Muscle Twitches: Causes and Concerns in Strength Training - Neurology

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I would like to inquire about muscle twitching issues?


A few days ago, I experienced muscle twitching in my shoulder that occurs intermittently.
I have been weight training, and although my performance has not declined or changed, the twitching in my left shoulder gives me a slight feeling of weakness in my left arm.
However, my grip strength measurements are normal; it just feels a bit soft and sore.
Additionally, my neck has become very tight due to prolonged studying, possibly due to poor posture.
When I researched online, I came across terms related to amyotrophic lateral sclerosis (ALS).
I would like to ask a doctor if this condition is normal, if it is related to my training, or if there are other factors involved.

CC, 20~29 year old female. Ask Date: 2023/07/04

Dr. Jiang Junyi reply Neurology


Hello Mr.
CC: You mentioned that you have a slight feeling of weakness in your left hand, describing it as "soft and sore." This symptom may suggest cervical radiculopathy.
This is a type of peripheral nerve abnormality that often presents with: 1.
Pain characterized by burning or electric shock sensations; 2.
Symptoms that have a specific dermatomal distribution, which can be provoked by touch or pressure; 3.
Accompanied by muscle soreness and weakness.

Evaluation of peripheral nerve issues typically involves electrophysiological studies to assist in diagnosis.
Nerve conduction studies assess the conduction velocity and waveform of large fiber nerves.
Electromyography (EMG) evaluates the muscle response in the affected nerve distribution area.

Your concern about "amyotrophic lateral sclerosis" (ALS) primarily refers to issues with motor neurons.
Motor neurons control muscle movement; generally, the motor neurons in the brain are referred to as upper motor neurons, while those in the brainstem and spinal cord are called lower motor neurons.
When motor neurons are damaged, our muscles may not receive adequate nutrients and chemicals, potentially leading to muscle atrophy.

Clinical diagnosis requires methods such as EMG and muscle biopsy.
I recommend that you visit a neurology clinic for further evaluation, preferably with a physician specializing in peripheral nerves, as they have more experience with EMG testing.

Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.

Dr.
Jiang Junyi, Department of Neurology, Taoyuan Medical Center.

Reply Date: 2023/07/04

More Info


Muscle twitches, also known as fasciculations, can be a common occurrence, especially in individuals who engage in strength training or other physical activities. In your case, the twitching in your left shoulder muscle, accompanied by a sensation of weakness, can be concerning, but it is essential to understand the potential causes and implications.

Firstly, muscle twitches can occur for various reasons, including fatigue, dehydration, electrolyte imbalances, or overuse of the muscle. Given that you are actively engaged in strength training, it is possible that your shoulder muscles are experiencing fatigue from the workouts. When muscles are overworked, they can become fatigued and may twitch as a result. This is often a benign condition and may resolve with rest and proper hydration.

Dehydration and electrolyte imbalances, particularly low levels of potassium, calcium, or magnesium, can also lead to muscle twitching. If you have not been adequately hydrating or if your diet lacks these essential minerals, it could contribute to the symptoms you are experiencing. Ensuring that you are drinking enough water and consuming a balanced diet rich in fruits, vegetables, and whole grains can help mitigate these issues.

Another factor to consider is your posture and the strain it may place on your neck and shoulder muscles. You mentioned that you have been studying for long periods, which can lead to poor posture and muscle tension in the neck and shoulders. This tension can contribute to muscle fatigue and twitching. It is crucial to take regular breaks, practice good posture, and incorporate stretching exercises to alleviate tension in these areas.

Regarding your concerns about conditions like amyotrophic lateral sclerosis (ALS), it is understandable to feel anxious when encountering symptoms that may seem alarming. However, muscle twitching alone, especially when not accompanied by significant weakness or atrophy, is typically not indicative of a serious neurological condition. ALS usually presents with more severe symptoms, including progressive muscle weakness, difficulty speaking or swallowing, and noticeable muscle wasting. Since you mentioned that your grip strength is normal, this is a reassuring sign.

If the twitching persists or worsens, or if you begin to experience additional symptoms such as significant weakness, muscle wasting, or changes in coordination, it would be prudent to consult a healthcare professional. They can perform a thorough evaluation, including a physical examination and possibly tests, to rule out any underlying conditions.

In summary, muscle twitches can be a common and often benign occurrence related to fatigue, dehydration, or muscle strain. Ensuring proper hydration, maintaining a balanced diet, and practicing good posture can help alleviate your symptoms. However, if you have ongoing concerns or if your symptoms change, seeking medical advice is always a wise decision. Remember to listen to your body, allow for adequate recovery time between workouts, and consider incorporating relaxation techniques or physical therapy if tension persists.

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