Strengthening activities or resistance exercise Exercise

• Generally, strengthening activities/exercises involve the major muscle groups.
•  It is important to think about strengthening the muscles of your arms and legs, stomach and back (‘core’) muscles.
•  Improved core strength can help improve your posture and balance, which can reduce the risk of falling and can help with day-to-day activities, such as wheelchair transfers.
•  Avoid excessive ‘eccentric’ activity. This means repetitive tasks or exercises where the muscle is being lengthened, for example squats.
•  Eccentric exercises put much greater force through the muscle and can lead to muscle soreness and potentially some damage.

Talk to your physiotherapist about which muscles you should strengthen and how, as this will be different for everyone.

It is important to think about improving the endurance of your muscles, rather than strengthening or trying to build up muscle bulk.

This will help you with day-to-day tasks and allow you to do them for longer, for example, being able to climb more stairs before you get tired.

It may not be possible to strengthen muscles that are very weak because of a muscle-wasting condition, but it’s important to maintain what you have for as long as you can.

How often should I do strengthening exercises and how long should each exercise session last?

• Ideally you should do strengthening exercises at least twice a week (UK Chief Medical Officer’s Physical Activity Guidelines 2019)
•  It is better not to do strengthening exercises on consecutive days; give your muscles a chance to recover.
•  Within an exercise session, you should alternate the muscles you exercise, so if you start with an arm exercise, do a leg exercise next.

If adding these exercises makes your muscles too weak, sore or fatigued to perform daily tasks, then do less exercise or speak to your physiotherapist

How hard should the strengthening exercises be?

• Low- to moderate-strength (resistance) exercises are safe for most people with muscle-wasting conditions.
•  Avoid lifting heavy weights as this may cause damage to already vulnerable muscles, and put additional strain on surrounding ligaments and joints.
• Take care to protect your neck, back and posture when doing any lifting, to avoid other injuries.
•  Increase the number of repetitions rather than the weight you lift.
•  Stop the exercise if your muscles shake too much or the movements become jerky.
•  When you start a new strength exercise you might expect to be a little bit achy, but any muscle soreness should have gone after 48 hours.

In very rare circumstances, people with muscle-wasting conditions can experience changes in the colour of their urine after exercise (in other words, urine that appears the colour of black tea or cola).

Attend A&E if you notice such a change, as this could be a condition called myoglobinuria.

In summary: