10 Top Risks Of Muscle Pain.

 Tips About Muscle Pain From Industry Experts

We're going to discuss calf pain today. You must know this if you’re having calf pain,

Is it a muscle strain? 

Is it a clot or is it

We even have another thing it possibly could be Compartment syndrome Was going to go over some of the possible signs of each and hopefully help you discern

But at some point, you may have to go to the doctor to actually, get this figured out, you’ll have to see a professional, particularly For blood clots, but we are going to go over some things that they’re going to look for and how they look for it as well.

We are going to start out with a muscle strain though

• When you have calf pain very common the most common cause
• The most likely cause is Straining a muscle
• A strain or slight tear
• And the activity is usually
• You’re out playing softball and you took off running from first base 
• You felt that sharp pain
• You’re jump roping
• Maybe running longer distances
• Very common in tennis players

Sometimes you could have a muscle strain and you don’t really know where it came from

•  It may be going up the stairs aggressively
• When you weren’t thinking about it
• It crept up on you
• So one way or another the location

 The location is Typically the muscle belly, although if it's a tendon, you know It may be lower down in here or right in the tendon itself.

Then you might have tendonitis

That’s a bit different then, but it does tend to be right in the middle there  basically, that’s where The gastric this bump here and the soles muscle here oftentimes right on that borderline

Sometimes in a little deeper, it does vary, it Oftentimes points tender if you’re pushing the muscle, if you can find the spot It’ll actually hurt, it might be the size of a quarter a little bigger than that

Heel Wedge

When you stretch it or dorsiflex often times that may irritate it particularly if you go a little more aggressively, the treatment is actually to wear A little heel wedge for a while,

That takes some of the stress off the cap, you take like a half-inch heel wedge and put it in your shoe,  it’ll take some of the stress off the calf while it is healing, right if you do that,

 You should put one under each foot otherwise, you’ll have one leg essentially shorter than the other but if you do that also, you should notice that It immediately feels better and it’s a short-term thing

Cold Packs

You’re not going to wear these on your feet because you don’t want the heels to tighten up other treatments for a muscle strain you’re going to use cold packs initially when it's tender and sore 24 to 48 hours generally

Gentle Stretching

You can do some gentle stretching, you just injured it.

You don’t want to stretch it aggressively and re-injure it, maybe some gentle range of motion and stretching initially particularly ibuprofen if you want to do some anti-inflammatory Over-the-counter, And then you know after it's starting to heal

Roller

 You may get into some soft tissue work either some cross friction mobilization or the six-inch roller where you’re going to work on that,

Typically a calf strain is going to heal within two weeks and is probably getting pretty good it may go up to six weeks depending on how aggressive you are if you go out and run or do something to irritate it, they tend to respond well mean, and two weeks is probably if it’s a new injury and you do the cross fibber Right away

Six weeks might be more for a chronic problem.

The Compartment Syndrome

This is more of a rare event

  you have actually four compartments in your calf and each compartment has Muscled in it when you exercise those compartments start to fill up with blood because the muscles need the blood But the blood doesn’t exit the way it’s supposed to, in Compartment Syndrome.

 Normally it does exist, right precisely so what happens is blood going in because you exercise, the blood not going out for whatever reason and the compartment starts to fill up and gets too much pressure get too much lactic acid in their pain starts and typical

Symptoms are

• Once you start an activity within a short time, you get a real sharp pain
• But then when you stop The pressure goes down and it feels better
• You do your activity again a sharp pain
• Stop If it's serious
• Youll see some swelling
• You may have numbness and tingle down your foot
• Because the nerve and the blood flow are Being Compromised

 If you're getting that kind of symptoms neurological symptoms you got to go in. I think you're going to see this quite often in runners I mean this type you might see it as a runner or Biker because you’re using the calf a lot.

 When I was running I get a little numbness and I think it was just a mild form of Compartment Syndrome Another time you get Compartment Syndrome is after trauma.

If the leg gets broken or a crushed syndrome where the leg got smashed That can irritate and start the blood flow problems, which can lead to Compartment Syndrome, so the compartments are made out of fascia and the muscles are inside the fascia.

They form again kind of a tube almost right around the muscle and again, they can only expand so much So the muscles expand from the blood flow.

It's compromising on the blood and the nerves.

That fascia though it’s not As far as a treatment on this Particularly if it's serious, it’s a simple surgery it’s simple once they Prepare everything It's 15 minutes They go in it's an incision.

They open up the compartment and release some pressure It actually has to heal up and it's all soft tissue.

I wouldn’t recommend doing it yourself

Blood Clot

we’re talking about is a DVT or a blood clot, deep vein thrombosis Professional term, right the layperson calls it a blood clot and That can happen here oftentimes, it’s a little closer to the knee You can get these blood clots throughout the body or anywhere, but this is a common location for them

The worry is that the blood clot could dislodge and go up into your lungs.

The concern is on airplanes when you’re on an airplane  go ahead and do ankle pumps because you’re sitting still there’s something to do with the air pressure too, on airplanes the simple thing is getting some exercise you get these muscles working Keep the circulation moving

You’re more at risk after surgery, obviously Surgery or maybe an injury that things are healing down there If you have a lot of swelling in your leg for whatever reason a little more concerned about it If you’ve suddenly become more sedentary for a reason and maybe because of an injury or something, then you could be more at risk

Normally you’re active, you broke a leg or whatever and you’re sitting around for days on end because of the injury But waiting for it to heal that’s always a concern as far as symptoms

Squeeze feel for temperature Tenderness, when you squeeze an area that’s got a deep vein thrombosis it’s pretty tender, yes it is, And then we’ve stretched the ankle.

There’s a test called the Homan sign We're not going to go through it in detail but you palpate, you stretch the muscle you check for temperature and the thing is if It's positive in the clinic Chances of it being a false positive are pretty high.

In other words, 50% of the time It may be a positive Homans  sign saying, it looks like a deep vein thrombosis And you take it in and do the confirmation test which is an ultrasound done in the hospital

Or where they have an ultrasound and that’s going to tell you, I don’t recommend you try to diagnose yourself with either Compartment Syndrome or blood clot You need a professional to do it.

Probably 10 people were sent in to check to see whether or not they’ve had a blood clot and it’s been five Or six that did.

 It goes along with the study that right about 50% And you know quite often, squeeze one side and squeeze the other side and compare if they both hurt you know Usually we take a lot of things into consideration.

  It's something you need to work with Day after day year after year to really get a good feel for both Compartment Syndrome and a blood clot or DVT So I hope this helps you understand a little bit about calf pain and some of the more common reasons for it and then you know what to do about it Yeah,

 Can Statins cause muscle injury? 

• The straightforward answer is yes In clinical practice we see this nearly daily with different patients. 
• In fact, the type of injury to your muscles has a variety of names.
• The most common is a medical term referred to as myalgia.
• You will have a feeling of soreness and stiffness or tenderness in your muscles sometimes this is described as cramp-like or like a cramp.
• The best way of comparing this is if you’ve ever had a viral infection, like the flu, that’s the type of pain I’m talking about.
• Another type of injury to your muscles is referred to as myopathy which just means your muscles feel weaker.  
• You may have pain and discomfort with this type of weakness.
• Then there is a muscle inflammation where you will feel muscle discomfort and soreness, this is called myositis. 
•  A step worse is a term called myonecrosis where because of muscle breakdown, a marker called CK is released and can be measured.
• The worst type of this is rhabdomyolysis, where during this muscle breakdown, a protein is released from your muscles and excreted in your urine.
•  You can also have acute renal failure at the same time with this condition. 

 You're more likely to have this breakdown of the muscles coupled with renal failure, especially,  if you're taking the type of drugs which can cause drug-drug interactions and the most common being  HIV drugs, Cyclosporine and Gemfibrozil.

Clinical symptoms? 

Typically your upper muscles in both your extremities feel weak and sore so things that you and I take for granted like getting up from your chair, walking up steps or stairs, and raising your arms will be affected and your activities of daily life are affected. 

Sometimes these symptoms feel cramp-like and some patients even complain about tendon pain as the tendons are close to your joints and this pain is radiating, this pain is also sometimes described as pain in the joints or joint pain. 

 Usually, in my experience, these symptoms occur within weeks after starting off Statin drugs,  but sometimes this can occur after months and sometimes even after years.

If you’re having pain or soreness talk to your doctor, talk to your physician about going off the drug, symptoms should resolve typically within two to four weeks sometimes it may even last up to six months.  

If you’re unlucky and this disorder does not resolve and you continue to have symptoms you may have a disease disorder called immune mediating necrotizing myopathy. 

 This is due to antibodies being built against an enzyme in the muscle this would probably need a referral to a specialist as further workup is required and needed including an MRI and a biopsy.  

Another disorder that may be induced by statin therapy is a condition called mono neuritis multiplex?

What does that mean?

It happens when there's damage to two or more nerve areas.

This is a type of neuropathy where nerves are affected,  so you will experience a group of symptoms such as numbness, tingling, a lack of sensation, difficulty controlling movement, and pain.

Another statin-induced disorder is a myopathy or weakness around your eyes which can mimic Graves disease or Graves disease eye disease.

Some Statin medications  with an increased risk for muscle injury: 

•  Lovastatin the brand name is Mevacor, 
•  Simvastatin the brand name is Zocor
•  Atorvastatin the brand name is Lipitor. 
•  The reason is the way these drugs are metabolized in your body.

Some other statin drugs have a lower risk if they are metabolized in  your body because they’re metabolized differently  

 Those are

• Fluvastatin is called Lescol which  is the brand name
• Pravastatin and the brand name  is Pravachol,
• Pitavastatin and the brand name is Livalo.

The ability to cause muscle injury among different statins also depends on the statin dose.

 So the higher the dose the higher the risk. 

 The other thing is that certain diseases 

Such  as

•  Hypothyroidism,
•  Renal failure,
•  Liver diseases  

Also associated with a higher risk of muscle injury secondary to Statins and as always genetics plays a role and makes you more susceptible to Statin injury.  

 I'm going to go through a list of drugs and if you're taking them there is a higher risk of drug-drug interaction with Statins and a higher risk of muscle injury.

  These drugs can be

• HIV drugs 
• Calcium Channel Blockers
•  Amiodarone
• Macrolide  antibiotics such as azithromycin and erythromycin  
• Anti-fungal medications
• Cyclosporines 
• Colchicine
• F rates
• Niacin

So talk to  your doctor if you’re taking one of these drugs 

  How do we diagnose a muscle injury from statins?

  Of course, you need a physical examination including detailed drug history and then you can do a blood test which includes a CK.

 Are you on a Statin and do you have muscle aches?

what are some of the things you can do together with your doctor to combat this muscle pain while you're taking a Statin?

Here Are The 6 Tips:

Tip 1:

 Discontinue the drug waiting for the resolution of symptoms.

Your symptoms  like I mentioned earlier on should resolve within a couple weeks,

Tip 2: 

 Your Doctor might lower the dose of the statin or even change the class of the statin to another alternative class of the drug. 

 Tip 3:

 Another approach is to give the drug every other day.

 Tip 4:

 If symptoms persist switch to a non-Statin therapy such as Niacin or Fibrates or a new class of drugs called PCSK9 inhibitors or  Bile Acid Sequestrants such as cholesterol.

Have fewer medications and fewer pills and reduce your pill burden and minimize the number of medications you’re taking to reduce side effects and to reduce drug interaction.

So how can you do that? 

• You can lose weight
• Enjoy a diet rich in fiber  
• Fruits, vegetables, and fish
• Lean meat and chicken
• Stay away from processed meat 

 Tip 5: 

Sometimes Vitamin D is lower and your doctor might choose to re-challenge you once the level has improved after being replenished with an appropriate dose of vitamin D. 

 Tip 6:

 which is the last tip, your Doctor might add Co-Enzyme Q10: doses can range from 30 to 250 milligrams per day.

 Coenzyme Q10  plays a role in muscle cell energy production  therefore this supplement is suggested to help  muscle-related problems caused by Statins,  however, the studies are mixed, and therefore  Have this discussion with  your Doctor, with your provider about adding this  supplement

 Conclusion

You're lifting weights. The first time feels easy, but each lift takes more and more effort until you can’t continue.

Inside your arms, the muscles responsible for the lifting have become unable to contract.

We often blame lactic acid or running out of energy, but these factors alone don’t account for muscle fatigue.

There’s another major contributor:

• The muscle’s ability to respond to signals from the brain.
• To understand the roots of muscle fatigue, it helps to know how a muscle contracts in response to a signal from a nerve.
• These signals travel from the brain to the muscles in a fraction of a second via long, thin cells called motor neurons.
• The motor neuron and the muscle cell are separated by a tiny gap, and the exchange of particles across this gap enables contraction.
• On one side of the gap, the motor neuron contains a neurotransmitter called acetylcholine.
• On the other side, charged particles, or ions, line the muscle cell’s membrane: potassium on the inside, and sodium on the outside.

The flux of these charged particles is a crucial step for muscle contraction: the change in charge creates an electrical signal called an action potential that spreads through the muscle cell, stimulating the release of calcium that’s stored inside it.

This flood of calcium causes the muscle to contract enabling proteins buried in the muscle fibers to lock together and ratchet towards each other, pulling the muscle tight.

With each contraction, energy in the form of ATP gets used up, waste products like lactic acid are generated, and some ions drift away from the muscle’s cell membrane, leaving a smaller and smaller group behind.

Though muscle cells use up ATP as they contract repeatedly, they are always making more, so most of the time even heavily fatigued muscles still have not depleted this energy source.

And though many waste products are acidic, fatigued muscles still maintain pH within normal limits, indicating that the tissue is effectively clearing these wastes.

But eventually, throughout repeated contractions, there may not be sufficient concentrations of potassium, sodium, or calcium ions immediately available near the muscle cell membrane to reset the system properly.

So even if the brain sends a signal, the muscle cell can’t generate the action potential necessary to contract.

The more regularly you exercise, the longer it takes for muscle fatigue to set in each time. That’s because the stronger you are, the fewer times this cycle of a nerve signal from the brain to contraction in the muscle has to be repeated to lift a certain amount of weight.

Fewer cycles mean slower ion depletion, so as your physical fitness improves, you can exercise for longer at the same intensity.

Many muscles grow with exercise, and larger muscles also have bigger stores of ATP and a higher capacity to clear waste, pushing fatigue even farther into the future.