EXERCISE AND DIET
Any physical therapist/physiotherapist working with a McArdle disease patient should be fully briefed by the patient’s McArdle specialist prior to first consultation. Common errors include:
– Holding stretches too long (page 12e).
– Exercising for short periods without achieving ‘second wind’ (page 12).
– Advising that pain is acceptable without realizing that McArdle patients are different, see (f) below.
– Failing to monitor CK levels to ensure that muscle damage is not being incurred (page 10).
Once a safe and effective exercise routine has been prescribed by the McArdle specialist, local facilities can be used to support patients.
Regular follow up will motivate patients, help to ensure their compliance with the prescribed exercise regime and avoid damaging activities (pages 12 and 13).
If physical therapy is required for other conditions or following unrelated injuries, stretches should be limited to approx. 6 seconds so that energy demand does not extend beyond the depletion of ATP in the muscles (page 12e).
Should massage be required, this should be gentle, not deep, massage. Massage should not be applied to a muscle which is in a rigid, fixed contracture.
McArdle patients do not get what is often described as a “lactic acid burn”, as their level of lactate and hydrogen ions does not “rise” on exercise .
Web page “Training support” and leaflet “At the gym” are intended for physical therapists/personal trainers helping people with McArdle’s. https://www.iamgsd.org/training-support
 A nonischemic forearm exercise test for McArdle Disease. Kazemi-Esfarjani P, Skomorowska E, Vissing J, et al. Ann Neurol. 2002 Aug;52(2):153-9.
McArdle Disease Medical Overview