Ongoing concerns

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RunTwitch

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Sep 25, 2019
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Learn about ALS
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Country
UK
State
BC
City
Manc
Hi there,

First of all can I just say thank you to giving your precious time to those of that have ongoing fears regarding their health. I wish you all the best with whatever circumstances you are facing.

A bit about me. I am a 42 year old, male, marathon runner. I have been twitching for 20 months, primarily in the calves (24/7). 1 year after the twitching began I completed a sub-3hr marathon. I must add I have always had health anxiety.

1 month before the marathon I decided to see my GP. I passed a clinical other than exaggerated reflex in my L arm, because of which the GP referred me to a neurologist. My neurologist appointment came 1 month after my marathon. The neurologist did a full clinical and told me not to be concerned – she saw no weakness, thought the reflex in my L arm was normal, and diagnosed BFS.

My relief lasted about 2 weeks. For the latter part of marathon training I had had a sore lower back, and as I work within healthcare was lucky enough for a physio to examine me. During the consultation she asked whether I was predominantly right handed, as there was significantly more muscle on the right hand side – almost like “muscle wasting on the left”. The neurologist had not asked to see my back. As you can imagine this set my anxiety sky high. I reasoned that I am predominantly R handed, and after the recent BFS diagnosis tried not to fall down the rabbit hole of constant worry and testing. However, I had also been having a bit of shoulder pain in that L arm, which was steadily getting worse (sharp pain when lifting my arm above my head). Fast forward 4 months and the L shoulder & upper arm discomfort/pain continues to worsen. I have also been having significant L deltoid & tricep ache and occasional pain in the L forearm. There is no doubt that my L arm tires quicker than my right. I recently completed a 13 mile run and my L arm became painful during the run. Following on from this, for the first time ever, I had Delayed Onset of Muscle Soreness (DOMs) in my left arm. When I lift heavy bags I feel pain in my upper back (scapula region) and the ache in the deltoid/trapezius. When I bend my head forward whilst looking in the mirror I notice that my L scapula head protrudes more than my R. I also notice occasional fasiculations in my L bicep, tricep and deltoid (whereas I haven’t noticed any in my right – though I don’t often look!). Recently, every morning my little fingers (bilaterally, worse in L) are stiff upon waking. I have researched this and it is almost like Trigger finger – they catch when flexing and again upon relaxing.

I have strength tested my left arm during routine workouts, and whilst there is slight weakness compared to my R, I believe this has always been the case. I can still do 80 press-ups, bicep curl, bench press etc. I am now starting to become very concerned as the upper arm ache progresses from an irregular occurrence, to an everyday event. I notice that when cycling I now rest my L arm on my knee. I don’t consciously do this, it has just started happening, as that arms tires.

More recently I have been getting an ache in my left calf. It feels almost like a pre-cramp, if that makes any sense. It doesn’t come and go, it simply remains, ever present. And last week when pushing hard on my bike that leg tired at lot quicker than my left, and I was left with a ‘dead leg’ when I finished the ride.

I have booked another appointment at the doctor (2 wks time) and will request bloods and onward referral to a neurologist. However, this process could take months. I guess I am writing to ask whether this sounds familiar to any of you, or if anyone may have an explanation for my ongoing symptoms?

Kind regards
 
Please read this if you have not already done so: Important - READ BEFORE POSTING! Answers to common concerns about possible symptoms!

You aren’t describing ALS.

At 42, I hate to say it, but you are now a middle-aged athlete, pushing yourself hard, at that’s about the time when injuries really start to show up. Most people have some asymmetry in their skeletal structure, at it can lead to imbalances in muscles, resulting in pain and injuries. People will start to show this in their 40s, 50s, and 60’s, with athletes often showing the effects earlier.

You’ve mentioned twitching. Twitching is common, nonspecific, and meaningless in the absence of muscle function failure which you have not described. You also mention lots of pain. This goes along with injuries and muscle strain from mechanical imbalance, resulting from the asymmetry I mentioned. Pain points away from ALS. Asymmetry of muscle bulk is also common in general, and is more likely to be noticed in athletes.

So by all means see your doctor to make sure there is no significant weakness or other abnormalities on exam. The physio noticing asymmetry in the muscles of your back just shows asymmetry, nothing more. However, a good physio can work with you to correct mechanical imbalances. This will help the asymmetry and should reduce the pain. It can also help you to avoid future injury.

But the good news.... no ALS here.
 
Please read this if you have not already done so: Important - READ BEFORE POSTING! Answers to common concerns about possible symptoms!

You aren’t describing ALS.

At 42, I hate to say it, but you are now a middle-aged athlete, pushing yourself hard, at that’s about the time when injuries really start to show up. Most people have some asymmetry in their skeletal structure, at it can lead to imbalances in muscles, resulting in pain and injuries. People will start to show this in their 40s, 50s, and 60’s, with athletes often showing the effects earlier.

You’ve mentioned twitching. Twitching is common, nonspecific, and meaningless in the absence of muscle function failure which you have not described. You also mention lots of pain. This goes along with injuries and muscle strain from mechanical imbalance, resulting from the asymmetry I mentioned. Pain points away from ALS. Asymmetry of muscle bulk is also common in general, and is more likely to be noticed in athletes.

So by all means see your doctor to make sure there is no significant weakness or other abnormalities on exam. The physio noticing asymmetry in the muscles of your back just shows asymmetry, nothing more. However, a good physio can work with you to correct mechanical imbalances. This will help the asymmetry and should reduce the pain. It can also help you to avoid future injury.

But the good news.... no ALS here.

Thank you Karen.
 
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