Clinically reviewed by What is muscular dystrophy
The muscular dystrophies are inherited conditions in which muscle fibres break down faster than the body can repair them, so the muscles slowly weaken. Duchenne muscular dystrophy is the commonest in children, and it affects boys almost only.
This page will be honest with you. These conditions are progressive and there is no cure. Nothing in physiotherapy reverses them, and anyone who says otherwise is not telling you the truth.
What physiotherapy does is real and worth having. It keeps joints moving, delays the stiffening that takes function away early, supports breathing, and keeps a child walking, sitting comfortably and taking part in life for longer.
Symptoms you might have
- Walking late, then falling often and tiring on short distances. Delayed walking in a boy is always worth a blood test
- Difficulty climbing stairs, running or jumping compared with other children
- Pushing up on the thighs with the hands to stand from the floor
- A waddling walk, and a tendency to walk on the toes
- Calves that look unusually large and feel firm
- Weakness worse close to the body, in the hips and shoulders
- Skills gradually lost rather than gained, which is what separates this from a simple delay
Why it happens
- A fault in a gene needed to make a protein that protects muscle fibres
- Duchenne and Becker are carried on the X chromosome, so boys are affected and mothers can be carriers
- Other types, such as limb girdle and congenital dystrophies, are inherited differently and affect both sexes
- Marriage within the family raises the chance of the inherited types, which is relevant in Pakistan
- Many cases are new gene changes, with no family history at all
- Nothing in pregnancy, diet or parenting causes it
When you should see a physiotherapist
If a child is losing skills, walking oddly, or struggling with stairs and getting up from the floor, the first step is a doctor, not a physiotherapist. A blood test for creatine kinase is simple and widely available, and genetic testing confirms the diagnosis. A child neurologist leads that work.
Once the diagnosis is known, start physiotherapy straight away. Stretching begun before the ankles tighten is far more useful than stretching begun after.
Any loss of a skill a child already had needs a doctor, and so does a sudden change in muscle tone or strength. Go to hospital for breathing difficulty, a chest infection, choking on food, morning headaches, daytime sleepiness, or swelling of the legs with breathlessness. Those point to the breathing and heart muscles and need specialist care, not physiotherapy.
Al-Shama Physiotherapy Clinic
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How it is treated
Physiotherapy in muscular dystrophy has clear goals: keep range, delay contractures, protect breathing, and keep your child moving and comfortable. None of it changes the muscle disease itself.
- Daily stretching of the ankles, knees and hips, and later the elbows and fingers, the single most valuable thing you will do
- Night ankle splints, which hold the stretch for hours and delay the heel cord tightening that ends walking
- Exercise therapy at low resistance, such as swimming and cycling, which keeps fitness without damaging fragile muscle
- Standing and walking programmes, including a standing frame once walking becomes hard, which helps hips, bones and comfort
- Breathing exercises and airway clearance, taught early and used more as the chest muscles weaken, alongside the respiratory team
- Seating, wheelchair posture and equipment, which protect the spine and keep a child upright and included
Steroid medicines, heart and lung monitoring, spinal surgery and genetic counselling are all doctors' work. Physiotherapy sits inside that team. A wheelchair, when it comes, is not a defeat. It gives back distance, energy and independence.
Exercises, and what to avoid
What helps
- A short stretching routine every single day: calves, hamstrings, hip flexors and the outer thigh
- Night ankle splints, worn as prescribed, which do the long hold you cannot do by hand
- Swimming, which is the best exercise in this condition because the water carries the weight
- Standing and walking spread through the day, in short easy spells rather than long efforts
What to avoid
- Heavy weights and resistance training. Dystrophic muscle is damaged by hard loading, not strengthened by it
- Exercising to exhaustion, or anything that leaves your child sore the next day
- Repeated stair climbing or downhill walking as exercise, which load muscle while it lengthens
- Long spells in bed after illness or surgery. Stiffness sets in quickly and is hard to reverse
What you can do at home
Make the stretches a fixed daily habit. Ten minutes every day beats an hour twice a week, and in this condition that difference shows in years of walking.
Fit the night splints into bedtime, and tell your physiotherapist if they rub rather than quietly giving up on them.
Keep your child's weight steady. Extra weight makes every transfer and every step harder, and steroid treatment can increase appetite.
Keep him in school, in company and in play. Take the car, take the wheelchair, take whatever is needed. Isolation costs more than tiredness.
Ask for a breathing review before your child needs one. Chest care is easier to set up early.
How long it takes
This is lifelong care, not a course of treatment. What changes is what the work is for at each stage.
In the walking years, the aim is to protect ankle and hip range and keep walking comfortable and safe. Daily stretching and night splints genuinely delay the tightening that ends independent walking.
Most boys with Duchenne find walking longer distances difficult somewhere in the early teenage years. Steroid treatment prescribed by a specialist usually delays that, and good stretching helps too.
After that, the work shifts to posture, seating, breathing and arm function. With modern heart and breathing care, many young men now live well into adult life, and physiotherapy stays part of that.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
مسکولر ڈسٹرافی ایک موروثی بیماری ہے جس میں پٹھے آہستہ آہستہ کمزور ہوتے جاتے ہیں۔ ڈوشین قسم بچوں میں سب سے عام ہے اور زیادہ تر لڑکوں کو ہوتی ہے۔
ہم آپ سے سچ کہیں گے: اس کا علاج موجود نہیں اور فزیوتھراپی اس کو واپس نہیں پلٹ سکتی۔
لیکن فزیوتھراپی کا فائدہ حقیقی ہے۔ روزانہ اسٹریچنگ اور رات کو ٹخنا اسپلنٹ سے جوڑوں کی سختی دیر سے آتی ہے، اور بچہ زیادہ عرصہ اپنے پیروں پر چلتا ہے۔
بھاری ورزش اور وزن اٹھانا نقصان دیتا ہے۔ تیراکی اور ہلکی ورزش بہتر ہے۔ تھکاوٹ کی حد تک کبھی نہ کروائیں۔
سانس کی تکلیف، سینہ انفیکشن، صبح سر درد، دن میں نیند، یا ٹانگوں پر سوجن ہو تو فوراً ڈاکٹر کو دکھائیں۔
Roman Urdu
Muscular dystrophy ek moroosi bimari hai jis mein pathay ahista ahista kamzor hote jate hain. Duchenne qism bachon mein sab se aam hai aur zyada tar larkon ko hoti hai.
Hum aap se sach kahen ge: is ka ilaj mojood nahi aur physiotherapy is ko wapas nahi palat sakti.
Lekin physiotherapy ka faida haqeeqi hai. Rozana stretching aur raat ko ankle splint se joron ki sakhti der se aati hai, aur bacha ziada arsa apne pairon par chalta hai.
Bhari warzish aur wazan uthana nuqsan deta hai. Tairaki aur halki warzish behtar hai. Thakawat ki had tak kabhi na karwayen.
Saans ki takleef, chest infection, subah sar dard, din mein neend, ya tangon par sujan ho to foran doctor ko dikhayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
Can muscular dystrophy be cured by physiotherapy?
Will exercise make my son's muscles stronger?
Why does he need splints at night?
Could my other children have it?
Is using a wheelchair giving up?
Related conditions
- Cerebral palsy treatment and physiotherapy
- Torticollis in babies
- Child not walking
- Delayed developmental milestones
- Low muscle tone in babies