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Bilateral Leg Quadricep Weakness, No Pain
I’m a very fit person who used to lift daily and was very strong. One day during training for the military after a body weight workout that wasn’t anything I thought was too hard, I had uncontrollable shaking in my legs for the whole day. After that for a week my quads hurt very badly and were very weak. Since then anytime I do anything remotely physical for more than 10 minutes I experience weakness in my legs and they feel unstable like they’re gonna give out at any moment. My strength is significantly down compared to what I was able to do just before this and feel like I don’t have full control over my quads in terms of contracting them. There is no pain associated with the weakness. This has been happening for 6 months, I have been seen by my primary care doctor and 2 neurologist as well as sports medicine and been through 2 months of physical therapy with no answers or improvement. I have had 2 negative EMG’s and NCV’s as well as a brain MRI and a lower back MRI. The only thing out of the ordinary in all the testing is moderate to severe foraminal stenosis which none of the doctors thought was anything but I’m starting to wonder if that could be what’s causing my weakness?
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hi,divedoc. Whatever is happening after ten minutes of activity is not happening while static and supine in the MRI or while stationary with the EMG or the Nerve conduction flow.
A chiropractor will give you the best physical exam for motion mechanics. There could be restrictive flow during activity. It rather sounds like central canal stenosis. It could be vertebral slippage spondylothesis aggravated by particular movements. https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/spondylolisthesis.html
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1 ReactionThank you for the information. I forgot to add that along with the foraminal stenosis I have a grade one anterolisthesis at L3-L4 with unroofing of the articular disk and bilateral pars defect.
divedoc94, it's good that the neurologists don't see nerve damage.
You might ( I would) send the MRI CD to several orthopedic surgeons. Find at least one who does minimally invasive surgeries. You may be able to have repair of the pars. With repair to the pars the disc might heal on it's own.
Unroofing of the disc means that the disc has separated from the vertebral body. In the video below the disc has separated and is herniated. Yours disc may not be herniated, and may be simply pressing against the spinal cord in certain positions or with certain weight.
You might look at artificial discs. You may be able to avoid fusion.
I'd consider surgery because spondylolisthesis is progressive as is disc disease and either can eventually damage the spinal nerves.
Grade 1 anterolisthesis increases with forward bending which we never do in an MRI tunnel.
I hope you have luck.
https://cantorspinecenter.com/conditions/pars-defect/#:~:text=Direct%20Repair%20of%20the%20Pars,normal%20motion%20of%20the%20spine.
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2 Reactions@divedoc94
In addition to what @gently recommended, you may want to have a cervical spine MRI to see if you have any compression there. Cervical compression can impact your leg strength and it is not picked up in an EMG/nerve conduction study. My orthopedic spine specialist told me spine issues are not measured by EMG and you could have a “normal” EMG but compressed spinal cord which happened to me. I just had a “normal” EMG but have a herniated C6-C7 disc pressing on my spinal cord and causing weakness in hips/legs, especially when standing up from seated position, going up stairs, and lifting leg up to put on pants.
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