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Muscle Twitching Fear: Foot Drop Strength Test Guidelines
If twitching muscles have you panicking, here’s how to do foot drop strength tests.
If you’re terrified that the twitching muscles in your leg or foot might mean that you have ALS (and you would have gotten this idea after googling “twitching muscles,” no doubt), then invariably, you soon learned of a phenomenon called foot drop.
Foot drop itself is not a disease; it’s a symptom that can have many causes.
“Foot drop is typically neurological in nature,” says Dr. Bruce Pinker, DPM, who specializes in sports medicine and surgery of the foot and ankle.
In addition to a neurological cause, “It can be due to stroke (cerebral vascular accident – CVA), which may or may not resolve with physical therapy,” continues Dr. Pinker.
“Usually, in cases of foot drop, the forefoot drags on the floor — as the foot cannot clear the ground during the swing phase of gait.”
But how do you do strength tests for foot drop?
If you had this problem, for real, not just perceived, your gait would be altered to accommodate it.
Namely, you’d be having to lift your knee higher when walking.
Is that what you’ve been doing lately? If not, ask yourself why you’re convinced you have foot drop (other than googling “twitching muscles”).
Now let’s think of some everyday movements that foot drop would prevent you from doing.
Using the pedals of your car might come to mind. Think of how often, during just one 20-minute trip in your car, your foot must flex and extend to work the pedals.
Shutterstock/StepanPopov
There are muscles in the lower leg that move (flex and extend) the foot. If they are weak enough, the foot will drop.
If you have a disease causing enough foot drop to interfere with your walking, it will also interfere with using your car’s pedals.
What about actual strength tests?
The gas pedal usage is a test of flexion and extension with no resistance. But strength? Well, how about trotting up a flight of stairs?
That takes a lot more strength then using a gas or brake pedal.
Can you trot up a flight of stairs without stumbling or struggling?
If your ability to do this has not changed, then this should be reassuring.
Let’s take the foot drop strength test a bit further now. If you belong to a gym, load a calf raise machine with weights. Go up on your toes, then go down (extend, then flex).
Shutterstock/Denis Val
Though the calf raise equipment is designed to work the calves, the foot plays a key role in this because calf muscles move the feet!
For instance, your gastrocnemius and soleus muscles (major calf muscles) are responsible for plantarflexion (going up on the balls of your feet).
Your anterior tibialis muscle enables dorsiflexion (raising the foot/toes upward).
On the calf machine, these two joint actions are possible with weights. See what you can do.
Don’t try to break records; just do what you’ve either been doing, or if you’ve never used this machine, start with light weights.
After doing what you can (don’t overdo it, though; you don’t want sore calves), ask yourself how possible it is to have pathological foot drop if both feet can carry out the motion.
Another strength test is a hard sprint across a parking lot. To be able to do this you must have fully intact, fully functioning muscles and nerves.
Shutterstock/Franck Camhi
Do some jumping. Jump onto a boulder or bench. Leap across a puddle or up a few stairs.
Jump down from a few steps. Jump rope. Bunny hop. Do squat jumps. Kick a heavy bag.
“The activities you have mentioned would qualify as a self-test for whether or not one has foot drop,” says Dr. Pinker.
Unfair Strength Tests for Drop Foot
If you’re freaking out over twitching muscles and decide that a good strength test for drop foot would be to see how long you can balance on one leg, you will set yourself up for doom.
That’s because balancing on one leg, while in a state of fear, is not easy, even for a fit individual. Instead, just run down the street for your strength test.
Don’t try crazy things like seeing if you can hop up a flight of stairs on one leg.
Even a healthy fit person would find this very difficult. Don’t even try hopping across a room on the single leg.
These feats require a level of agility and strength that come from specific training.
The average person will struggle or may not even be able to do them.
And remember, exercise can cause some harmless muscle twitching.
Dr. Pinker is with Progressive Foot Care, which provides state-of-the-art, full diagnostic testing and treatment of the foot. He’s a professional foot and ankle health and wellness speaker who delivers many original seminars annually such as “Keep On Running.”
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
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Top 10 Muscle Twitching Reassurance Rules for ALS Fear
If twitching muscles are terrifying you about ALS, here’s all the reassurance you need from someone “eight years out” from benign fasciculations.
“Muscle twitching, also called fasciculations, are small, local muscle contractions that occur involuntarily,” says Morton Tavel, MD, Clinical Professor Emeritus of Medicine, Indiana University School of Medicine, and author of “Health Tips, Myths and Tricks: A Physician’s Advice.” Dr. Tavel adds, “Deeper areas can be felt but are not visible.”
Rules for Twitching Muscle Reassurance
#1 Muscle Twitching Is Common
Dr. Tavel explains, “They occur in nearly all healthy men and women.
“In some cases, these fasciculations can be annoying but, if a neurological examination is negative, it’s best you disregard them.
“Fasciculations have a variety of causes, and most of these are benign, especially when the eyelids are affected.”
#2 Search Result Deception
If ALS sites appear at the top of the first page of search results for “Why do my muscles twitch?” this in NO way correlates to the odds that your twitching muscles are being caused by ALS.
Just because sites that mention ALS are in the top half of the first page of results, doesn’t mean this is what you should fixate on.
However, people tend to fixate on the first five results of a search.
Shutterstock/fizkes
What puts something on the first page of Google is the way the article is written plus other factors that Google’s web crawlers detect.
If it’s cleverly written, especially on an SEO-optimized site, it will be in the top three—and often in the No. 1 spot.
If I wrote an SEO-optimized article claiming that most muscle twitching is caused by drinking orange milkshakes, it just might end up on the first page of search results.
#3 Avoid ALS Sites
These will only get you more worked up, more panicky.
Many posters in ALS forums don’t even have ALS.
I also wonder how many thread responses you must read before you come upon one that was posted by an actual neurologist.
Be leery of forums. These are people just as panicky as you.
However, every so often, a thread is started by someone who got a very bad diagnosis—not necessarily ALS; could be MS or some other neurological malady.
Just stay off the ALS sites. These will only fuel your panic.
#4 Avoid Yahoo Answers
I swear, some of the answers are really nutty.
The fact that the avatars are cartoon faces all in the same pose doesn’t help with the credibility of the people “answering” the questions. Just skip it.
#5 Do Strength Tests
As a former personal trainer, group fitness instructor and always longtime fitness and strength enthusiast, I fully endorse strength tests for reassurance.
But you must do these within reason. Come on, if you’re not into lifting weights, don’t expect to hoist a 30 pound box of books onto a high shelf without difficulty (especially if you’re a woman who’s never weight trained).
Don’t try strength tests you’ve never done, either. For instance, if you’ve never before balanced for one minute on one leg while holding a bowling ball…don’t do this as a strength or coordination test.
Instead, keep tabs on tests of strength that your body is already used to, such as trotting up a flight of stairs, carrying out heavy garbage, and of course…gym workouts if you’ve already been doing them.
If your best bench press is five pounds less than it was last week, don’t panic.
If you normally bench 185 but next week can’t even do a single pushup, then yes, something is going on — but still, don’t jump to conclusions; it could be an injured rotator cuff.
Being able to lift more weights than previously, of course, is major reassurance. For reassurance, keep tabs on your gym progress.
#6 Avoid Mirrors Other than for Normal Use
Stop checking your tongue!
Stop checking the symmetry of your legs!
Stop analyzing your dents!
#7 Love Your Dents!
Did you know that people trying to lose weight just LOVE to see dents? So do people training for a physique or bodybuilding competition.
Dents almost always mean three things going on:
1) Low body fat in that area; new ALS awareness draws your attention to it
2) Recent fat loss which increases “definition,” and
3) The body’s natural asymmetry if the dent is visible or more prominent on one side.
Shutterstock/Chad Zuber
When I was a personal trainer, my clients loved showing me their newly discovered dents. Except they didn’t call them dents. They called them “definition.”
Dents in extreme form are called “cuts” by physique and bodybuilding athletes. A person with the so-called buff body has tons of dents, and if you look closely enough, they are NOT symmetrical.
For example, the “dent” (technically known as “separation”) in the quadriceps muscle group is often a bit more pronounced in one leg than the other.
#8 Time Passage
Though anyone who’s frightened by twitching muscles doesn’t have the patience to wait things out, it’s so very true that time passage without progression of symptoms is a powerful reassurance tool.
Mark a red “X” on a hardcopy calendar to indicate each day that there’s no progression, such as true muscle weakness (e.g., you can’t hold up your hairbrush, can’t blow dry your hair, can’t hang up clothes, can’t lift up the cat, can’t carry groceries, etc.)
Not being able to carry a 30 pound box of books up from the basement without fatigue doesn’t count—unless you’re a bodybuilder—and even then, bodybuilders aren’t immune to fatigue.
#9 Sliver Thin Odds of ALS
You’re more likely to get killed in a car accident than develop ALS.
Do you not realize how rare ALS actually is?
Sure, it gets a lot of publicity, especially with the ice bucket challenges, but this is a very rare disease. Yet how many people have you personally known who died from cancer?
#10 Get an EMG
If push comes to shove with your anxiety, get it over with: an EMG. Normal results go a long way in reassuring you.
Dr. Tavel’s medical research includes over 125 publications, editorials and book reviews in peer-reviewed national medical journals. He was formerly director of the cardiac rehabilitation program at St. Vincent Hospital in Indiana. mortontavel.com
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/TuckerBlade
WHY Exercising Your Abs Every Day Will Waste Your Time
It makes ZERO sense to work your abs every day, so stop this madness!
You should not work your abs every day. This is senseless.
As a personal trainer I never endorsed this mad practice. Why would you want to do this?
Do you believe that exercising abs every day (movements that specifically target this area) will more quickly flatten the belly and show a six-pack or definition than if you did your abs, say, only three times a week?
Working the abs every day seven days a waeek will waste your time and guess what: will be no more effective than if you bench pressed every day or performed leg extensions every day.
Are there days you don’t do abs but that you DO do exercises such as deadlifts, pushups, pull-ups, squat jumps?
LISTEN…
Your abs get worked when you do those deadlifts, pushups, pull-ups, squat jumps and other compound movements.
Doing ab-specific exercises day after day will only make you better at doing ab-specific exercises.
This is great now if you’re training for the ab-targeting-exercise Olympics. But if you’re training for that svelte middle or even further…definition or a six-pack, lay off all the ab-targeting movements. Big time sink.
Two days a week of four hard sprints at 12 mph on the treadmill (do not hold on), with about two minutes of walking in between, will do far more to bring out your abs than will an extra four days a week of 20 minutes’ worth of sit-ups and crunches.
Replace your ab-targeting movements with the deadlift and chin-up/pull-up.
If you’re wondering how chin-ups or pull-ups will work the abs, you’ll find out when you learn how to do these movements with no assistance!
In the meantime, ask a person who can do chin-ups or pull-ups unassisted if they can “feel” their abs smoking like mad at any point during the movement. Listen to their response!
Ab-targeting exercises do not raise resting metabolism.
The fat-burn is minimal because abdominal muscles are naturally weak and small.
Do ab exercises 2-3 times a week and only for five or so minutes, and make the routine INTENSE. This will strengthen your core to a degree.
But for stripping off the fat and strengthen your core a LOT, include the following exercises in your regimen and just forget the daily ab bonanza:
Pushup. Freepik.com, pressfoto
Deadlift. Freepik.com
Pull-up/chin-up
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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10 Worst Weight Routines for Rotator Cuff from Bad to Worst
That doggone rotator cuff!
Here are 10 strength training exercises to AVOID if you have a sensitive rotator cuff.
If you have a painful rotator cuff, here are the 10 worst weight routines, especially with heavy loads or inadequate warmup.
These routines are likely to bring out pain in your injured or inflamed rotator cuff or worsen pain that’s continuously there.
I have done all of these weight routines, and I’ve had rotator cuff issues in the past.
Believe me, these strength training moves are notorious for causing RC problems as well as aggravating existing rotator cuff pain.
Though some people may find a few of these actually friendly to their compromised rotator cuff, the general rule is that these 10 exercises are not very friendly to the RC muscles and their tendons.
“The rotator cuff muscles are not large muscles, but there is a group of four of them that provide stability to the shoulder with moving the shoulder and gripping objects to carry them,” says Dr. Megan McLain, PT, DPT, co-founder of Intuitive Choice Physical Therapy & Wellness in Atlanta, GA.
“This follows that if any of the rotator cuff muscles are injured, then there is less muscle stability for the joint, which can lead to other issues like tearing of the labrum [cartilage].”
In order of bad to worst, here are the weight exercises that will make a strained rotator cuff bite back at you.
Dumbbell Shoulder Press
This means dumbbells, barbells and machines. For dumbbells and machines, use a neutral grip (palms facing each other), as this usually minimizes shoulder pain.
Shutterstock/BLACKDAY
Overhead Triceps Press with Dumbbell; Behind Neck Triceps Press with Cable
With one dumbbell, this presents a potential problem if the weight is heavy enough — not necessarily during the actual exercise, but getting the weight up above your head from your lap in the first place. It’s even worse bringing it down.
Credit: Roberto Berlim
I was using a 45-pound dumbbell (for both hands) when my shoulders were perfectly healthy, and even then, I could sense that my rotator cuff didn’t like it when I hoisted that weight from my lap to over my head, and then bringing it back down when the set was finished.
If you have rotator cuff issues, these maneuvers will bring out the pain.
A similar triceps exercise is the press-down that’s done with a cable, arms behind the neck.
“Putting the arms behind your back and then adding weight puts excess strain through the rotator cuff muscles and the ligaments of the shoulder capsule,” says Dr. McLain.
“The biggest danger here is if you lose control of the weight at all, it will pull your arms up behind your back, which if this happens suddenly, can tear or strain muscles or tendons in the anterior shoulder or under the shoulder blade.
“This exercise is most likely to compromise the pec, subscapularis or the supraspinatus, two of which are rotator cuff muscles.”
Bench Dip
Shutterstock/RomarioIen
If you have RC pain, you may want to skip seated dips, even with bodyweight only.
Parallel Bar Dip
Shutterstock/Syda Productions
Ditto. This just won’t feel pretty if you have an inflamed rotator cuff.
Wide Grip Lat Pull-Down
These will really sting a problem rotator cuff at heavy enough weight. It’s even worse if done from behind the neck.
Oddly, when done with very, very light weight, the frontal version can be therapeutic.
Nevertheless, even moderate weight might aggravate an injured rotator cuff.
Use a narrow grip for strength training on this apparatus.
Behind Back Military Press
Shutterstock/Artem Postoev
“Pushing a large amount of weight from a position behind the head puts excess strain through the anterior capsule of the shoulder, and can put the supraspinatus muscle in a compromising position under the acromion, which can cause fraying of the tendon,” explains Ashley Irvin, a licensed physical therapy assistant with 15+ years experience and co-founder of Intuitive Choice Physical Therapy & Wellness.
Even people with healthy shoulders shouldn’t do these. They can cause a rotator cuff injury.
Flat Bench Press
Many people who do a lot of heavy bench pressing have suffered rotator cuff pain at one point.
Anyone with rotator cuff issues will feel pain doing these, often even with light weight.
Pushup
This shouldn’t be surprising; it’s an inverted bench press. Deep pushups are even worse.
Ask a person with a painful rotator cuff what it feels like to do a pushup. They won’t even want to think about it.
Lateral Dumbbell Raise (Side Raise)
If your arms are straight or only vaguely bent, these will kill, depending on which rotator cuff tendon is irritated.
Credit: George Stepanek
The person with a bad RC won’t even be able to raise their arms (nearly straight or even slightly bent) much, sometimes even without any weights in their hands.
The more the elbow is flexed, the less pain, but if the rotator cuff is damaged enough, you won’t be able to do these even with bent arms.
“The reason this exercise can be problematic is a mismatch between the muscle’s strength and the amount of weight,” says Irvin.
“This exercise uses what’s referred to as a long lever arm for the rotator cuff tendons, meaning that the weight is far away from where the muscle is located.
“This exercise will be quite painful if someone already has a rotator cuff tear, particularly in the supraspinatus tendon.
“If you’re going to perform this exercise, start with a manageable weight and make sure that your elbows aren’t locked out, so that all of the muscles in the arm are actively helping you perform the movement.”
Upright Row
Shutterstock/Mihai Blanaru
This exercise is a major enemy to an injured rotator cuff. If your shoulder feels tweaky even in the slightest, avoid this exercise.
Cable Crossover
Shutterstock/Jasminko Ibrakovic
I’ve ranked this the worst because this is the routine that injured my rotator cuff the worst.
The pain was frightening when it happened — a sudden onset of acute pain during the routine — and accompanied me all day long as a strong ache that took several days to dissipate.
The result? My chest routines were squashed; most shoulder routines eliminated, along with no dipping.
It took over a year, possibly 18 months, before I had regained the strength I had before the injury.
Rotator cuff muscles and tendons. Jmarchn, CC BY-SA 3.0creativecommons.org/licenses/by-sa/3.0
Honorable Mention
Pull-ups. Depending on the nature of the rotator cuff issue, pull-ups can cause problems.
“This requires you to lift your whole body by just using your shoulder muscles and arms to complete the motion,” says Dr. McLain.
“This requires a lot of generated power through your shoulder joint to be able to lift your body throughout the range that is needed to complete a pull-up.
“During part of the movement, you will have your arms almost full extended, putting more strain on your RC muscles that are the prime movers to help stabilize your shoulder.
“Because of the stability required for the movement, and the fact that the rotator cuff muscles are so important for stability, this is an exercise that should be progressed very carefully to avoid excess strain.”
Lat pull-downs are a better alternative – but make sure your grip width isn’t too wide!
Single-arm heavy ball slam to the floor. “This exercise can be problematic if you haven’t trained a throwing motion before or if you aren’t used to using a ball with a heavier weight,” says Dr. McLain.
“The quick movement and excess load of the ball in the hand can strain the rotator cuff muscles.
“If you are already used to throwing, start out with a lighter weight or slower movement to give the rotator cuff tendons time to adjust to the added load.
“As an alternative, using two hands on a med ball when performing any type of throw is the best option because this limits strain through one shoulder.”
So take it from me, these are the worst weightlifting moves for the rotator cuff, healthy or injured.
Dr. McLain puts it this way: “I would say no exercise is inherently good or bad.
“It’s typically more the length of the lever arm or the amount of weight that causes issues versus the exercise itself.
“It is all about managing the amount of load through the rotator cuff tendons.
“There are certainly exercises that are more appropriate for an individual, depending on their medical history, or that put the shoulder in a less potentially compromising position, especially if someone already has a diagnosed tear.”
Dr. Megan McLain, PT, DPT, puts her clients first while providing one-on-one in-home care. With physical therapy and health coaching services, Dr. McLain addresses all aspects such as physical barriers, mindset, accountability and knowledge that may be impacting the client’s experience.
Ashley Irvin is a licensed PTA and co-owner of Intuitive Choice Physical Therapy and Wellness. She provides holistic in-home care and addresses all factors that could be impacting her clients’ pain experience. She provides physical therapy, health coaching and personal training.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/KDdesignphoto
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