How to Access Physiotherapy

Your doctor must refer you to physiotherapy treatment. You’ll need to find and contact a private or public physiotherapist yourself. Therapy may involve individual or group training depending on your needs and functional level.

In some countries there is a possibility to get free physiotherapy, ask your own GP or healthcare center if it is a possibility in your country.

General physical exercise and individual therapy are recommended, although myasthenia cannot be cured through training. The goal of training is to maintain joint mobility and muscle strength and prevent secondary issues like neck pain from compensatory movements.

A physiotherapist experienced with the disease can create a customized program tailored to your strength, ensuring the training isn’t too strenuous.

Some individuals benefit from swimming, especially in warm water. Others find swimming too tiring due to water resistance or muscle relaxation in warm water. You can also get horse-physiotherapy, for some that will be the right thing.

Special Challenges with Exercise When You Have MG

When you have myasthenia gravis (MG), you may face unique challenges when exercising because your level of physical function can fluctuate from day to day and even throughout the day.

Well-Regulated Medication

You are advised to begin exercising only once your medication is properly adjusted. If your treatment is not stable, you may experience significant discomfort during and after physical activity. In the following days, you may also experience pronounced fatigue and breathing difficulties. Therefore, close coordination with your neurology department is essential to ensure your medication is well-regulated.

Avoid Overexertion

Once your medication is stable, you can begin training. Recent research shows that both resistance and cardiovascular training can be beneficial for most people with MG. However, exercise programs should be tailored individually, and both you and your physiotherapist should be attentive to signs of fatigue triggered by exercise. These signs might include drooping eyelids and difficulty holding up your head. It takes some time to learn how to recognize your body’s signals.

It is recommended to train at the time of day when you feel most energized. You should avoid stress, as it can also trigger fatigue. Therefore, consider reducing or skipping your workout if you have other demanding activities planned for the same day or the following day.

Some people with MG are sensitive to extreme temperatures. If you consider swimming as a form of exercise, first test whether your body tolerates warm or cold water.

Helpful Tips

When planning your training program with your physiotherapist, it’s important to keep the following in mind:

  • Avoid high-intensity training with many repetitions
  • Vary your exercises from session to session and during each session
  • Alternate between strength, balance, and flexibility training
  • Include rest breaks in your workout
  • Incorporate:
    • Fall prevention training
    • Exercises for facial and breathing muscles
  • Be mindful of room temperature, as heat can increase fatigue

For individuals who are in a myasthenic crisis or at risk of developing one, strenuous physical activity and exercise should be avoided.