Defining Clinical Weakness

What is a good definition of clinical weakness?

Being a doc myself, I only use the term 'clinical weakness' to describe objective weakness that I, as a doctor, have elicited in examining a patient.Being a BFS patient myself, I would say that most cases of 'clinical weakness' are noticed by patients before by the doctor and is usually the very reason for attendance to the doctor. So if you haven't noticed any weakness and have good strength then I would say you are safe to assume that you don't have 'clinical weakness.'I think it useful to distinguish 'clinical weakness' from perceived weakness, which is the general weakness I feel in certain muscle goups when trying to do things. The latter is common in BFS and of no concern medically.All the bestSimon

Nice to see you back Simon, but not nice as I thought you were going to forget about us!!!I have a question about the difference between clinical weakness and perceived weakness.I feel like things are heavier than they used to be, although I can still lift them. I also get a strange sensation when picking things up like it is more work. If I had clinical weakness in my fingers, would I be able to pick up a laptop or textbook by just pinching with my thumb and then each finger? Not little finger though...I also feel that I have bigger dents between muscles in my right arm. Could this just be that these muscles are more toned (right-handed).I would love people's opinions on this.

I have found dents in my legs, and worried over them as well.But when you really examine it, I think its more of a lack of fat on that side and maybe increased muscle definition.I worry less and less about them every day. Everyone has some asymmetry like this. We just dont notice it bc we dont examine our bodies like this until we start twitching.Bottom line: Dents like these ARE NOT atrophy. And without weakness, True weakness, they are meaningless.Perceived weakness is funny. We have all had it. And you can make yourself crazy over this! But really, if you have equal strength, then its not real weakness. People with neurological weakness know it. Its very clear, and there is no mistaking it. They can't pick things up, and it is easy to pick up on a clinical exam.Good luck and hang in there. Its really mind over matter. It may be a struggle with mental relapses here and there, but we can all beat this.Keith

Hi Rachel,I posed the same question to my PT about finger strength and she does not seem to be concerned at all. I have issues with a few fingers in one hand - like you wrote in your earlier posts, it feels like it is harder to handle objects. I also feel pain in these fingers so I wonder if the pain causes the perceived weakness, as it truly makes it uncomfortable to pinch/hold items. When I use these fingers I feel an uncomfortable tightness and pain in my upper back as well and I have a feeling that this is where the problem originates from. The fact that you can still lift those objects is what matters, as you certainly don't have any profound, clinical weakness. The danger of self testing fingers is that it can lead to a repetative injury - the muscles here are not very strong to begin with and are not used to excessive use and overload. In my situation, I came to the conclusion that increased use (i.e. working out) of a muscle will lead to dents. This summer I added a grip strength exerciser to my workout routine and very soon, I had these symmetrical dents in the wrists in both hands. First I freaked out but the dents have not increased and I can still handle the same load and tasks, so I believe that the new type of workout added those dents by the tendons. I hope you will be able to worry less about this. Take care, Kat

Hi RachelThe feeling that your muscles have to work harder than they used to when you lift objects is something I have developed when I got BFS but this is definitely different from clinical weakness, so no need to worry about anything scary. Ditto for the dents. On anxious days I find dents here and there and feel worried but when I am in a more logical frame of mind I realise that this is nothing to do with the atrophy that I see in some of my patients, which is quite different.Take care of yourselfRegardsSimon

I am confused on this atrophy thing. when a muscle atrophies, does the whole muscle atrophy or does it start at one end and go from there?