Showing posts with label Recovery. Show all posts
Showing posts with label Recovery. Show all posts

Sunday, October 13, 2013

Muscle Atrophy

Muscle Atrophy

What is Muscle Atrophy?


Have you ever experienced fracturing a limb and not being able to use it for quite some time? You will then realize that the other limb seems to appear bigger over the affected limb. This could be an indication of muscle atrophy. What then is muscle atrophy? Muscle atrophy or muscle wasting can be defined as the loss of muscle tissues. There are several conditions which would lead to muscle atrophy. The mere lack of exercise or a sedentary lifestyle may cause your muscles to atrophy. More serious conditions such as poliomyelitis, amyotrophic lateral sclerosis (ALS) which is popularly known as Lou Gehrig’s disease, Guillain Barre Syndrome (GBS), inflammatory diseases like rheumatoid arthritis and several other diseases would cause muscle disuse which eventually result to muscle wasting or atrophy. Sustaining an injury after a vehicular accident would also cause muscle atrophy and even the aging process would as well lead to it. More specifically, muscle atrophy can be classified into two:








Disuse atrophy
This primarily occurs due to lack of muscle use. When you have a sedentary way of living and you fail to indulge to any forms of exercise that permit muscle use, you may likely suffer from disuse atrophy. There are also other medical conditions which would limit your muscle use. A debilitated or bedridden patient would likewise also suffer from disuse atrophy due to the limited range of motion. Astronauts are also at risk for disuse atrophy because of the prolonged weightlessness they experience which would trigger calcium loss in the bones.


Neurogenic atrophy
When there is damage to a certain nerve that joins the muscles, neurogenic muscle atrophy is likely to occur. Of the two types of muscle atrophy, this is the more serious one. Compared to disuse atrophy, neurogenic atrophy takes place more suddenly. Conditions like amyotropic lateral sclerosis, Guillain Barre Syndrome, poliomyelitis and other diseases with neuromuscular involvement can be classified as neurogenic atrophy.


Muscle Atrophy Symptoms


Aside from the visible muscle wasting, the following symptoms may also be present in muscle atrophy.



  • Problems in maintaining balance, as well as walking

  • Weakness in the facial muscles

  • Speaking may become a difficulty and memory loss may also be present

  • Tingling and weakness in the extremities

  • Loss of muscle coordination

  • Numbness or tingling in arms or legs

  • Gradual loss of movement

  • The weakness may become progressive limiting your movement

  • Easy fatigability


Most importantly, you should note for the danger signs of muscle atrophy which include the following:



  • Changes in sensorium and sudden loss of consciousness

  • Slurring of speech

  • Local or generalized paralysis

  • Eye pain with blurring or even sudden loss of vision

  • Severe headache


When you noted any of the above mentioned life-threatening symptoms of muscle atrophy, do not be reluctant to seek medical help because this may indicate an impending doom. There should not be a delay so as to prevent irreversible damages.


Muscle Atrophy Causes


Generally, there can be two causes of muscle atrophy. First off, this can be due to the lack of muscle use probably because of impaired mobility in cases of bedridden people and those with inflammatory joint diseases such as rheumatoid arthritis. Damage to nerve can also cause neurogenic muscle atrophy. Some cases of muscle atrophy may be due to the normal process of aging. Nonetheless, this can also be specifically due to the following factors:


Disuse Atrophy Causes



  • Becoming bedridden

  • Dermatomyositis- This is a disease manifested by the presence of muscle inflammation and skin rash

  • Sustaining an injury such as arm or leg fracture

  • Malnutrition- This makes a person very weak to initiate even a single movement.

  • Muscular dystrophy- It is possible for someone to inherit this condition which is characterized by the gradual loss of muscle tissues leading to muscle weakness.

  • Osteoarthritis- As people grow older, they may also likely suffer from a condition called osteoarthritis which commonly brings about pain and impairs mobility.

  • Polymyositis- This is characterized by muscle inflammation which eventually leads to muscle weakness.

  • Rheumatoid arthritis- This is a type of inflammatory joint disease which would also cause muscle atrophy.


Neurogenic Atrophy Causes



  • Alcohol myopathy

  • Amyotrophic lateral sclerosis (ALS) – Former athlete, Lou Gehrig, was the first person to be diagnosed of this disease. This is a serious type of muscle weakness which may lead to death.

  • Diabetic neuropathy- The nerve can also get damaged with high glucose levels.

  • Guillain-Barre Syndrome (GBS) – This is another type of autoimmune disease which also causes muscle weakness.

  • Multiple sclerosis- This is brought about by the demyelination of the protective cover of the nerve called myelin sheath which leads to muscle weakness and loss of muscle coordination.

  • Neck or spinal cord injury

  • Spinal cord atrophy- Some people are born with this condition which causes damage to the spinal cord leading to profound weakness.


Muscle Atrophy Diagnosis


Aside from the presence of clinical manifestations and thorough history taking, muscle atrophy can be confirmed through the following:

  • CT scan

  • Electromyography

  • MRI

  • Muscle/Nerve biopsy

  • Nerve conduction analysis


Muscle Atrophy Treatment


There are varying modes on how to treat muscle atrophy and these may include the following:



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Exercise


This is the best way to treat muscle atrophy. Most types of disused atrophy can be cured with this, so long as there’s not a presence of a more serious condition like GBS, ALS and many others. The suggested exercises include brisk walking, swimming, jogging and other cardio exercises. However, before you indulge to any of these, it is imperative that you consult your physician first for any limitations.


Medications


Medications would usually include corticosteroids and other anti-inflammatory drugs to halt the inflammatory process, if there’s one.


Joint manipulation by a chiropractor


Ever heard of a chiropractor? A chiropractor is an individual licensed to do joint manipulation to correct impaired mobility. The joint is literally stretched to allow more movement. However, this may not work especially for more serious conditions.


Surgery


Surgery may be the last resort to treat muscle atrophy.


Recovery


There are several factors which influence the rate of recovery in people with muscle atrophy. Often, those who are only suffering from disuse atrophy would eventually recover in no time, provided that rigid exercise is done. However, for those with more serious conditions like Guillain Barre and ALS, a more intensive treatment is required. Overall, the chance of recovery for people with muscle atrophy largely depends on the type of muscle atrophy one has.













MCL Tear

MCL Tear

What is MCL Tear?


An MCL tear or Medial collateral ligament tear is a physical injury sustained on the knee, dealing critical damage to one of the vital components of the joint in the knee that offers support and stability to the entire limb and body.








The MCL is one of the four main ligaments of the knee, along with the anterior cruciate ligament, the posterior cruciate ligament, and the lateral collateral ligament – each one an important factor to keeping the knee steady and secure as they are all made of a tough material designed to withstand stress and great power. However, despite their natural durability, these ligaments are not immune to injury and possible permanent damage.


Any form of injury to the MCL can be extremely painful and is mostly brought about by sports accidents. The tear is caused by applying a high amount of stress or pressure onto the joint, which may be achieved through landing onto a bent knee with great force. This incident stretches the MCL beyond it capacity and in consequence, tears the ligament apart. The tear impairs the affected leg’s ability to control flexion, maintain stability, as well as rotate, as each one is a role the medial collateral ligament performs – along with the main function of preventing the leg from flexing inwardly for far too much.


Recovery and treatment for MCL tears depends upon the extent of the injury. The MCL tears are classified according to grades that indicate the degree of damage that has been dealt. The grade of injury is determined according to the symptoms experienced.


Symptoms


The symptoms that accompany the MCL tear are crucial to determining the magnitude of the injury along with the appropriate care needed and the potential for recovery. In general, the following are the typical symptoms of an MCL tear:



  • Severe pain, situated directly on the location of the medial collateral ligament

  • Development of a swollen knee, centered over and around the torn medial collateral ligament

  • Appearance of visible bruising on injured area; will usually develop within 2 days after the injury is sustained

  • Patient may state that the knee feels unstable or gives the impression of being on the edge of giving out


To further characterize each grade of an MCL tear, each symptom possesses specific features that distinguish the injury to a particular grade alone, possibly classifying the damage as 1st, 2nd, or 3rd grade. The following is the system utilized for determining the grade given to an MCL tear:
Grade I MCL Tear

  • Minor pain and tenderness

  • Ligament does not feel unstable

  • Pain only experienced upon applying pressure onto the MCL


Grade II MCL Tear

  • Observable looseness of the knee when moved with assistance

  • Instability experienced especially when patient attempts to turn or pivot

  • Greater pain and tenderness

  • Affected knee is swollen


Grade III MCL Tear

  • Extreme pain and swelling

  • Limited ability to bend the knee

  • Knee is found to give out or buckle as stability is severely impaired


Treatment and Surgery


The treatment necessary for an MCL tear will depend on the grade of the injury. Certain methods are maintained constant regardless of the grade however; these include the control of pain as well as the rehabilitation to regain movement and strength. Braces are also often utilized to supplement treatment by stabilizing and immobilizing the knee while it is still in the process of recovery.



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The specific treatment for Grade I tears is not extensive as the injury is minor and does not leave permanent debilitation of mobility. Treatment consists of maintaining rest and avoiding activity for a period of weeks to give the ligament some time to heal. Pain and swelling is helped through applying ice over the site of the tear, as ice or the application of any amount of cold promotes the constriction of blood vessels supplying the injured area – thereby limiting bleeding and pain. Anti-inflammatory medications are also prescribed to address swelling. The doctor will then prescribe some knee exercises to bring back normal tolerance to movement in the affected knee.


For grade II MCL tears, a hinged knee brace is commonly used for treatment, allowing movement but simultaneously providing support at the same time. Treatments for Grade II injuries are grossly similar to that for Grade I MCL tears.


Grade III MCL tears will require more extensive treatment due to the greater severity of the injury. Patients are given braces for the knee and are temporarily required to make use of crutches for movement while the pain in the injury still persists. After the period of immobilization, the patient will return for regular exercises to engage his or her range-of-motion, improving the joint’s return to tolerating movement.


Another method of rehabilitation apart from range-of-motion exercises involves stationary bicycling. The patient can then progress along treatment by attempting walking and jogging, depending on the severity of the pain that accompanies the activities.


Surgery is only a final resort for severe MCL Tears. The procedure is termed as arthroscopic surgery, involving the repair of the torn ligament or even replacement of the MCL if mere suturing or repair does not appear to suffice.


Recovery


Recovery, like treatment for MCL tears, will depend on the extent of the injury as the time it takes for an injury to heal is directly proportional to the immensity of the damage incurred. For MCL tears that are classified to belong to the lowest grade, Grade I, full recovery may take only about 2 to 10 weeks. Recovery periods for Grades II and III of MCL tears are not as easy to calculate because damage sustained is considerably greater in these cases. In most cases, Grade II MCL tears may require at least a month for full recovery to take place, after which normal sports activities may then be resumed. Grade III MCL tears will need a greater amount of time to heal, taking as much as about 6 weeks up to 3 months before the patient may be able to go back to his or her usual routine of sports and other physical activity.