Achilles and Calf problems

[pennstater]

I am not sure if this is somehow related to MS or just other causes. Has anyone had issues with their Achilles and calf muscles?

I twisted an ankle 2 years ago and have been battling achilles tendonitis since. It would get better then flare up again. So my MRI showed multiple issues with various tendons in the leg and foot. It also indicated that I had calf muscle atrophy. This is so strange to me, as I have always had muscular calves and even the physical therapist commented on that (was in PT for the achilles tendon late fall until they told me I needed to go back to doc).

I have been in a brace round the clock for a month, and will be for another month after my check-up. For now, still no walking, biking, or swimming for exercise - anything that causes the tendon to move. Only gentle stretching allowed.

I wear orthotics all the time and they were checked by multiple people that they are a good fit. Until the tendon flared again in the summer, I was walking 3 miles a day.

Once the main tendon has calmed down, back to PT. After that, will get a general overall assessment on gait, posture, etc...
The muscle atrophy has me concerned. I am sure it is all playing together, but worry it will lead to further problems. My neuro asked some questions, said possible MS contributing, but was leaning toward more structural than MS related. Agreed with need for general assessment by PT.

Has anyone else had calf atrophy? Has it led to other problems for you? Was it MS related or non-MS? What was done to prevent further atrophy? I want to be as pro-active as I can to try and prevent further issues. I do weight train as well, but some are off limits now.

Walking in nature was always something that benefitted me mentally, as well as physically. It has been 5 months out of routine and I am so missing it. I feel so out of sorts without it.

[rdmc]

Sorry to hear about your problems with your calf. MS can do such crazy thing.

I have calf atrophy, on both sides, but more significantly on my weaker side (my problems are usually related to left sided issues from my tongue, right down to my ankle.)

Everybody's different, but for me my atrophy can be seen, but if a bout with increased spasticity occurs, my calf will go from looking atrophied to looking like I'm a body builder. The spasticity significantly increased the tone in my calf muscle that is left, and won't let it relax.

I have a Baclofen pump, so this doesn't happen a lot, but if, for whatever reason, my MS decides to act up, and my calves won't relax the muscles due to spasticity, I have to head to my pump doctor to get my Baclofen dosage turned up. Within a half day, my calf loses the tone, relaxes, and goes back to is atrophy look.

[pennstater]

Thanks for sharing rdmc. Glad that doesn't happen too often. I hope you don't get alot of pain when it does flare up.

What is odd for me is that it is the left leg, my right has been affected the most from MS. And my left calf is visibly larger than right (clot ruled out), so they think I tend to use left more than right and compensate more on left side. But yet, the left has atrophy?

As for spasticity, my last neuro put me on low dose baclofen when started having calf spasms, but current neuro does not see any evidence of spasticity and recommendedcI stop the baclofen, which I did 2 weeks ago. Calves just started spasms last night again, so going to make sure no hydration issues before calling.

[502E79]

Has anyone else had calf atrophy? Has it led to other problems for you? Was it MS related or non-MS? What was done to prevent further atrophy? I want to be as pro-active as I can to try and prevent further issues. I do weight train as well, but some are off limits now.

Hi Pennstater,

My right side muscles are effected by MS spasticity. Limbs lead the parade. Atrophy of right side muscles, in calf, thigh & buttocks is visible and Neuro explained the decline as MS related.

Structural problems will result (my spine has a noticeable curve, sigh, but no pain! Credit back & ab exercises ! ) as well as related issues so "hardware," PT & stretching are definitely beneficial.

IMO preventing further atrophy of your spastic side or your atrophic calf can best be addressed by usage. Despite pain there are no guarantees.

Side note- I have always said that MS is a thief. Use everything, if you neglect anything, the next time you revisit that movement or exercise, you could notice loss. Listen to your PT but only you know your body.

Disclaimer... I am PP so keep that in mind.

[pennstater]

IMO preventing further atrophy of your spastic side or your atrophic calf can best be addressed by usage. Despite pain there are no guarantees.

Side note- I have always said that MS is a thief. Use everything, if you neglect anything, the next time you revisit that movement or exercise, you could notice loss. Listen to your PT but only you know your body.

Disclaimer... I am PP so keep that in mind.

Thanks for the input! Agree with the "use it or lose it" saying. Also think it is even more important with MS. Use what you can while you can.

I was ok with the pain, but was at risk of rupture. I am trying to avoid surgery at all costs. I had multiple micro tears, in addition to the tendonitis/tendonitis. So the brace is to try to help calm it down. The ortho didn't want to put me in a boot because of the issues they cause in other areas (backs, hips, knees), plus contribute to weakening and instability of the area. I have been doing leg stretches I can for other muscles to try to retain what I can while waiting this out.

I am really not sure if I have spasticity or not. 1st neuro said no, 2nd yes, current neuro says no. Not sure how the calf atrophied, as I did walk, stretch, and bike prior to this flair up in the fall.

[KoKo]

Kathy ~

I'm not sure how widely used the FES (Functional Electrical Stimulation) treatments are at physical therapy clinics.

FES can stimulate muscles when there is nerve damage, or when the muscle can't be exercised.

The electrodes deliver electrical pulses to the nerves, which then tell the muscles to contract, which would hold off further atrophy until you are healed and can exercise your leg again.

I have never used FES, but would love to own a FES cycle for my legs to help maintain muscle strength.

Similar to rdmc and Jer, I have significant atrophy on one side (hand, arm, shoulder, glute, total leg, ankle, foot).

I am also a person with PPMS.

Good luck!

[pennstater]

Much appreciated KoKo. That is an interesting question. My niece is a PT, but lives 6 hours away. She is out of town, but will ask her whether used or not when she returns. I might also pop in and ask where I normally go. Will let you know what they say.

[Mamabug]

Sorry to hear about your problems. I don't have any similar symptoms to relate.

As always,. I believe that since MS is a neurological illness and our brain controls everything, anything could be MS, but not everything is.

Clear as mud.

[pennstater]

Thanks for the laugh Mamabug! Neuro did talk about doing an EMG, but when I asked if it would change my next steps, he said no, would send me to PT as well.

[MS TOO]

I don't have any answers but can relate and commiserate! I am SP and my left side is my weakest, I have foot drop on that side. I've also suffered from plantar fasciitis (flat feet) and have a contracted left Achilles tendon which they put in a cast for 5 weeks or so to try and stretch back out. I don't know that it helped much and I've tried multiple night braces to stretch it but just can't sleep with my ankle locked in a torture device!

I also have spasticity and am taking baclofen but more painful are the spasms and cramping I get! I once had a calf cramp so bad that I couldn't walk for 3 days and when I had blood work done, they found enzymes indicating that I had torn the muscle. Unfortunately, this lock down is not doing me any good as I am working from home and am not walking much. I walked more when I went to the office.

And just to complicate this even more, since I am working from home, I haven't been wearing shoes as much and I started getting pain in my left sole behind my big toe. I talked with the podiatrist who added metatarsalgia to my list of feet issues.

I know I need to exercise and stretch more but that is not possible with my current work load. I am looking at retiring in less than 2 years if I can stick it out that long!

[pennstater]

MSTOO - Sorry to hear. Your spasms do sound incredibly painful. I would definitely wear your shoes when working from home, especially if you have orthotics for your feet. I feel it when I don't have the orthotics in.

I can understand not having the time/energy to exercise when working. My only exercise was walking from the train to the office while working. It was only after I stopped that I could do more.