What Kind of Exercise Is Safe When You Have Duchenne Muscular Dystrophy?

“Exercise with DMD is about preserving mobility, reducing stiffness, and supporting overall well-being, not building strength through overload,” says Matthew Cifelli, DPT, founder of Attain Physical Therapy with locations in New Jersey and Florida.

“Parents are often understandably worried about how active their child can safely play,” says Cifelli. “The key message is that movement is important, but it must be gentle, paced, and non-damaging to tissue. The goal is to keep kids moving in ways that support mobility, joint health, and emotional well-being, without accelerating muscle damage.”

There’s no one-size-fits-all approach to exercise when you have DMD. It’s important to speak with your doctor or a physical therapist before beginning an exercise program, so that they can help you create a personalized plan that balances healthy activity against the risk of damage.

The types of exercise recommended for DMD provide maximum benefits with a low risk of damage to muscles.

Stretching

“In the early stages of a DMD diagnosis, the most important form of exercise is stretching, including lengthening of the posterior muscle chain, such as hamstrings, calves, glutes, and back mobility, as these are the primary muscle groups that become tight,” says Clarissa Aguirre, DPT, a board-certified pediatric physical therapist at Village Pediatric Therapy in Yorba Linda, California.

Strengthening

“It is important for patients with DMD to avoid high-resistance and eccentric strengthening [muscle contractions where muscles lengthen under tension], in addition to overexertion without sufficient rest breaks,” says Aguirre.

Good options include using lighter weights and resistance bands, and doing exercises like yoga or tai chi. Aim for two or three times a week.

Aerobic Exercise

“Exercises that minimize stress on deteriorating muscles, such as swimming or pool therapy, are recommended,” says Andrew Gorecki, DPT, a physical therapist in Traverse City, Michigan, and co-founder of the remote therapeutic monitoring platform MovementRx.

Walking, cycling, and even dancing can also be done safely. Try to do about 30 minutes a day, at least five days a week, broken up in shorter chunks if that’s easier for you.

Balance

Standing

Exercise with DMD needs to be personalized to fit you or your child’s abilities and interests. “People with more fatigue or contractures may need shorter, more frequent sessions,” says Cifelli. “Those with better mobility may tolerate slightly longer bouts of low-impact activity.”

He points out that energy levels can fluctuate day to day, so it’s important to build in flexibility. As much as possible, movement should be incorporated into daily activity, and you should pick things you and your child have fun doing.

“Some kids thrive socially, while others prefer quiet, predictable environments,” Cifelli says. “The best routine is one the child enjoys and can sustain without strain.”

Beyond swimming, you can walk laps, do calf and hamstring stretches while sitting on the pool stairs, and make “snow angels” while you float on your back to work the full range of motion in your shoulders and hips. Stretch your lung capacity by blowing bubbles underwater.

“Modifications are essential to keep exercise safe and accessible,” says Cifelli. “Avoid high-load movement patterns that require significant trunk or hip control. Use chairs or bolsters for seated or supported stretching and break up activities into short intervals to help prevent fatigue.”

• Yoga
• Zumba
• Aerobics
• Resistance or weight training

“It’s okay to experience a mild sense of effort or a gentle stretch sensation,” says Cifelli. “Slight fatigue that resolves quickly with rest is what you should be looking for. Fatigue should never accumulate, and if you or your child looks or feels worse as the session goes on, it’s time to stop.”

• Dark or red urine (sign of an iron-containing protein from the breakdown of muscle cells)
• Trouble sleeping
• Shortness of breath that continues longer than a few minutes after stopping the exercise
• Fast heartbeat that lingers after your workout

“Intensity needs to be adjusted if you feel fatigued beyond 24 hours following a workout that leaves you sore the next day,” says Gorecki. “You may need adjustments in accommodations, which can come with the progression of the condition.”

• Exercise and physical activity are an essential component of care in DMD, to maintain mobility, strengthen muscles, and enhance overall quality of life.
• Safe exercise with DMD should focus on low-intensity aerobic activity, gentle stretching, and muscle strengthening.
• Exercise with DMD is not “one size fits all,” and an individualized approach must be taken according to your age, muscle function, and preferences.
• Too much exercise can damage your muscles; it’s important to be aware of warning signs such as pain and cramping.