Restless Legs and Polio; Muscles Tears and Polio

Post-Polio Health, Volume 31, Number 4, Fall 2015

Question: I had what was termed a “mild” case of polio in 1951 at age 7. Other than a barely noticeable curvature of the spine and temporary weakness in the neck, I had no ill effects and was back in full action within a couple months. I played sports throughout high school and have run a variety of races since my early 30s, including marathons and, yesterday, at age 71, I completed a nine-mile race.

A friend made me aware of PPS in 1985. Reviewing the literature, I saw that avoiding strenuous exercise was recommended, but I have continued to run on and off through the years without apparent PPS issues or serious structural problems.

I do have questions about two conditions. One is Restless Leg Syndrome, which I’ve experienced on and off since about the time I had polio, and I wonder if polio survivors are especially prone to it.

My other concern is with random “muscle tears” in my lower and upper legs, which I have experienced since my early 40s during times when I am running frequently. Curiously, the tears don’t happen when I am in the act of running, but more likely when I am rambling through the house. I have worked with a sports physical therapist who does not believe I have PPS. Do you see any relationship between these two conditions and polio or post-polio?

Response from Dr. Fred Maynard: Congratulations on remaining in such good physical shape at age 71 – my age! I am impressed that you have pursued many good strategies to get help with your concerns. Here are my thoughts about the two issues you raise.

Restless Leg Syndrome (RLS) remains a poorly understood condition and probably represents a spectrum or variety of conditions in regard to etiology or cause. A number of studies on polio survivors suggests that RLS is more common and particularly in relation to sleep apnea syndromes. I would also say that strenuous use and possible “overuse” does lead to muscle aches and restlessness in anyone. If you have experienced some of these symptoms ever since your childhood polio, then it makes sense that you would experience it more during periods of long distance running. If it does not persist when you are not running a lot and your overall leg muscle strength has not declined over the years more than expected with aging (hard to judge but certainly modest), then I would not be concerned about your polio history in relationship to these RLS symptoms.

Regarding your “muscle tear” symptoms, I think stretching exercises are probably the best strategy to manage them. Again, they probably relate to your strenuous use of the muscles which is normally followed by microscopic muscle-damage changes and make muscles more vulnerable to minor injuries during unplanned non-focused normal-activity related contractions. I would say that if you have had these for a long time, the soreness subsides/ resolves fairly quickly and your overall leg strength has been maintained, I would not be particularly concerned about the relationship of these symptoms to your polio history.

Overall, I would agree that you do not have PPS. I think it is fine for you to remain involved in running as you like and enjoy it and to continue to vigilantly monitor your symptoms and their intensity vis-a-vis the intensity and duration of the strenuous running-related use of your leg muscles. Clearly these activities continue to keep you happy and healthy.