DEAR DR. ROACH: My wife (age 59) has very poor leg strength. This has been the case for a number of years now, and her deceased mother had similar problems. Walking up a flight of stairs, especially if they are somewhat steep, can be a real challenge for her. She is not overweight and is, otherwise, healthy. I’ve asked her to consult her doctor about this, but she doesn’t seem to want to.
I’m hoping you can shed some light on this and hopefully suggest what may be causing the problem. Is it as simple as needing to strengthen her legs through exercise? Could it be a circulation issue? — C.H.
ANSWER: Although the most likely explanation is that she isn’t using her legs as much as she should (there’s truth to the old saying “use it or lose it”), I am concerned enough to add my voice to yours that she should be evaluated.
Circulation problems do prevent people from exercise, although the usual symptom I hear isn’t loss of strength. It’s usually pain with exercise. Many people note a deep, aching discomfort in the legs that only goes away when they stop exercising. This symptom is usually reproducible. I’ve talked to many patients who have a bench they stop at every day when they are walking. The medical term for this is “claudication,” and it usually signifies blockages in large blood vessels.
Treatment is important not only for symptomatic relief, but because blockages in blood vessels going to the legs are often accompanied by blockages in blood vessels to the heart and brain. Treatment can also reduce the risk of heart attack or stroke.
However, there could be a nerve problem to the legs as well. Many neurological conditions can prompt this. The muscle itself could have an issue, as adult-onset muscle diseases are uncommon, but not rare.
A careful exam by her regular doctor is necessary to start identifying whether this is a treatable medical condition, or whether an exercise program is what she needs to improve leg strength.
DEAR DR ROACH: I read your recent column on incontinence after prostate surgery and would like to suggest another option. Dribblestop is a clamp that is quite effective and a noninvasive solution. It can be purchased online or at a medical supply store for about $100.
I wish there was such an easy solution for women! — L.B.
ANSWER: I’ve never prescribed a penile clamp. It is used for stress urinary incontinence and is most often used intermittently, such as during periods of exercise.
Most men in a trial described it to be the most secure and the least likely to leak, but nearly all men described it as painful or uncomfortable. A clamp should only used by a man with a normal bladder capacity who is able to put it on and take it off himself, and it shouldn’t be used by someone who has problems with sensation.
Most men in a study using different types of devices for incontinence after prostate surgery preferred to use a variety of devices and pads. No one solution is best for everyone.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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