the pool). May be it is just a mental block.

    Keep me posted. I love to hear people fighting back and winning the battle.

  • Ted,

    I am having the same problems here with the calf muscle weakness. I am trying the anti-inflammatory drugs to try and relieve the pressure on the nerve.
    I am still have numbness and on slight pain. Like you worried about the weakness in the leg. Doc thinks surgery may be best. Let me know how u are doing.

  • Mark210,

    The numbness and the pain are going away, but the weakness is still there. But the backpain accompanied with tingling and pain in the leg come back if I sit too long. Walking or lying down seem to be the "cure" in these circumstance. I am not taking any medications now, but the idea of taking anti-inflammatory drugs for the weakness sounds interesting.

    My NS did not recommend surgery, but would have performed it if I had insisted. I am sort of used to the weakness at this point and it has not affected my daily life much. It is only causing a small limp while walking and I am hoping that it would get better with exercises and patience.

    Thanks, and please keep me posted!
  • About 5-6 months after my microDs, I regained the muscle strength in my calf. My doctor had me stand on one leg and push up and down on the ball of foot. then, some other tests to see if I gained muscle strength.
  • TedC

    It is great that you are seeing results from conservative treatment. Your doc seems to be one cool cucumber and you are fortunate! One thing I have learned about spine surgery, is that it is like opening a can of worms. So in many respects, if at all possible, it is best to leave that can unopened for as long as possible. When we are in pain and frustrated by the time and patience that it takes to rehab, surgery can have the appearance of a magic pill. Many people get upset when they can't have that perceived magic pill and stayed focused on the wrong thing. Conservative treatments can and do work, especially in the young and physically fit. Glad to hear things are going so well for you. Muscle weakness is generally caused by nerve impingement. As the nerve heals (which is a slow process) then the muscle will begin to recover. Just keep an eye on it and when in doubt, check with your doc.

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