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352007 tn?1372857881

Muscle fatigue or weakness or both?

Hi it's me again. I hate to rant on such a small matter, but I'm here again, experiencing difficulty going up my stairs that I've been up and down minimum 30 times a day for the past 10 years.
This past week, as soon as I hit stair #4, my thighs begin to burn and have pain and I get to the point where my legs can't support my weight and I end up leaning forward, crawling the rest of the way.  Sometimes, it's hard for me to get up from a sitting position to stand to even hold my own weight as if I was carry 1000 lbs. Or when I go to sit, instead of an easy lowering down and sitting, its more of a plop because my muscles are feeling fatigued/weak or both.

I can't seem to find the correct terminology for this.  Each day for the past few weeks, I am taking walks to try and increase my tone and strength and it appears, that no matter how many times I do this, I'm not feeling stronger.

However, let me say that next month or two or three, I may feel back to somewhat normal and I feel almost at tip top shape.  I feel like I'm losing my mind here.

Is this my imagination?  I wonder if its some lactic acid build up.  Meaning on those weak/fatigued or both days/weeks I can't do my walks, (go photographing my shorebirds on beach or do household chores going up and down my stairs (have three floors with 15 steps each.

Today I tried to do squats, keeping my back straight and lowering down bending at my knees and bringing myself back up.  Well on the second dip, I couldnt pull myelf back up. My bottom just dropped to the floor.

So what gives?

Someone please help me identify the terminology so when I go to my Rheumatologist appointment, I'm describing it correctly.

Thanks in advance.

Lisa
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987762 tn?1671273328
COMMUNITY LEADER
Hi, this was actually one the hardest things for my athletic brain to understand, well the brain is still thinking its an athlete but the body is soooo not keeping up. Honestly before my big bang of 09, i'd already been experiencing for years, these odd blocks of time were i was unable to to actively participate in any of my sports, all sports that required physical strength, coordination and balance.

It made zero sense to have these odd blocks of time, when i couldn't do what i was known to do, lol i was in my 40's and still skateboarding, running up multiple flights of stairs, doing handstands, cartwheels, balance on one leg with the other next to my ear etc lol no one would ever say that i wasn't fit, or that I was out of shape because it was obviously not true.  I was use to and welcomed the adrenalin rush of activity and knew just how much I could push my self but for those blocks of time.......everything i knew my body could do didn't make an ounce of difference. I'm thinking these blocks of time were probably a combination of fatigue and muscle weakness.

It was only after my big bang that i really discovered repetition did the exact opposite of what i expected, the more I did to get stronger the weaker I became, the heavier I felt, the more unbalanced, the more fatigued I got etc but still my brain couldn't work it out because it was not suppose to be happening. More equals less....how could that be right if the 'use it or loose it' principal is right?

I knew the muscle memory was intact because i could do anything once or twice but I would quickly fold like a house of cards. As an athlete muscle fatigue is understandable but hitting the wall over nothing was really confusing. Seriously talking about nothing, lol my hairbrush would gain 20 pounds with each brush and the emptier my coffee cup got, the heavier it seemed.

For me muscle weakness is multifaceted, and also interconnected to my level of fatigue because the more fatigue i have the more muscle weakness I have to deal with as well lol the 'use or loose it' principal is more like 'use it and loose it' for me :D the more I talk the worse the oral muscle weakness and the harder it is to get the sounds out right, same applies to walking the more I walk the harder it is to walk normally and not like a drunk puppet.

Its definitely not from lack of usage lol I was a talk-a-holic or a sedentary lifestyle for me, its the faulty wirings fault. anyhoo this is a worthy read....

http://mssociety.ca/alberta/pdf/Active/UnderstandingMSandExercise.pdf

Cheers.........JJ    
Helpful - 0
645800 tn?1466860955
Lisa,

  I have no O-bands in my CSF either yet have a MS DX.. That is NOT a requirement for having MS. Also your MRI report sounds like they were saying that you probably have MS that is stable. That last Neuro you saw is a jerk in my opinion and you should find a new one, preferably an MS specialist.

As for the legs, from what you have written I don't believe the problem is a lack of conditioning. It is more likely that it is the nerves are not giving your muscles the correct signals for them to work correctly. I have the same problem with my two floor house. Some days I have no problem with the steps but others I can't make it up the stairs, and even some days I have trouble going down them as well.

Dennis
Helpful - 0
352007 tn?1372857881
Wow.  What a great explanation.  I know I read somewhere at least a year ago or so on the health pages about weakness vs fatigue too.

My problem seems to be reading comprehension, especially when I'm fatigued. So with reading what you wrote I understood it for the most part, but retaining is another story.

Yeah I don't think its normal for me (a woman who was tip top shape 3 years ago) going on a decline due to occasional inactivity (there were months where I couldnt do much but still I did do things -- just not as good), that is suffering at stair #4 and has to crawl the rest of the way. My muscle is fatigued.

I tried this two days ago at the beach to photograph birds. I was dying in the sand.  This is what I do, I normally can walk and walk and as the years pass, its becoming less and less.  Two days ago, I was laying in the sand photographing birds at eye level and went to get up and my legs couldn't support my weight to "get up" from a sitting position.  I dont know why that happened, but luckily a birder I have known for two years was walking passed me and helped me get up.  Once I was up I stood for a few and then went to my car.  

It took awhile, but I got there.  Thank god.  

I think maybe I should ask the Rheumatologist for a PT eval again, perhaps some conditioning exercises so I can do those stairs ALL the time.  That's the thing which puzzles me.  I can't do it ALL the time.  Why one month its not a problem to hop skip and jump the stairs and let's say two months later I'm having difficulty.  

It's frustrating, it really is.

I know when I went to my last Neurologist she told me I could take MS off the plate entirely because my LP showed no o-bands.  That she was not impressed with my lesions.  

Yet, my MRI report states on 6/21/13:

".........Flair images demonstrates scattered t2 hyperintensities of high signal in the bilateral periventricular regions and centrum semiovale in unchanged configuration from prior study.  There is an increased T2 hyperintense signal also noted along the inferior aspect of the corpus callosum."

Impression:  Persistent increased signal of abnormality in the bilateral periventricular and centrum semiovale regions, not SIGNIFICANTLY changed from the prior study.  CONSISTENT WITH STABLE DEMYELINATING DISEASE.


Ok am I barking up the wrong tree here?  Or what?

Lisa

Frustrated.

Helpful - 0
645800 tn?1466860955
Thanks so much for stating what I was trying to do so good.

Dennis
Helpful - 0
333672 tn?1273792789
I think in your appointment, you should just describe your experiences as you have done and let the rheumatologist put a name on it. I have sometimes had more trouble communicating with doctors by trying to put a label on something too soon than if I had just let them analyze my experiences.

That said, this is how I understand the difference between weakness and muscle fatigue (with the caveat that I may be wrong). Weakness is your baseline. For example, you are sitting in the neuro's office, presumably reasonably well-rested and not having recently exerted yourself a lot. The neuro does that thing where they ask you to hold your arm or knee up. The neuro pushes on it and you're supposed to resist. The neuro generally only does this once. This is a test for muscle weakness. In MS, of course, the muscle weakness isn't caused by an inherent problem with the muscles themselves, but is due to the fact that the muscles get weak after a long enough period of not receiving the correct or any signals from the motor neurons in the brain. They get weak from disuse, but not in a way that can be fixed by exercising more. I think you can get relatively better by exercising appropriately (this is the trick), but exercise can't solve the underlying problem.

Muscle fatigue is the increasing weakness and heaviness that you feel after using your muscles. My physical therapist once demonstrated this for me by having me resist his pushing on my arm or having me push on his arm (I forget exactly but something like that with the arm). He had me do this three times and by the third time I was obviously weaker and having to work harder. Maybe I couldn't even do the task anymore. He said this is muscle fatigue. This happens in normal people, too, but he pointed out that it was abnormal for my muscles to fatigue so quickly. The rate of muscle fatigue is much higher in MS. So far as I understand it, muscle fatigue in MS is what is known as central motor fatigue and is caused by the motor neurons fatiguing and thus failing to fire. So the problem isn't really in the muscles.

There is an interesting theory that fatigue while exercising isn't all in the muscles for normal people, either: https://en.wikipedia.org/wiki/Central_governor

(After looking at that wikipedia article, I followed a link to https://en.wikipedia.org/wiki/Muscle_weakness, which talks about muscle weakness and neuromuscular fatigue and may be of interest)

Demyelinated neurons have to work harder to fire and thus tire more quickly. This is the idea behind Ampyra, which lowers the bar for an axon to fire so it will fire more easily.

I do think there is a relationship between weakness and muscle fatigue as over time, it gets harder and harder for the neuron to fire. What was once the level of strength after a certain amount of exertion may eventually become your new baseline weakness.

RE: exercise. When I have taken up an exercise program, even pre-diagnosis and before I had very many symptoms, it has not really resulted in any long-term improvement. At first, I do see some improvement, but then it plateaus or I even get worse at doing whatever. The last time I tried to take up a vigorous walking program, after a week or two I found that I couldn't go as far and that it was making me really tired. I have had this problem with weights, too.

Research suggests that people with MS who exercise do better than those who don't. However, I think you have to find a way to exercise in the right way, which I haven't found yet.

That's a bit of a mishmash, but I hope there's something useful in there.

sho
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352007 tn?1372857881
Thank you for responding.  I appreciate your input.  I suppose when I go to the Rheumatologist, I can just state what happens and then he can determine what it is.

It seems to me no matter how I try to excercise (I've picked up walking everyday going the same distance and increasing little), and I still cant seem to strengthen my muscles or stamina.  I'm short of breath upon exertion and I'm sure that has to do with my large bullae in my lungs.

Thanks again to both of you.

Lisa
Helpful - 0
645800 tn?1466860955
The last time I was in PT I believe they referred to this as weakness. And yes I have those type of problems you were describing all of the time. I really hate it when I am having them as it makes me feel like I have no control of my life.

My doctor tried to have me do PT from the weakness but it didn't help. In fact they ended the PT before it was due because at least with me the exercises were making my legs weaker. It was after that while doing some research on-line I found some article that stated that with some MS patients repetitive exercises do weaken the muscles instead of strengthening them. So they recommended aqua style exercises for those patients so that the heat from the exercises do make things worse. That was a couple of years ago so I don't remember where I read that.

Dennis
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Avatar universal
That is a horrible feeling to have, I'm sorry I don't have much to offer.

Personally I would consider it weakness but muscle fatigue could be part of it.
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