Physical therapy

Any physical therapist/physiotherapist working with a McArdle disease patient should be fully briefed by the patient’s McArdle specialist prior to first consultation. Common errors include:

– Holding stretches too long (page 12e).

– Exercising for short periods without achieving ‘second wind’ (page 12).

– Advising that pain is acceptable without realizing that McArdle patients are different, see (f) below.

– Failing to monitor CK levels to ensure that muscle damage is not being incurred (page 10).

• Once a safe and effective exercise routine has been prescribed by the McArdle specialist, local facilities can be used to support patients.

• Regular follow up will motivate patients, help to ensure their compliance with the prescribed exercise regime and avoid damaging activities (pages 12 and 13).

• If physical therapy is required for other conditions or following unrelated injuries, stretches should be limited to approx. 6 seconds so that energy demand does not extend beyond the depletion of ATP in the muscles (page 12e).

• Should massage be required, this should be gentle, not deep, massage. Massage should not be applied to a muscle which is in a rigid, fixed contracture.

• McArdle patients do not get what is often described as a “lactic acid burn”, as their level of lactate and hydrogen ions does not “rise” on exercise [1].

• Web page “Training support” and leaflet “At the gym” are intended for physical therapists/personal trainers helping people with McArdle’s. https://www.iamgsd.org/training-support

[1] A nonischemic forearm exercise test for McArdle Disease. Kazemi-Esfarjani P, Skomorowska E, Vissing J, et al. Ann Neurol. 2002 Aug;52(2):153-9.