Weak medial gastrocnemius

[JustLyn]

In 2000, I herniated L4-L5 disc with resulting excruciating pain down my right leg into my foot with residual right lateral foot numbness and calf weakness.  I underwent partial disectomy and laminectomy of L4-L5 eight weeks later and within a year I had minimal pain and about 85% of my calf strength back.  The next 7 years were unremarkable and I played sports, worked as a nurse, basically returned to my normal life.  Then in December 2007, I developed a slight limp, suddenly realizing that my calf muscle was once weak again.  I, however, was not in any pain.  An MRI confirmed that I have re-herniated L4-L5 and there is nerve compression.   I saw a neurosurgeon and he told me that I really shouldn't have surgery because my level of function is so high and that my pain is not debilitating.  He told me there is no guarantee that with surgery that my leg weakness would get better, and in fact I could end up worse because of scar tissue.  Here is my question:  Is there anyway that I can increase the strength in my gastrocnemius if the nerve is compressed?  I am a nurse and have a physical therapy backround as well.....how can I strengthen a muscle that is not receiving the impulse from the nerve?  Should I have an EMG?  The lateral head of my gastrocnemius seems to be working fine, it is the medial head that isn't working, resulting in weak plantar flexion.  This causes me to limp when I walk and my right leg gets very tired, followed by my left leg for picking up the slack.  I also cannot run very well.  Did the neurosurgeon take this too lightly?  Should I be considering surgery to avoid permenant nerve damage, or is it already too late?

[mkuhn12]

I had a microdisectomy on L5/S1 back in December 2015 and have since have not been able to flex the medial gastrocnemius and it has severely atrophied.  The lateral portion on the muscle has become extremely strong and it seems like the back part of my knee (on the lateral side) had developed this hard-over developed "something" and is causing me a great deal of pain and tightness around my knee.  The left side of my foot feels like it is being torn apart and/or very numb.  I can walk but it feels like all the pressure and activity is solely on the lateral part of the muscle.  Any thoughts?  This is driving me crazy!

[bartb888]

did you do an EMG?

[don1952]

by Don

I am having the same problem with my left calf. I've had an MRI and the Nerve Conduction Test. I've been to the neurologist and an orthopedic surgeon. Neither can uncover the problem. The medial gastrocnemius has nothing and is wasting away while the lateral seems to be working fine. It is frustrating, has given me a limp and my legs wear out fast. Have any of you had knee injuries in the past. My knee caps have dilocated several times. I also have polyneuropathy in both legs. How is that for you?

[bartb888]

Maybe I can help. Have you done MRI of the affected calf muscle?

[flangey]

Since Nov 2004 I have had wasting in my left medial gastrocnemius muscle.  The lateral head seems to be just fine.  I have had numerous MRI's (3) with no clear evidence of any nerve root impairment in the lower lumbal or sacral region.  I have had 2 EMG's which clearly show nerve entrapment to the muscles of the lower left leg.  To date a clear diagnosis has never been made and the medial gastroc is now virtually completely wasted.  Walking is an issue as I have had a noticeable limp for some time now.  There is very little plantar flexion left on my right side.  I have never had a nerve biopsy and I am wondering if that is worth investigating.  I am considering a trip to John Hopkins to see if I can get a diagonosis.  MF

[bartb888]

hi, how did it go?

[Dr Rajgopal]

Hi,
I would suggest that you must consider going for surgery if physiotherapy is not doing any good . Nerve compression due to herniated disc may lead to paralysis of both the limbs  . You must go for an EMG and nerve conduction studies to know the muscle tone and nerve conduction . . There is hardly a way you can increase the muscle strength in the absence of nerve impulses . The conduction and functioning of muscles may return to normal only on decompression of the nerves . The risks of surgery are same as with any other surgery but there is no other alternative if your condition is deteriorating . Most of the patients do well after the surgery . Please take a second opinion of a spine surgeon . Hope this helps you . Take care and regards !

[tallguy001]

I also have an issue with my left calf, medial gastonimus totally inactive lateral seems to be working. You sound like you've got further than me with your research, I think it may be related to a previous tear ninjury but no doctor will agree or diagree with this.
Its very very frustarting and hard to get answer isnt it?

Ewan