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  • Sevas13tra
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    Post count: 1

    Hello doctor!

    Had a significant herniation at L5/S1 that caused limping. I was taken in pretty quickly (within a week) for surgery. Naturally the surgery cleared up all other symptoms except the limping. I am an athlete so I exercise regularly, however I cannot walk without a limp nor can I run (which is part of my job) so this is significantly impacting everything in my life. I have muscle weakness in the glutes, hamstring, and calves, although they have improved a lot over the last 10 months. My main concern is that I can’t lift up to my toes on my right side, but I can stand on my toes (once I get up with help). I also feel in my right knee some locking or resistance when I walk as well. After surgery I was not referred to physical therapy or anything but I’m not sure that would help. I’m not sure what I can do… I’m praying that this isn’t permanent but fear that it is and will be ending my career soon. I read your article and it said that muscles farthest away from the nerve root have the most difficult time to heal… but I’m not sure this is muscle or nerve or both. Any insight would be appreciated. Thank you!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    A typical disc herniation at L5-S1 will injure the S1 nerve which innervates the calf muscles (Gastroc and Soleus) as well as the gluteus maximus. This means that you will have weakness getting up on your toes (heel raises) and weakness of extending your hip. These weakness are more pronounced ascending and especially descending stairs. The act of muscle shortening (actively moving a joint instead of weighting an already locked joint) makes it much more difficult to get up on your toes vs. holding a locked ankle joint (“I can’t lift up to my toes on my right side, but I can stand on my toes (once I get up with help)”.

    The good news it is 10 months since surgery and it can take up to 18 months to know the final healing results. Yes-PT is still important as you can strengthen the currently functioning muscle fibers to take over for the non-functioning ones. I’ll again point out 2 articles to read.

    https://neckandback.com/conditions/how-muscles-recover-from-nerve-injuries/
    https://neckandback.com/conditions/peripheral-nerve-anatomy/

    Dr. Corenman

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