What it is
A short, honest summary.
- —Inherited disorders causing progressive weakness and wasting of skeletal muscle.
- —Duchenne, Becker, limb-girdle, facioscapulohumeral, and others — each with its own pattern and pace.
- —Heart and lung muscles can also be involved, requiring coordinated cardiac and respiratory care.
What families notice
The signals worth taking seriously.
- 01Difficulty climbing stairs or rising from the floor
- 02A waddling or wide-based gait
- 03Calf enlargement (in Duchenne)
- 04Frequent falls or loss of running ability in childhood
- 05Postural changes — increased lordosis or scapular winging
My approach
How the work is structured.
- —Submaximal strengthening to preserve function without overworking vulnerable muscle.
- —Stretching to prevent contractures, particularly at the hips, knees, and ankles.
- —Bracing, equipment, and home modification timed to the disease stage.
- —Respiratory physiotherapy and integration with paediatric cardiology where indicated.
What recovery looks like
A plain-language picture.
“MD is progressive. With early, careful work, we preserve walking longer, prevent secondary complications, and protect the experience of childhood and adulthood.”
FAQ
Common questions, answered briefly.
- How young can physiotherapy start?
- From diagnosis. Even toddlers benefit from play-based programmes that build the right movement patterns.
- Should we avoid all sports?
- No — non-eccentric, paced activities like swimming and cycling are usually encouraged. We avoid contact sports and exhaustion.
For clinicians
Clinical detail, assessment and evidence.
Clinical summary
The picture in clinician register.
The muscular dystrophies are inherited disorders of progressive myofibre degeneration; Duchenne, Becker, limb-girdle and FSHD differ in onset, distribution and pace, and several carry cardiac and respiratory involvement. Submaximal, non-eccentric exercise preserves function, while eccentric and exhaustive loading risks overwork weakness. Contracture prevention and respiratory care are anticipatory.
Terminology
Terms worth being precise about.
- Gowers' sign
- Using the hands to 'climb up' the legs when rising — a marker of proximal weakness.
- Pseudohypertrophy
- Apparent muscle enlargement (often calf) from fatty/fibrous replacement, seen in Duchenne.
- Overwork weakness
- Function lost to exhausting or eccentric loading of vulnerable muscle.
- Contracture
- Fixed shortening of muscle-tendon units; prevention is a core aim.
Assessment & measures
What the first sessions measure.
- —Type-appropriate functional scales (e.g. North Star Ambulatory Assessment in Duchenne) and timed function tests.
- —Goniometry for contractures, particularly hips, knees and ankles.
- —Respiratory function; coordination with cardiology surveillance.
Red flags
Signs that need urgent escalation.
- New exertional breathlessness, orthopnoea, or palpitations — cardiorespiratory involvement.
- Rapid loss of ambulation.
- Falls with fracture risk.
Referral & MDT
When and to whom to refer.
Paediatric or adult neurology. Cardiology for surveillance; respiratory team; orthopaedics for contracture and scoliosis; genetic counselling for the family.
Evidence
References and guideline anchors.
- Submaximal exercise in muscular dystrophy — PLACEHOLDER — verify against current guidelines before launch.