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MUSCLE WEAKNESS

General Information

DEFINITION--Profound muscle weakness following hard or unaccustomed exercise.

SIGNS & SYMPTOMS

  • Unaccustomed exercise.
  • Symptoms that appear following a period of rest after the exercise, an hour or 2 later or the next day. Frequently a high-carbohydrate meal is eaten after competition or vigorous physical exercise, followed by a night's sleep. The muscle weakness then appears the next day.
  • Weakness that begins in the legs and progresses to the arms or other muscles in the body. Disabling fatigue accompanies the muscle weakness.

    CAUSES & RISK FACTORS

    Decreased potassium levels in the circulating blood and muscle cells. The decreased potassium levels can be brought about by any of the following:
  • An underlying inherited disorder called PERIODIC PARALYSIS (See Glossary) that interferes with muscle cellular metabolism.
  • Excessive exercise in hot weather with loss of water, sodium and potassium, leading to dehydration.
  • Diuretic medications that cause sodium loss and excessive potassium loss through the kidneys. The sodium loss is desirable; the potassium loss is a significant undesirable side effect that may lead to major body disturbances. Customary doses of diuretics may require reduction during hot weather.

    HOW TO PREVENT

  • Prevent potassium loss, increase fluid intake and adjust exercise programs and medication dosages during hot weather.
  • Avoid the combination of diuretic medications, alcohol and heavy exercise during exceptionally hot weather. This combination can be lethal, causing strokes and life-threatening episodes of irregular heart rhythms.
  • Increase potassium-rich foods in your diet.
  • Take potassium supplements (with a doctor's prescription) prior to vigorous exercise if you have had an exercise-induced muscle weakness in the past.
  • Modify activity level to one below that which triggers attacks.

    WHAT TO EXPECT

    DIAGNOSTIC MEASURES
  • Your own observation of symptoms and signs.
  • Medical history and exam by a doctor.
  • Blood studies (sometimes) to measure potassium levels.
  • Electromyography (See Glossary).

    SURGERY

    None useful nor necessary for this disorder.

    NORMAL COURSE OF ILLNESS

    Curable and preventable without long-lasting complications by modifying the exercise program, taking potassium supplements, and avoiding dehydration.

    COMPLICATIONS

  • Permanently weakened muscle groups (rare).
  • Fear of recurrence, resulting in unwarranted abandonment of the exercise program.

    HOW TO TREAT

    NOTE -- Follow your doctor's instructions. These instructions are supplemental.

    MEDICAL TREATMENT

    Must be individualized according to the underlying disorder.

    HOME TREATMENT

  • Replace lost potassium with supplements or increase high-potassium foods in the diet.
  • Replace fluid loss with water instead of soft drinks.
  • After vigorous exercise, avoid a high- carbohydrate meal.

    MEDICATION

    Your doctor may prescribe potassium supplements for muscle weakness.

    ACTIVITY

    If exercise-induced muscle weakness is a recurrent problem, it may be necessary to cut back on your activity level permanently.

    DIET

  • If you have a potassium deficiency, eat foods high in potassium, such as dried apricots, whole-grain cereal (hot or cold), dried lentils, dried peaches, bananas, peanuts, citrus fruits or fresh vegetables.
  • Following a diet high in complex carbohydrates makes good nutritional sense to all those hoping to maintain or reach a good level of health and fitness. However, do not eat such a meal within 3 to 5 hours before competition, and eat only lightly directly afterwards.

    CALL YOUR DOCTOR IF

  • You have persistent or recurrent muscle weakness following exercise.
  • You develop new symptoms after starting any prescribed medicine. All effective medicines have potentially undesirable side effects. These can frequently be controlled by modifying the dosage.
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