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Loss of tone and mass in left quad

post #1 of 8
Thread Starter 

I am currently trying to figure out why my left quad has lost tone, strength and mass.  It is quite floppy as compared to my right and is approximately 1" smaller in diameter.  I experienced significant pain in my left knee/leg some weeks ago and received some Prednizol (?).  The pain is gone but so is the quad (somewhat).  I can walk (with a slight limp) and bike and I plan to ski next month.  I have not consulted an MD yet but I do have a physical next week.  I can't put my finger on what may have happened other than something that might have occurred on a long bike ride or some kind of back related issue from sitting in front of a pc for hours.

 

I'll be 65 next month and I'm concerned about whether there is an issue with knee or back that might be causing this.  I just found this forum and have been impressed with the responses I've read.  

 

Would anyone care to make a guess or offer some advice?  Thanks.

post #2 of 8

Let us know what your doc says.  I have mild arthritis in my left knee, but nothing structurally wrong according to orthopod from a few years ago.  It responds well to cycling, but not so well to jarring activities such as jogging and aggressive skiing.  I use a brace on that knee during skiing because of rare occasions of instability, but not off the slopes.  I'm about a half dozen years younger than you.  Over the last few years my left quad has atrophied to a small degree (10%?) compared to my right one.  I assume that I am favoring the stronger leg in some way.  I believe the atropy thing can happen rather quickly depending on the degree of compensation/limping/favoring you're doing because of your pain.  Maybe a PT here will respond to your question?  Perhaps after an assessment your doc can recommend an exercise regimen for your situation?

post #3 of 8

Yah,

I have a left knee that has required a bunch of surgery since my youthful motorcycle racing career.

Probably due for replacement soon, I'm 66.

Left quad and calf about 10% smaller than right.

So it goes

Your warranty has expired and things are going to get worse.

Attitude is important here.

Do the best you can with what you have and, as my 100 year old Aunt says, "Don't Sweat the Small Stuff."

Just don't quit!

 

post #4 of 8

If you haven't already checked out the posibility of a quadriceps tendon injury--I'd do that!  There is a forum on here especially for those of us who have had the injury/surgery....yours sounds like it could be a pre-surgery issue!  I wish you good luck and God speed!!

 

Cathy

post #5 of 8
Thread Starter 

Thanks for the reply.  I can't really look back and see an "event" that might suggest an injury to my quad.  My gp has set up an appt. with a neurologist for some tests (tomorrow).  

 

I'll post an update after I get some results.

 

Thanks again.

post #6 of 8
Thread Starter 

I've now visited with a neurologist and a neurosurgeon.  My MRI revealed degenerative disks up and down the spine (the doctor's words were "you have the spine of an 80 year old" ...I'm actually 65).  The atrophy in left quad is most likely due to some kind of nerve issue at L3,L4.  The surgeon says he could make an argument for a fusion or at least a laminectomy.  I'm doing PT now but I'm not all that optimistic that I can avoid some kind of surgery.  I'm not sure how much worse the atrophy will get without some kind of procedure.  Anyone have any similar experience or ideas on new procedures, surgeries, etc.?  Thanks.

 

 

post #7 of 8
Quote:
Originally Posted by mreichr View Post

I've now visited with a neurologist and a neurosurgeon.  My MRI revealed degenerative disks up and down the spine (the doctor's words were "you have the spine of an 80 year old" ...I'm actually 65).  The atrophy in left quad is most likely due to some kind of nerve issue at L3,L4.  The surgeon says he could make an argument for a fusion or at least a laminectomy.  I'm doing PT now but I'm not all that optimistic that I can avoid some kind of surgery.  I'm not sure how much worse the atrophy will get without some kind of procedure.  Anyone have any similar experience or ideas on new procedures, surgeries, etc.?  Thanks.

 

 


My suggestion would be to not give up on physio too soon. degenerative disks are not uncommon at your age - it's a normal part of aging. Based on this study (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2867597/), 90% of people age 65 or older have at least some disc degeneration. Take a look at the research (google scholar) and you'll see that MRI evidence of disc degeneration is not well correlated with pain. 

 

The way I interpret that is that the medical community doesn't really understand how to to diagnose when the disc is really a problem.

 

If you look at research studies about disc surgery outcomes, you'll see that they aren't good. I suspect this is related to lack of understanding of who is really a good candidate for surgery. 

 

That said neurological symptoms (loss of muscle mass) should not be ignored! But hopefully conservative methods (physio and appropriate exercise) will help. Trying a different physio may be the answer - some are awesome while others are pretty bad. 

 

Good luck!

 

Elsbeth

post #8 of 8

Part of my grad work looked at data for college volleyball players....w/o any pain or issue, 20% had disc issues!!!

 

Stick w/ the PT & if need find one that is better versed in spine.  Everyone has their strong suites & one who sees / treats a ton of backs can really help.  Remember too, your leg prob did not get this way overnight & will take some time to return.  Muscle training, neurodynamics, gapping & postures of comfort can all help!

 

A good spine pro will also let you know when to see a MD asap should you have radical changes in neuro function!

Best wishes!!

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