How I Exercise Safely with MG

When I was first diagnosed with myasthenia gravis (MG), I couldn't lift my arms above my head 10 times. Fortunately, my MG weakness improved with treatment and lifestyle changes. But easing back into exercise after MG, I had to accept my new limitations.

I recognized I was starting at a different point when it came to my strength, and that empowered me to exercise safely and avoid injury or worsening of MG symptoms. Embracing my new body and making needed alterations to my exercise routine allowed me to adapt to MG-friendly exercises without surrendering to its limitations.

Although it can be difficult to accept change or know how to approach exercise safely after MG, there are a few things that helped me. And remember, your doctor's guidance is crucial. They are your safety net, ensuring your well-being as you navigate your exercise routine with MG.

Warm-up before exercising

When I want to exercise on a good MG day, I start with mobility movements. I incorporate stretching, like lunges and lateral crab walking. Then, I use a resistance band to assess my strength before moving on to weights.

Find the right workout

Until my MG symptoms were controlled, I couldn't exercise on the treadmill, rowing machine, or stationary bicycle. Even now, repetition triggers my symptoms, causing neck pain and prolonged weakness. I found success and have gained strength with progressive overload weight training. It involves gradually increasing weight or repetitions based on what my body can handle rather than aiming for a specific number of repetitions.¹

If I am dealing with muscle imbalances or weakness due to MG, I modify my workouts to avoid injuries - especially when using weights. I opt for weight training machines for stability and safety, instead of free weights and barbells. If maintaining my balance is still challenging with weight machines, I consider reducing the weight or switching to a different machine. I use a mirror or record myself to help ensure proper form and conserve energy.

Ask for help at the gym

If you're not sure about something at the gym, it's okay to ask for help. I struggle with embarrassment when I can't figure out a machine or feel I'm using an incorrect form. But I keep in mind that so many individuals are also beginners in the gym. If you are new to weight machines, have a gym staff member show you around and show you how to use the equipment, or consider hiring a personal trainer for a session to teach and assist you.

Improve endurance, breathing, and mobility

With MG, fatigue and breathing issues can make us feel like we've run out of energy quickly during exercise. To increase endurance, I practice breathing exercises like belly breathing and improve my posture to strengthen muscles involved in breathing, swallowing, and speaking muscles.

I find thoracic expansion exercises, such as yoga poses like cat-cow and thread-the-needle, beneficial for improving breathing, respiratory muscle strength, and spine mobility. These exercises target the thoracic spine - the upper and middle region of the back.²

By relaxing and expanding the thoracic region, these exercises help me prevent injury and reduce unnecessary energy expenditure caused by a stiff thoracic spine. The organs impacted by this spine area also include the heart and lungs. I like to prioritize these exercises to help my respiratory muscles and hopefully reduce weakness in these areas. ²

Prioritize rest and recovery

In the media, we often see stories of professional athletes fighting through pain or injury to secure a win or reach their goals. But we don't need to push ourselves to the point of pain or risk injury to achieve results. We may try to tune out MG weakness, but recognizing the need for rest and recovery is respecting our body's limits and can be crucial in preventing overexertion and potential injury.

After easing back into exercise post-MG, I experienced increased weakness and soreness. When working out in the past, I experienced soreness as a normal part of muscle repair. But after MG, the soreness became more pronounced. Now I aim to stop my workout when I feel I've exerted 50-75 percent of my physical energy.

Although I am shortening the duration of exercise, it also helps shorten my recovery time and allows me to exercise more often so I don't lose motivation. On rest days, I also use my massage gun, do slow stretching, and flexibility-focused yoga flows. This helps me feel most recovered the next time I exercise.

Adapting to change

MG symptoms can be unpredictable and influenced by various factors. This made it challenging for me to stick to a consistent exercise routine. But I've found that living with MG means being open to spontaneity and seizing opportunities to exercise when my body feels best.