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What Causes Muscles Atrophy?
Question: What can cause muscles to atrophy?
Nov. 2014 left hip replacement.
March 2015 FREE FELL off of bike directly onto the operated leg incision.
When getting off the bike to stop for an intersection, I put my left leg down to hold me up. There was ZERO strength.
March 2016 had a bone scan done. Left leg continued to be weak, i.e. still cannot stand on my left leg to put on trousers or shorts without holding on to something. Radiologist report detected an infinitesimal movement of the prosthesis creating unstable body imbalance.
OTHER contributing factors. Lower back discomfort. Possible spinal column pinched nerves.
Through pt work outs I have learned that my left glute is soft and not firing. Doing dry needle therapy to get it started.
SO muscles have "possibly atrophied" I have heard mentioned twice. Once by an orthopaedic surgeon and once by a pt therapist as the source of my LEFT operated leg's weakness NOW a year and a half after the
Nov. 2014 procedure.
PLAN to DATE
Re-do the LEFT hip with a more secure prosthesis THIS July 29th. The bike FALL most likely jostled the
prosthesis. Instead of it grafting naturally with the bone it is now forming a fibrous grafting, i.e. which is unstable.
SO what is causing my left leg to remain weak? ATROPHIED muscle or something else.
Nov. 2014 left hip replacement.
March 2015 FREE FELL off of bike directly onto the operated leg incision.
When getting off the bike to stop for an intersection, I put my left leg down to hold me up. There was ZERO strength.
March 2016 had a bone scan done. Left leg continued to be weak, i.e. still cannot stand on my left leg to put on trousers or shorts without holding on to something. Radiologist report detected an infinitesimal movement of the prosthesis creating unstable body imbalance.
OTHER contributing factors. Lower back discomfort. Possible spinal column pinched nerves.
Through pt work outs I have learned that my left glute is soft and not firing. Doing dry needle therapy to get it started.
SO muscles have "possibly atrophied" I have heard mentioned twice. Once by an orthopaedic surgeon and once by a pt therapist as the source of my LEFT operated leg's weakness NOW a year and a half after the
Nov. 2014 procedure.
PLAN to DATE
Re-do the LEFT hip with a more secure prosthesis THIS July 29th. The bike FALL most likely jostled the
prosthesis. Instead of it grafting naturally with the bone it is now forming a fibrous grafting, i.e. which is unstable.
SO what is causing my left leg to remain weak? ATROPHIED muscle or something else.
Brief Answer:
Muscle atrophy results from not moving the muscles, or nerve injury
Detailed Answer:
Dear XXXX,
Thank you for trusting us at HCM with your question.
Muscle atrophy can result from not using the muscles for long durations after injuries or surgeries. This can be addressed by physiotherapy and training. I suspect though from your history that you were active enough since you were biking and it was not a problem of lack of activity.
Therefore, the second possibility is nerve injury. Nerves are important to maintain the muscle tone. if neural pulses are not getting to the muscles to keep muscle tone, hypotony happens and atrophy follows. Peripheral nerve injury can happen due to trauma.
Please refer to a neurologist for a check up on peripheral neural functions.
In any case, physiotherapy and targeted exercises for increasing muscle mass can help in recovery and regaining both muscular size and strength.
Kind regards,
Dr. Nazzal
Muscle atrophy results from not moving the muscles, or nerve injury
Detailed Answer:
Dear XXXX,
Thank you for trusting us at HCM with your question.
Muscle atrophy can result from not using the muscles for long durations after injuries or surgeries. This can be addressed by physiotherapy and training. I suspect though from your history that you were active enough since you were biking and it was not a problem of lack of activity.
Therefore, the second possibility is nerve injury. Nerves are important to maintain the muscle tone. if neural pulses are not getting to the muscles to keep muscle tone, hypotony happens and atrophy follows. Peripheral nerve injury can happen due to trauma.
Please refer to a neurologist for a check up on peripheral neural functions.
In any case, physiotherapy and targeted exercises for increasing muscle mass can help in recovery and regaining both muscular size and strength.
Kind regards,
Dr. Nazzal
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Nerve injury as a result of hip replacement surgery.
1) How likely?
2)Is it possible that a nerve is CUT getting to the hip replacement location?
AND RECOVERY is through physical therapy?
3) Nerve trauma. Define please.
4) Lower back pinched nerves a possible source of the left leg weakness?
Thank you.
1) How likely?
2)Is it possible that a nerve is CUT getting to the hip replacement location?
AND RECOVERY is through physical therapy?
3) Nerve trauma. Define please.
4) Lower back pinched nerves a possible source of the left leg weakness?
Thank you.
Brief Answer:
Detailed answer
Detailed Answer:
Nerve injury as a result of hip replacement surgery.
1) How likely?
Nerve palsy; nerve injury leading to clinical hypotony and palsy, is an uncommon but acknowledged complication of total hip replacement. The overall prevalence is approximately 1%. From those 1%, mostly sciatic nerve is the one injured other possibility is the femoral nerve. (Schmlazried et al).
2) Is it possible that a nerve is CUT getting to the hip replacement location?
In the majority of cases, the origin of the palsy is unknown. Because peripheral nerves are sensitive to compression, unrecognized compression may play a role in these cases. A study of Mayoclinic shows that it seems the surgery provokes an autoimmune reaction of inflammatory neuropathy confined to the leg that went under surgery, so cannot be attribute to surgical technique.
AND RECOVERY is through physical therapy?
Peripheral nerves have a higher possibility of recovery compared to central nerves, can be slow but physiotherapy is proven to help in recovery. The prognosis for neurologic recovery is related to the degree of nerve damage. Complete, or essentially complete, recovery occurs in approximately 41% and another 44% have only a mild deficit. In your case you have good prognosis since you had motor function within approximately 2 weeks of surgery have a good prognosis for recovery.
3) Nerve trauma. Define please.
Nerve trauma means nerve injury. For example the nerve was cut, that is trauma, if the nerve was under pressure for long duration this can lead to ischemia and result in nerve trauma. If for example lower back has disc prolapse and pressure is applied to the sciatic nerve feeling of numbness pain and muscular atrophy can result.
4) Lower back pinched nerves a possible source of the left leg weakness?
Yes, a MRI to the lower back can reveal if there is any disc prolapse leading to pressure on nerves of lower leg, which will lead to leg weakness, plus constelation of symptoms such as pain,and numbness.
I hope this provided insights and more information related to your question.
Kind regards,
Dr. Nazzal
Detailed answer
Detailed Answer:
Nerve injury as a result of hip replacement surgery.
1) How likely?
Nerve palsy; nerve injury leading to clinical hypotony and palsy, is an uncommon but acknowledged complication of total hip replacement. The overall prevalence is approximately 1%. From those 1%, mostly sciatic nerve is the one injured other possibility is the femoral nerve. (Schmlazried et al).
2) Is it possible that a nerve is CUT getting to the hip replacement location?
In the majority of cases, the origin of the palsy is unknown. Because peripheral nerves are sensitive to compression, unrecognized compression may play a role in these cases. A study of Mayoclinic shows that it seems the surgery provokes an autoimmune reaction of inflammatory neuropathy confined to the leg that went under surgery, so cannot be attribute to surgical technique.
AND RECOVERY is through physical therapy?
Peripheral nerves have a higher possibility of recovery compared to central nerves, can be slow but physiotherapy is proven to help in recovery. The prognosis for neurologic recovery is related to the degree of nerve damage. Complete, or essentially complete, recovery occurs in approximately 41% and another 44% have only a mild deficit. In your case you have good prognosis since you had motor function within approximately 2 weeks of surgery have a good prognosis for recovery.
3) Nerve trauma. Define please.
Nerve trauma means nerve injury. For example the nerve was cut, that is trauma, if the nerve was under pressure for long duration this can lead to ischemia and result in nerve trauma. If for example lower back has disc prolapse and pressure is applied to the sciatic nerve feeling of numbness pain and muscular atrophy can result.
4) Lower back pinched nerves a possible source of the left leg weakness?
Yes, a MRI to the lower back can reveal if there is any disc prolapse leading to pressure on nerves of lower leg, which will lead to leg weakness, plus constelation of symptoms such as pain,and numbness.
I hope this provided insights and more information related to your question.
Kind regards,
Dr. Nazzal
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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