Physical Therapy for Muscle Weakness

MUSCLE WEAKNESS 101

Let’s face it, we all know what it feels like to be weak. Whether you have tried and failed to set a new deadlift PR or attempted to lift your leg off the ground for the first time after knee surgery, muscle weakness can happen to all of us. Physical therapists address muscle weakness due to all kinds of conditions. Some people arrive at physical therapy wanting to get stronger after an illness or injury and others have simply weakened after a period of inactivity. Nonetheless, addressing muscle weakness the right way is necessary to ensure success and prevent injury. 

Weakness is a relative term. You can be too weak to do a pull-up but strong enough to do everything else in your daily life. You can also be too weak to sit yourself up in bed. Same problem but vastly different implications. The needs of those experiencing muscle weakness can vary dramatically depending on its severity and cause. Let’s explore some of the common causes of muscle weakness followed by an introduction to physical therapy for muscle weakness.

COMMON CAUSES OF MUSCLE WEAKNESS

1. Slacking at the gym

A wonderful thing about healthy muscles is that they respond to stimuli by getting stronger or weaker. Lifting weights two to four times a week following the principle of progressive overload (increasing resistance over time) will inevitably result in stronger muscles in four to eight weeks. But life has a way of messing with our routines and suddenly you find yourself hitting snooze and skipping sessions at the gym. In no time at all you notice you can’t lift the same weights as easily and you see your toned muscles getting a bit smaller. In a way, your muscles have become weak, too weak to move the same amount of weight you could when you were training regularly. Despite feeling weak in the gym, most people experiencing this type of weakness will continue to perform their daily tasks without difficulty. 

2. Bedrest or illness

Every day you spend in bed requires at least three to four days to recover due to the negative effects that bedrest has on your muscles, cardio and respiratory systems. When you aren’t up and moving around, muscles can quickly begin to atrophy and the neuromuscular connections between the brain and the muscles start to deteriorate. Add on the effects that illness, injury or surgery can have on your system and weakness can develop quickly. Spend two weeks in a hospital bed and you might not recover your normal level of strength and fitness for at least six weeks. 

3. Neurologic injury or illness

Injury to the central or peripheral nervous system can cause varying levels of muscle weakness. The central nervous system (CNS) consists of the brain and spinal cord. The brain and spinal cord house what are called upper motor neurons. When your brain decides to contract a muscle or a reflex movement is initiated at the spinal cord, a nerve impulse travels through the CNS eventually passing into the peripheral nervous system (PNS) and out to a muscle.

Any injury or illness that impacts the brain or spinal cord can interrupt this pathway. If the area of the brain that tells a certain muscle to move is injured or if there is a blockage or interruption somewhere along its pathway in the CNS, the corresponding muscle will not be able to contract normally and sometimes not at all. This can lead to muscle paralysis, weakness, and eventually atrophy. Examples of CNS injuries that lead to muscle weakness include spinal cord injuries, traumatic brain injuries, strokes, multiple sclerosis and .ALS 

The peripheral nervous system (PNS) consists of nerves that originate just outside the spinal cord and travel through the face, trunk and limbs to innervate muscles in those areas. Injuries or conditions affecting the PNS prevent nerve signals from traveling normally to the muscles. If the signal is weak, the muscle will not contract strongly. If the signal eventually disappears altogether, the muscle becomes paralyzed. Conditions and injuries that affect the PNS include peripheral neuropathy, spinal radiculopathy, crush injuries to a nerve, nerve palsies and Guillain-Barre Syndrome. 

4. Myopathies

Myopathies are a group of diseases that attack the muscles. With myopathies, the nerves that tell a muscle to contract are healthy but the fibers, proteins, enzymes or cells essential for muscle contraction are not. Some myopathies are inherited and others are acquired, or develop later in life. Muscle weakness, cramps, stiffness and fatigue with exertion are common symptoms of myopathy. The muscles closest to the trunk like the thighs and shoulders are most affected. Some myopathies are progressive. These conditions can cause minor weakness but can also lead to severe weakness that affects even the most basic activities of daily living and self-care. 

Examples of myopathies include Duchenne Muscular Dystrophy, metabolic myopathies and critical care myopathy. 

PHYSICAL THERAPY CAN GET YOU STRONGER

While an uninjured and healthy person may choose to work with a personal trainer or coach to help them reach their strength and fitness goals, physical therapists are healthcare professionals trained to address symptoms like muscle weakness in individuals dealing with illness, injury, disease or disability. If you have been injured or are living with a disability, you may be unsure how to approach strengthening safely and effectively. No need to worry, this is why physical therapists exist! My team of therapists and I will review your medical history, take the time to understand your strength goals and how muscle weakness is impacting your life. 

We will create an individualized functional and isolated strengthening program that considers your goals, past medical history and tasks and activities that are salient to you. We can also address pain, flexibility, cardiorespiratory endurance and balance to ensure that you are ready to get back to the activities you need and love to do. By the end of your physical therapy treatment, you should feel confident that you can continue with an exercise program on your own that will help you stay as strong as possible. 

If you are dealing with muscle weakness and ready to learn how physical therapy can support you, call Evolve Physical Therapy today to schedule an initial evaluation. 

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About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

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