Why are your muscles weak?
When we are young, we expect our muscles to be strong and healthy. For most of us, this is the case. However, one day, you notice that your son’s having trouble walking and realize that he has been falling frequently. What does this mean? What treatment will help him get better?
Muscular dystrophy is the name given to a group of diseases that affect the muscles of your body. All of them are caused by mutations of your genes that cause the production of proteins that your body needs to form healthy muscles to be inhibited. Over time, this causes progressive weakness and loss of muscle mass. There are several different types of muscular dystrophy. The most common is Duchenne type and affects boys more than girls with onset starting in early childhood. It is estimated that one-third of people who have this type do not have a family history of muscular dystrophy. The most common symptoms are frequent falls, difficulty getting up from a lying/sitting position, trouble running/jumping, waddling gait, walking on toes, large calf muscles, muscle pain/stiffness and learning disabilities. Becker type is another common form of muscular dystrophy and is similar to Duchenne type in symptoms, but they appear later (teenage years to mid-20s), the disease progresses more slowly and the symptoms are milder. There are four other types that are not as prevalent as the Duchenne or Becker. Myotonic (Steinert’s disease) is when you are unable to relax muscles on command after they have been contracted. Typically, the first muscles to be affected are the muscles of your face and neck. This type is the most common one to appear in adulthood. Facioscapulohumeral (FSHD) starts by affecting your face and shoulders. Most often, it presents during teenage years, but can occur at any time. Limp-girdle is when the disease affects your hip and shoulders first and causes difficulty in lifting the front part of your foot, which results in frequent falls. This type occurs during childhood or teenage years. Congenital type appears before the age of two and, in some cases, is discovered at birth. This type can progress slowly or rapidly and cause mild to severe impairment.
Muscular dystrophy can affect anyone of either gender, any age or any race. If you have a family history of it, then you are at greater risk of having it yourself or passing it on to your children. All types of muscular dystrophy have similar complications due to the muscle weakness. It can influence a wide range of body systems because it depends on which muscles are involved. The most common issue is difficulty walking. Most people with muscular dystrophy end up needing to use a wheelchair at some point during their lives. To go along with the decreased mobility are the development of contractures (shortening of muscles/tendons are your joints) and scoliosis (your spine becomes curved because your muscles are too weak to hold it straight). Muscular dystrophy can also cause swallowing problems, breathing difficulties and heart issues if any of the muscles that help regulate these functions are damaged by the disease.
Currently, there is no cure for muscular dystrophy. The goal of treatment is to treat the symptoms and allow you to maintain independence and mobility as long as possible. The first part of treatment involves using medications to help treat symptoms. There is a relatively new medication, eteplirsen, on the market that is used specifically for muscular dystrophy. It is aimed at increasing muscle strength, but it is unclear how effective it is at this point. In order to do this, it works on a specific gene mutation in your body (this mutation only affects one in seven people with the disease). The most common medicine used to help increase muscle strength, thereby delaying the progression of the disease, is the class of medications known as corticosteroids. These are beneficial, but long-term use can cause weight gain and weakening of your bones. For some individuals, they need to take medications for their heart due to the damage that is caused by the disease.
The other major treatments for muscular dystrophy is the use of therapy and devices to help increase and maintain mobility. Stretching exercises that help with range-of-motion are extremely beneficial at keeping your joints flexible. Low-impact aerobic exercises, like walking or swimming, and mild strength training can also be useful. As the disease progresses, using braces is good for keeping your muscles and tendons stretched/flexible, which helps to slow the progression of contractures. If contractures of your spine prohibit your breathing, you might need surgery to correct it. Using canes, walkers or wheelchairs can help you maintain your independence. Another type of therapy to consider is speaking to someone regarding your feelings about your muscular dystrophy. It is a difficult disease to be diagnosed and live with, so having a support system is essential.
Unfortunately, there is no way to prevent muscular dystrophy from happening. Until we can figure out what triggers the genetic mutation, it will be challenging to determine who will have it versus who won’t. Doing your best to live a healthy lifestyle by eating nutritious foods, exercising and not participating in any bad habits is a good thing to do regardless, but is especially helpful in treating muscular dystrophy, if you happened to be diagnosed with it.
Muscular dystrophy is a debilitating disease that makes living independently particularly challenging as the it progresses. Hopefully, we one day have a cure for it. If you have any questions or concerns, please speak with your doctor. If you would like more information, please visit the Muscular Dystrophy Association at https://www.mda.org/