PLS and intercostal muscles

[dkcarl62]

Has it been suggested to any of you that your speech difficulties are a result of weak intercostal muscles? Let me back up a bit - the neurologist I saw at last clinic visit isn't convinced a dx of UMND ALS is appropriate for me. He's leaning toward PLS. But then after a speech eval, the SLP said I had weak intercostal/diaphragm muscles.

You input is appreciated.

Deb

 

[affected]

Hi dk what kind of speech issues?

 

[Schmutz]

Not to be picky, but I think you meant intercostal muscles. It took me a couple of searches to find them. Those are in your chest and can definitely affect speech. My doctor never mentioned them,but my speech has only just begun to become gravelly.

 

[dkcarl62]

You are correct Schmutz. How do I change the post title? Tillie, I sound breathless. Labored. I speak slowly, but my tongue works well. My words are understandable.

Deb

 

[ShiftKicker]

Deb, I get the same when I'm fatigued or feeling high emotion. I was told it was diaphragmatic spasticity. If the diaphragm is spastic, it can be weak, and you wouldn't have the same kind of breath control as you once had. Your intercostal muscles could be overworked as a result of picking up some of the slack with a weak diaphragm, or they could be spastic as well. Did your SLP give you any ways to help with breath control?

The SLP I spoke to gave me breathing exercises to hang on to as much breath capacity as I could. Basically, take a normal breath in and hold it for a second or two. Then, without breathing out, try to take in as much breath as possible and hold for an additional two or three seconds. Breathe out slowly through pursed lips. It seems to stretch out the stitch in my side when intercostal cramps set in as well.

 

[affected]

Thanks Deb, and it looks like the mods changed the title for you

Funny I didn't notice the spelling error as I knew the muscles you meant.

Yes, the speech problems you describe are from not having enough breath to speak well. Speech, after all, is a result of air moving through the voice box, so if breathing is shallow or difficult then the tone of the voice can change, and the voice weakens, and of course combining speaking with breathing can make your breathing more laboured.

Breath stacking has been described and lots of PALS say that it really helps. There are lots of videos online that show how to do it.

 

[dkcarl62]

Thanks for changing the spelling, mods! Important for search results! So back to my original question tho. Is diaphragm weakness a symptom of PLS? I thought only ALS caused muscle weakness.

Deb

 

[affected]

My understanding is that yes, with PLS you can still develop breathing problems.

Breathing is directed primarily by the diaphragm which is a big dome shaped muscle that runs along under the lungs.
The intercostal muscles are a whole bunch of smaller muscles that sit between each of your ribs.

 

[dkcarl62]

Fiona, I've seen two SLP's so far and neither has suggested exercise. I appreciate the heads up about breath stacking and will check that out. Thanks for the answer, Tillie. I hope more PLSer's with this problem chime in on this thread.

Deb