This last week, I saw a patient who had calf muscle jumping. In fact, unlike other cases, which can be subtle, this one was really easy to see, so I took some video and thought I’d share this with you. So what causes calf muscle jumping?
The calf muscle is called the gastrocnemius muscle by healthcare professionals. Every muscle has an innervation, which means a nerve that tells it what to do. When that nerve is irritated or damaged, the muscle it supplies tends to jump or “fasciculate” (medical term). This is just a reflex response of the muscle when it has no instructions from the nerve on how to behave.
In the case of the calf muscle, it’s innervated by several spinal nerves, including S1 in the low back which then becomes the tibial nerve in the leg. So if there’s pressure on that S1 nerve from a bulging or herniated disc or an injury to the tibial nerve, the result can be calf muscle jumping.
Many times the calf muscle jumping is pretty subtle, so if you’re not looking for it, you may not notice it. I have it personally from time to time, so I know that I notice it, but many patients don’t even know it’s happening. However, it jumped out while examining a patient this week, so I decided to take a video of the calf as well as the ultrasound image.
Look at the video of the calf muscle above. You can see the muscle jumping. Now look at the ultrasound image of the same muscle and you can see the muscle jumping as well. On the right, I also included an ultrasound video of another muscle in the leg that isn’t innervated by the sacral nerves. Notice how much calmer that muscle is on the ultrasound (almost no jumping).
Since the most common cause of calf muscle jumping is irritation of the S1 nerve in the low back, this problem is usually caused by a disc bulge or arthritis pressing on or irritating that nerve. Hence, the way to treat it is to treat the nerve. We have successfully treated this problem by precisely injecting the growth factors from the patient’s own blood platelets around the irritated nerve. This is called a platelet lysate epidural. If the disc bulge is bigger and if the disc degeneration isn’t too severe, the problem can also be treated with a precise injection of specially cultured stem cells into the bulge. This procedure can reduce the size of the bulge by healing the injured fibers that cause the bulge.
The upshot? Don’t ignore calf muscle jumping. It’s a sign that the nerve that supplies the calf muscle isn’t happy. If it happens once or twice and never again, you may want to blow it off; however, if it keeps happening and won’t go away and your doctor tells you to ignore it, then you may want to find a new doctor!
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…