Crohn’s Disease: Early vs. Long-term Symptoms

“Crohn’s is the inflammation of the intestine, from mouth to anus, usually in the small or large bowel - or both,” says gastroenterologist Sander R. Binderow, MD, FACS, FASCRS of Atlanta Colon & Rectal Surgery.

“Some patients have anal Crohn’s or Crohn’s of the stomach; however, that is very rare,” adds Dr. Binderow.

This disorder is an inflammatory bowel disease that is actually associated with an increased risk for colon cancer. Microscopic colitis is also an inflammatory bowel disease, but is not associated with an increased risk of any kind of cancer. Microscopic colitis is often misdiagnosed as irritable bowel syndrome.

“Crohn’s presents as a diarrheal-type illness, where the large intestine lining is inflamed, and with Crohn’s, there is not as much blood,” says Dr. Binderow. “Patients tend to be ill, where they lose a significant amount of weight, do not eat and have a loss of appetite.” If you think these symptoms sound like those of colon cancer, you are correct.

Long-term Symptoms of Crohn’s Disease
“Long-term symptoms can include a stricture, which causes abdominal pain, nausea and vomiting, narrowing of the colon and fistulas,” says Dr. Binderow.

If you’ve been diagnosed with Crohn’s disease, you should be vigilant about colon cancer screening. You can begin this with Cologuard, a non-invasive way to screen for colon cancer. It’s a test that you take at home. Using the latest in DNA technology, Cologuard identifies precancerous cells. If your test result comes out positive for this, your next step should be a colonoscopy.

Constant Need to Burp: Most Likely Cause

A GI doctor explains what the most likely cause is if you constantly need to burp.

The important thing to note here is if frequent burping is your only symptom, rather than it’s also accompanied by (not necessarily at the exact time that you burp) concerning symptoms such as abdominal pain, blood in the stools, unexplained weight loss and undue fatigue.

So let’s say that lately, you just seem to be burping a lot, but otherwise feel as healthy as ever.

“Most people talk while they eat, which leads to burps and farting,” explains gastroenterologist Sander R. Binderow, MD, FACS, FASCRS of Atlanta Colon & Rectal Surgery.

“There is a possibility of a small bowel obstruction if a person is burping, but in that case the patient would be more concerned about the pain they are experiencing and would go to the doctor for that obvious symptom rather than burping alone.

“It is possible a patient could be burping more often if they suffer from reflux; however, most times if the symptom of burping is the only one that the patient is experiencing, they are likely talking more while they eat.”

Have you been going out to dinner more frequently, and hence, talking more while you eat? Try not to gulp air as you take in food or drink beverages.

But what about the question, Can excessive burping actually be a symptom of cancer? Yes, it can. In this article, Dr. Maxwell Chait explains what kinds of cancer can cause this seemingly innocuous symptom.

What about colon cancer? If you’ve been experiencing a lot of burping lately, chances are extremely unlikely that this is being caused by cancer of the colon. However, other GI symptoms can be caused by this disease, such as abdominal pain, constipation, blood in the stools (which may appear dark, not necessarily red), unexplained fatigue and unintentional weight loss.

By the time symptoms of colon cancer begin presenting, the disease has spread beyond local confines. That’s why it’s so important to be screened for it. You can start with Cologuard, a non-invasive home test that utilizes state-of-the-art DNA technology to identify abnormal cells. If you have abnormal cells, the next step is a colonoscopy.

Bits of Foam in Diarrhea Explained by Doctor

What are the “bits of foam” that someone might see in their diarrhea? And can this ever be a sign of a disease?

These are questions I asked of gastroenterologist Sander R. Binderow, MD, FACS, FASCRS of Atlanta Colon & Rectal Surgery.

Foam in diarrhea can occur in the small intestine, when air combines with the bowel movement that is in rapid transit, which is the nature of diarrhea,” explains Dr. Binderow. “The diarrhea combines with air, creating small foam. This is not a sign of any type of disease when it is observed alone with no other symptoms.”

So next time you see foam or white fuzzy mucus in your diarrhea, remind yourself that it is the product of air combining with your bowel movement.

However, there are other features that you should be concerned about that are not related to bits of foam. For example, do you see what appears to be blood in your stools? Or does your diarrhea alternate with going days without any bowel movement? These are concerning signs, and though colon cancer can be one of the causes, there are numerous other non-malignant causes for such symptoms.

If you have not yet had a colonoscopy but are concerned, you may want to consider Cologuard, a non-invasive screening test that you can give to yourself at home. Using the latest DNA technology, Cologuard can identify abnormal cells in your stools. If the test results show this, you would then need to undergo a colonoscopy. 

Diarrhea vs. Loose Stools Comparison

The line between diarrhea and “loose” stools is very fuzzy; at what point are loose stools actually diarrhea? Is there a way to test the substance to classify it as one or the other?

I posed these questions to gastroenterologist Sander R. Binderow, MD, FACS, FASCRS of Atlanta Colon & Rectal Surgery.

Dr. Binderow explains, “To answer, one must specify that the diarrhea is a medical term and diagnosis, and “loose” stools are a patient observation. A patient could have diarrhea; however, it is also possible that they just have loose stools.

“Diarrhea includes bowel movements more than three times per day with copious amounts, and it can be mixed with mucus.

“If a patient has acute diarrhea, it is often the body’s response to something a person has eaten and needs to get rid of. A doctor does not normally recommend treating, and rather, it is best to let the body process the issue. If it continues for weeks at a time, it is then necessary to bring to the attention of a physician.”

Colon Cancer Worry
Diarrhea or “loose” stools, in and of themselves, are not common features of colon cancer. The issue with colon cancer is if diarrhea (or what the patient may perceive as loose stools) alternates with constipation (going days without a bowel movement).

Nevertheless, if loose stools or diarrhea have you worried about colon cancer, it is recommended that you have a non-invasive screening exam for this disease. Cologuard is non-invasive and can be done in the convenience of your home. Cologuard uses the latest advances in DNA technology for identifying any abnormal cells in the sample. If the test results are positive for abnormal cells, you would then be recommended to follow up with a colonoscopy.

What Is Pronator Syndrome: Causes, Solutions, Prevention

Pronator syndrome can cause painful symptoms in the hands and forearms that mimic carpal tunnel syndrome. Pronator syndrome is when the pronator teres muscle of the forearm presses upon the median nerve, the same nerve that's involved in carpal tunnel syndrome.

Pronator teres syndrome is a nerve entrapment condition. The median nerve gets compressed by the pronator teres muscle; the median nerve is located beneath the superficial head of this forearm muscle.

“Activities involving repetitive wrist and forearm movements are thought to increase the risk of developing pronator syndrome,” says Jonathan Oheb, MD, North Valley Orthopedic Institute, Chief of Orthopedic Hand and Upper Extremity Surgery.

“Pronator syndrome occurs secondary to increased pressure on the median nerve in the forearm.  These repetitive motions can lead to muscle hypertrophy and/or swelling, increasing the pressure over the nerve as it travels through the forearm.  This is often in conjunction with a patient’s underlying anatomy which may predispose them to developing this in the first place.”

As a certified personal trainer, I'm very familiar with the pronator muscle (reverse arm curls target it); this muscle is responsible for the wrist joint action of pronation, i.e., turning the forearm over so that the palm faces downward or behind you, depending on where your hands are in space; or, if the hands are elevated, turning the palms facing away from you (as in a pull-up).

Though the compression site is in the upper forearm, the symptoms will not only be felt in this area, but also will affect the hand and fingers. The median nerve controls movement and sensation in most of the hand.

When you want to move your thumb, for instance, a signal from the motor control region of your brain travels down your neck to the median nerve, which extends from the neck region (spinal cord) and runs the entire length of the arm, with its final distribution to most of the hand, including the thumb.

The electrical nerve impulse signal, that originated from your brain, will zip down the median nerve all the way to the thumb, where the nerve distributes to thumb muscles. The electrochemical impulse will cause the thumb muscle to contract: You just moved your thumb. These nerve signals travel about 50 meters per second.

If the median nerve is compressed somewhere along the way, some of the nerve signal from your brain will never get past the compression point, and hence, why movement in the fingers can be limited or "stiff."

Numbness is also a symptom for the same reason in reverse: Sensory neurons normally send signals up the median nerve to the sensory interpretation center of the brain. If there is a blockage of these signals at the compression site, all the signals won't make it to the brain, and hence, numbness, rather than a full sensation of feeling.

In addition to compromised motion and numbness, pronator syndrome also causes pain, including in the hand. The median nerve distributes to the thumb, index and middle fingers, and the half of the fourth finger that faces the middle finger.

Face your right palm towards you. Imagine a line running down lengthwise the fourth finger, dividing it in half. Continue "drawing" that line all the way to the wrist. Now, imagine shading the portion of your hand and fingers to the right of this imaginary line. This is the area impacted by pronator syndrome.

In other words, the other longitudinal half of the fourth finger, plus the entire pinky and outer portion of the palm, are not affected.

Nevertheless, these symptoms can also be caused by carpal tunnel syndrome, despite what you might have read or will read. Wrist motions should not aggravate pronator teres syndrome symptoms.

A chiropractor misdiagnosed my mother with pronator teres syndrome based on questioning her and feeling her arm for pain triggers. Then an ER physician misdiagnosed her; he suspected nerve compression at the neck and ordered an MRI. The MRI showed cervical disc degeneration and he said, "It's what I suspected: nerve compression of the neck."

The most definitive test to rule in or out nerve entrapment conditions is the EMG test. An EMG test ruled out cervical compression and pronator syndrome in my mother, and solidly confirmed carpal tunnel syndrome. Interestingly, the neurologist who performed the EMG test, prior to the test, was very convinced she had pronator syndrome.

But an EMG test does not lie. It revealed a nerve signal conduction blockage at the wrists of both hands: carpal tunnel syndrome.

Treatment for pronator syndrome may consist of simply massage. A chiropractor might be convinced that chiropractic manipulation can correct the problem over a number of visits. Various exercises including yoga positions may also help. If these fail, surgery is a final resort.

Dr. Oheb explains, “Ways to reduce the risk of developing pronator syndrome mostly involve proper warm-up and stretching before strenuous activity.  Also, maintaining good strength and flexibility through regular exercise can be preventative.” 

Twitching Calf Muscle Strength Tests

If you’re scared you have ALS due to twitching calf muscles, here are strength tests that if you pass, should be of reassurance.

Are your calf muscles twitching? Are you scared it's ALS? How can you tell this isn't ALS? Even if you had a negative EMG, you may still not be reassured and may be continuing to obsess about twitching calf muscles.

Or, worse yet, perhaps you have no medical insurance and can't afford to pay out-of-pocket for an EMG. Strength tests for muscles will help tremendously in dissolving fear of ALS.

As a personal trainer, I can’t imagine that someone with ALS and twitching calf muscles would be able to perform the following exercises. If you struggle at all but ultimately complete the exercise, do NOT let the struggling cause panic. I deliberately have my gym clients perform exercise routines that make them struggle.

So if there's struggling, it's because of the exercise itself, in combination with anxiety.

These calf muscle strength tests are in no particular order. Again, and read this several times if necessary: Struggling in this context does NOT mean ALS! It may mean being out of shape, lacking coordination and/or having anxiety.

These exercises involve foot control. Foot plantarflexion is controlled by calf muscles: gastrocnemius and soleus. If a person has a pathological foot drop, that individual will not be able to perform these exercises, period. (You probably already know how a “foot drop” relates to ALS.)

This test is not about a perfect, flawless performance. It's about completing the exercises regardless of skill level. A person will either complete them or won't. Never mind how long it took, how many attempts it took, or how difficult it was.

Calf strength test #1 -- Stand at top of staircase, but backwards. Walk down staircase backwards and very slowly, but with each step, place only the ball of foot on the stair. Do not place hands on anything for support.

Each time you place foot on stair, hold position for three full seconds before proceeding down to next step. Expect some struggling; this requires agility. You’ll find it easy to imagine that a person with ALS affecting calf muscles will not even be able to support their down-coming weight as they place it on the ball of their foot; these muscles control this joint action, not foot muscles.

Expect balance challenges. But if you can make it down just one stair on the ball of your foot, backwards, consider this completion of the test, even though you might lose balance on all the other stairs. Repeat this test, because the second time won't be as tricky.

With enough repetitions of this calf muscle strength test, you will eventually make it down every step, on the balls of your feet, holding out for three seconds, without much struggle. There will be a learning curve and progress, something you will not be able to imagine a person with ALS affecting their calf muscles will experience.

So if progress took half the day before you finally made it down all stairs without losing balance, consider yourself successful.

Calf strength test #2 -- Grab an invisible or real jump rope and jump for one minute. A healthy person without ALS will not detect an aberration with the suspect leg; instead, the healthy person’s foot will cooperate and will have the spring of the other foot.

If you feel exhausted after one minute, this means that more aerobic exercise is in order (your heart needs more training), and hence, there’s no reason to fear ALS over this particular feature.

If your calf muscles are burning after one minute, this is normal. A person without ALS affecting calf muscles should be able to jump rope cleanly, even if the calves burn.

Calf strength test #3 -- If it's your right calf muscle twitching, ask yourself if you had any problems driving today. Remember, movement of the foot down against an object, such as a car pedal, is controlled by calf muscles. The foot must continuously alternate between pressing downward and then releasing the pedal.

This may seem simple and not even seem like a strength test, but calf muscles are working to control these precise gas pedal movements. A healthy muscle can do this, and if yours did today, don’t panic about ALS.

Calf strength test #4 -- Stand only on the foot of the calf in question. Go up on toes, still just on this foot, while other foot is off the floor. Stay up for 10 seconds, then release. For extra reassurance, hold the up position for 30 seconds.

Calf strength test #5 -- Hop across the room on one foot. A person without ALS foot drop will have no problem doing this.

Strength Tests if You Fear ALS

Ever wonder what strength tests for ALS that a healthy person could pass?

As a fitness expert/personal trainer, I’ve devised some strength tests that should put your mind to ease about ALS if you’ve been freaking that you might have this disease due to muscle twitching, muscle cramps or perceived weakness.

These are easy strength tests to perform, and experts use these to test for ALS. This article is several years old (originally appeared at, which shut down July 2014) and reposted to this site (I’m the original author). The site that I got this ALS information off of is now a “404” page, but the dead link is at the end of this article under “Source.”

If you can perform all of these strength tests, then you likely do not have ALS, even if your muscles are twitching or cramping 24 hours a day.

If you've been spending hours every day doing strength tests for ALS, you can finally stop the obsession, because these strength tests I'm about to describe are official ALS strength tests given by physicians for neurological exams.

To perform these strength tests for ALS, you will need a partner. However, after each description of these ALS strength tests, I have described the exercise equivalent.

ALS strength test 1: Shoulder flexion. Raise both arms at same time in front of yourself, straight, palms down. Partner applies resistance atop your forearms. Both arms should resist with equal strength. Gym exercise equivalent: shoulder frontal raises with dumbbells.

ALS strength test 2: Shoulder flexion. Raise both arms at same time, palms up, arms straight, as if holding large pizza box. Close eyes and count to 10. Palms should remain up. This sounds easy, but when ALS affects upper body, at least one arm will "drift" such that palm starts turning downward; forearm starts turning inward; and arm then drops. Exercise equivalent: shoulder frontal dumbbell raises, holding dumbbells with palms facing ceiling.

ALS strength test 3: Biceps resistance. Position arm to 90 degree bend, upper arm vertical or almost vertical. Partner presses down on wrist, his hand atop your arm. You resist by "curling" or bringing hand up towards shoulder. Ability to do this should be equal in both arms. Exercise equivalent: Biceps curls with dumbbells or a barbell.

ALS strength test 4: Triceps resistance. Position arm as though raising a knife to stab someone; hand is about eye level. Partner presses against your wrist from below it and you resist, pressing forearm downward. Strength should be equal in both arms. (Keep in mind that it's not uncommon for one arm to be a LITTLE stronger than the other.) Exercise equivalent: Triceps push-downs.

ALS strength test 5: Wrist extension. Hold arm out straight, but partner supports it by holding forearm from below. With other hand, partner presses on top of the top of your hand (your hand is palm down), and you resist. Exercise equivalent: Dumbbell or barbell wrist extensions.

ALS strength test 6: Grip. Partner stands before you. With your arms bent to about 90 degrees, grab partner's fingers. But grab only his index and middle fingers; completely grab them. His arms are bent 90 degrees while you do this. He then tries to removed his fingers from your grip. He should not be able to do this if you have healthy strength.

However, my own opinion, as a personal trainer, is that if the partner is strong, he just may be able to remove his fingers. I, personally, don't believe that it's a rule that the partner can't remove his fingers. Exercise equivalent: hand grips.

ALS strength test 7: Hip flexion. Lie on floor, legs straight. Partner presses on one knee while you resist by raising leg. Partner repeats with other knee. Strength should be equal; you should be able to resist. Exercise equivalent: weighted leg lifts.

ALS strength test 8: Hip extension. Lie on floor, legs straight. Partner presses upward against from beneath your thigh (hamstring). Exercise equivalent: Hip extension machine.

ALS strength test 9: Hip adduction. Lie on floor, legs straight. Partner places hands on both inner thighs and tries to spread them out; you resist. Exercise equivalent: hip adduction machine.

ALS strength test 10: Knee extension. Lie and slightly bend one leg so that partner can support it beneath thigh (hamstring) while placing other hand atop calf. Extend knee or kick out leg while he resists by pressing down on calf. Exercise equivalent: "leg extension" machine.

ALS strength test 11: Knee flexion. Same thing except partner places resisting hand beneath calf and tries to keep you from pressing downward. Exercise equivalent: seated leg curl machine.

And two more: Plantarflexion. Lie on back and partner places hand behind foot against ball of foot. He pushes towards you and you resist against him (think in terms of pressing on gas pedal of car). Exercise: "calf machine" at gym.

Dorsiflexion. Same as above except partner applies resistance against front of foot near toes; resist this. Exercise: walking on heels.

Hip abduction. Lie on floor, legs straight. Partner places hands against outer sides of your thighs and tries to prevent you from spreading legs apart. Exercise equivalent: hip abduction machine.


Twitching Muscles: Most Common Cause of Muscle Twitching

Twitching muscles (fasciculations) are very common. Every man and woman experiences muscle twitching. Twitching muscles are most often in the legs, but muscle twitching can occur in the facial muscles, neck muscles, chest muscles and even back muscles.

"Fasciculations can appear in almost any muscle," points out Daniel Kantor, MD. He is the Medical Director of Neurologique, an organization dedicated to the care of patients, research and education. 

Muscle twitching usually goes unnoticed unless it's excessive, and/or the muscle twitching causes an entire finger or toe to "jump." Also, muscle twitching can often be clearly seen when it happens, especially if the twitching muscle is in the quadriceps muscles, chest muscles or face muscles. Muscle twitching means things are more normal than abnormal.

“Muscles may randomly twitch for many reasons,” notes Carolyn Dean, MD, ND, and medical advisory board member of the Nutritional Magnesium Association ( She continues, “They can twitch due to anxiety or stress, a sleepless night, too much coffee or after exercise.”

Anxiety and stress are perhaps the No. 1 cause of muscle twitching, which is what comprises benign fasciculation syndrome when in excess and accompanied by cramping and/or stiffness and some exercise intolerance.

Benign means the muscle twitching will not develop into anything serious. Fasciculation is the medical term for muscle twitching. Syndrome means that typically, a lot of muscle twitching is also accompanied by muscle cramps, muscle aches and some tingling.

But these other symptoms often come on after the person starts excessively worrying that the muscle twitching is a sign of a deadly disease.

Anxiety makes muscles twitch. It's that simple. One theory is that in ancient times, early man had to always be ready for action, living in a harsh environment with no modern-day conveniences to protect him. His muscles, his entire nervous system, had to always be prepared for a fight with danger, or for a flight from danger.

We are genetically hardwired to physiologically react to a crisis situation. Our muscles are on standby to jump into action. But contemporary stress is different from ancient stress.

Today, we don't need to be ready for the charging bison or hissing snake. But just the same, our bodies are under siege by other forms of anxiety: job stress, paying bills, foreclosure threats, protecting teens from drugs and sex, marital problems, traffic jams, business meetings, etc. It's no wonder that our muscles are always jumping.

When we are under chronic stress, our muscles twitch because they think that at any moment, action will be required of them. So they are, in a sense, gearing up for the fight or flight, kind of like a track sprinter dragging his foot backward on the track as he prepares for the race. Anxiety tells the muscles, "Get ready. On your mark, get set..."

But the "go" never happens, because the stress is not of a life-threatening nature (such as a charging bison, falling rock or hissing snake). So the muscles remain in idle, like a car at a stop light. The engine is on, but the car goes nowhere. The engine, in this case, is the muscles twitching. They are not relaxed. They are anticipating.

So when you notice a lot of muscle twitching while under stress, realize that this means that everything is working just fine. “We also believe that when we are stressed, our nerves are at a heightened sense of alertness, so sometimes our [nerve] impulses fire off more easily,” says John Whyte, MD, board certified internist in Washington, DC, and author of “Is This Normal? The Essential Guide to Middle Age and Beyond.” 


Twitching Muscles, ALS and Beating Fear

If you're terrified of ALS because of twitching muscles, here is a complete guide to get you through your most terrifying moments.

As you already know, ALS is an incurable, fatal disease, and if you've googled twitching muscles or muscle twitching, you've seen the ALS links pop up. This is because twitching muscles is a symptom of ALS.

And since googling, you've been terrified of ALS, because of your twitching muscles and the web sites that list muscle twitching as a symptom of ALS.

Being terrified of ALS, even though only 5,000 Americans a year get diagnosed (, is far more common than you think. Many men and women are scared out of their wits over the possibility of having ALS, even though their only "symptom" is muscle twitching -- which, by the way, is a perfectly normal bodily occurrence.

Everybody has twitching muscles, especially after exercise or during moments of anxiety, including anxiety that you might have ALS.

"Fasciculations can appear in almost any muscle," says Daniel Kantor, MD, who’s the Medical Director of Neurologique, an organization dedicated to patient care, research and education. “When we overuse a muscle, it can twitch...your leg muscles may twitch after a long run.”

Being terrified of ALS is a prevalent phenomenon in this cyber age.

Terrified of ALS - Upon realizing that muscle twitching is a symptom of ALS, some people will then study up on this horrible disease and learn that muscle weakness and muscle cramping are also symptoms. It's at that point, or shortly after, that these individuals then begin perceiving muscle weakness and cramps.

Terrified of ALS - This is why, when a person realizes this sequence of symptoms, they begin manufacturing the existence of muscle weakness. This leads to an obsession with repeatedly testing out the perceived area of weakness with various strength tests.

This can occupy a significant part of their day. This fixation develops into making constant visual comparisons of one side of their body to the other, to check for muscle atrophy (wasting). How does one stop this two-ton snowball from hurtling down the hill?

“Our bodies are not bilaterally symmetrical,” points out Marc I. Leavey, MD, who is a primary care physician with 40-plus years of experience, and has a blog, STRING OF MEDICAL PEARLS. “Even identical twins have subtle differences,” says Dr. Leavey. If you are right handed, your right arm will be a bit more developed from the increased use over years.” 

Terrified of ALS?
Next, hang a nice calendar and every morning, place a red star (or make a big red circle) on that day. Before you know it, two weeks' worth of stars or circles will have passed -- and you're still able to run, lift, jump, go up and down stairs, unscrew jar lids, etc.

Keep putting those red marks down every morning. Soon, you'll have 30 days behind you, and the more time behind you, the smaller your fear of twitching muscles will become.

The sight of 30 red stars will be very encouraging. Soon, you'll have 45 red stars to look at: even more encouraging. When you have 60 red stars facing you, you'll feel wonderful. Just keep marking that calendar every day. It won't be long before 90 red stars are gleaming at you: That's three solid months behind yourself -- and you're still able to run, lift, use your hands, etc. The fear of dying will be the size of a peanut.

In ALS, by the time a person can see the atrophy, there has already been significant muscle weakness. True weakness includes difficulty doing simple things like walking up stairs or stocking shelves with cans.

Like Dr. Leavey says, the body is not symmetrical. If you start looking for asymmetry, you'll find it all over the place. Every time you fixate on something, this causes neurological changes in your brain as far as reorganization of the wiring, and hence, new thought patterns evolve, and sometimes these thought patterns are not healthy, are obsessive, and mushroom into full-blown panic over ALS.

You are literally "molding" your brain this way. Chronic anxiety leaves its mark on the brain and it becomes easier to allow intrusive fears of dying to grip your soul.
But, this molding process can be reversed with behavioral modification and the calendar tracking.

Terrified of ALS? Strive to go 15 minutes without thinking about the disease and ignore twitching, muscle size comparisons, etc. Next step: Go 30 minutes. Keep increasing. Forbid thinking about ALS for allotted time periods. This will gradually "remold" the wiring or thought patterns in the brain.

The brain physically changes according to our environment. The mind can be retrained to think the way it did before your fear of ALS developed.


Twitching Muscles: Exercise that Can Cause Muscle Twitching

Do you have twitching muscles? Does muscle twitching scare you into thinking you might have ALS or multiple sclerosis?

After all, muscle twitching can be a symptom of ALS, but save the panic attack because in ALS, muscle twitching is also accompanied by muscle weakness.

And by muscle weakness, I do not mean struggling to hoist a heavy garbage bag; or muscle weakness in that the left arm is sagging a bit while you are struggling with that grueling chest exercise or arm exercises. As a personal trainer, I’ve seen this all the time.

Muscle twitching is a common result of strenuous exercise and weightlifting routines that leave muscles fatigued afterwards. "Above all, fatigue is the reason for the muscle twitching," explains Dr. Kevin Plancher, MD, a leading sports orthopaedist and sports medicine expert from the New York metropolitan area. He says that “erratic firing of the muscles” can result from them being overworked. In addition, says Dr. Plancher, lactic acid buildup can “alter the way muscles contract as well, possibly causing twitching.”

To think that twitching muscles might mean a neurological disease is like thinking that a little gas means you have stomach cancer. Exercise is a leading cause of muscle twitching. The fancy name for muscle twitching, in the absence of clinical weakness, is benign fasciculations. Fasciculation means muscle twitching.

Intense aerobic exercise has a tendency to cause muscle twitching or benign fasciculations -- once the aerobic exercise is over and you have taken up a restful position, such as in front of the computer. You may find a lot of muscle twitching going on in your legs, calves and arches of your feet.

I've found that my twitchiest moments (legs) occur after trail running and power hiking. Heavy leg pressing has been known to make my calf muscles twitch -- between sets. Heavy weightlifting exercises, as opposed to lighter weightlifting exercises, are more likely to make muscles twitch.

Bench presses, pull-ups and intense triceps routines may trigger twitching muscles as well. Muscle twitching following strenuous exercise is perfectly normal. In fact, rather than let the twitching muscles induce fear that you have a deadly disease, remind yourself that muscle twitching means you conducted a rigorous workout -- and that's the way workouts should be: rigorous.

So what really makes muscles twitch, once you are in a resting state following the exercise? Lactic acid buildup comes to mind. "Movement is a very good way to minimize the twitching,” suggests Dr. Plancher. This is because movement, as opposed to rest, “helps the body move the excess lactic acid out of the muscles. It allows the electrolyte levels in the muscles to normalize if they are unbalanced due to fatigue of the nervous system.”

Motion, then, “sloshes around” the lactic acid. While inert at your computer following an exercise session, you experience the twitching, but the moment you get up and walk across the room, the twitching stops. Or, it will usually stop just from moving your legs about while you remain seated.

Another cause is that the motor neurons are still "excited" or innervated from the exercise, and they need some time to calm down. Random electro-chemical impulses are firing away, causing the muscles to twitch. If anything, this means your muscles are in fine working order.