Looking to get moving but worried about safety? You’re not alone. Muscle weakness and other myasthenia gravis (MG) symptoms like fatigue and uncoordinated movements, can pose challenges to being physically active. It’s understandable to worry about your safety while exercising with MG.

“Extremely fatigued,” one MGteam member wrote. “It’s like I can feel it drain out when I have done too much. It leaves my face and lowers and out my body it goes … If I don’t lie down, I will fall down.”

MG symptoms might make you want to avoid working out. Still, research suggests people with stable MG can safely exercise and, as a result, improve muscle function. Read on to learn more about the benefits of exercise, risks to be aware of, and some tips about activities that tend to work best for people living with MG.

Talk with your doctor before starting any new physical activity. Your doctor can help you avoid injury, set healthy goals, and refer you to resources or a physical therapist to design an exercise routine.

Benefits of Exercise With Myasthenia Gravis

Physical exercise not only has physical benefits but also can positively affect mental well-being. Gentle, regular exercise is fine for most people with MG. Though research is limited to small studies, results have shown that people with stable MG can benefit from both cardiovascular and resistance exercises. For those with mild-to-moderate, well controlled MG, an individualized exercise plan, such as 150 minutes of moderate-intensity physical activity every week, can be a safe and beneficial MG treatment strategy.

One small study found that eight weeks of resistance exercises led to a 10 percent increase in knee extensor strength among participants with myasthenia gravis.

A review of studies examining muscle training programs for people with MG found that, overall, their muscles grew stronger, fatigue lessened, and quality of life improved. A different review concluded that regular exercise, whether focused on endurance or strength, is beneficial for people with neuromuscular disorders in general.

Exercise and Mental Health

Exercise may improve mental health too. One small study of a 12-week aerobic-and-resistance training program found small improvements in quality of life, as measured by an MG-specific quality of life assessment. However, a different study found mixed results, so more research is needed on how exercise affects people with MG.

Some MGteam members report that exercise generally lifts their mood or reduces stress. One member shared, “Got up early, ate breakfast, and completed stretching and strength exercises. Then I walked my 30 minutes. It’s a great day so far!” Responding to a member’s question about how others manage stress, one member said, “I engage in music-listening, singing, or exercise.”

Risks of Exercise with Myasthenia Gravis

Pushing your muscles to exhaustion can make weakness worse in people with MG. Because MG muscle fatigue and weakness often worsen with repetitive and prolonged use, it’s important to listen to your body and take breaks to let your muscles recover. Watch for the physical signs of fatigue in a person with MG, which may include drooping eyelids or trouble holding your head up.

Timing Is Everything

In addition, avoid strenuous exercise during flare-ups or if you’re at risk for myasthenic crisis, a serious condition where the respiratory (breathing) muscles become very weak. Stop all physical activity and seek medical advice if your breathing, swallowing, or speech problems worsen.

"Definitely try to walk to preserve strength and mobility.”

— An MGteam member

Having the right conditions for exercise is also important for people with MG. Exercise when you have the most energy — for most people with MG, this is early in the day. Extreme temperatures, particularly heat, may increase fatigue, so avoid hot yoga and saunas and exercise in cooler environments when possible.

Older adults with MG, people with other serious health conditions, and those with severe MG may need alternative, lower-intensity physical activities. An individualized movement plan can help you find the right balance for your body.

Check in With Your Doctor First

It’s always best to talk to your neurologist or another doctor before starting any new exercises. You might also see a physical therapist to help you establish an exercise routine that works for you. Don’t be afraid to ask for exercise help — there are plenty of healthcare and movement specialists who can help you develop a safe and effective exercise program.

Tips for Safe Exercises With Myasthenia Gravis

You don’t need complicated exercise routines. The Myasthenia Gravis Foundation of America recommends walking, resistance-band exercises, and yoga are great low-impact ways to stay active.

Walking

Walking is a type of aerobic exercise that can help you get your heart rate up while still being low-impact. One of the great things about walking for exercise is how simple it is — all you need is a place to walk and some comfortable shoes.

The Myasthenia Gravis Foundation of America recommends starting with short walks, like two minutes a day, and working your way up to longer walks. Move at a pace that works for you. It’s important to respect your body and know how much it can handle that day, even if the walk is short.

As one MGteam member put it, “Today I took a walk to the lobby from my room. It’s a respectable exercise. That was enough for a so-so day. Definitely try to walk to preserve strength and mobility.”

Resistance-Band Exercises

Resistance-band exercises are a form of strength training that can help increase muscle strength. Resistance-band exercises make your muscles work harder when the band or tube is stretched. These repetitive movements against resistance make the muscles stronger over time. Because MG causes muscle weakness that can sometimes be debilitating, increasing muscle strength can help make everyday activities easier.

For example, one small study found that eight weeks of resistance exercises led to a 10 percent increase in knee extensor strength among participants with myasthenia gravis, which helps with everyday movements like walking, climbing stairs, and standing up. The resistance training also led to a 23 percent increase in shoulder abductor strength — the muscles that allow you to move your arms from your side to above your head.

All you need is a resistance band to get started. You can try a light band at first, which will provide less resistance, and work your way up to heavier bands over time. Start slowly with a couple of exercises and work your way up to multiple repetitions. Ask your healthcare team or physical therapist for specific resistance-band exercises to include in your weekly routine.

Yoga

Yoga is a great way to get moving, and it can improve blood flow, balance, and strength while boosting energy and mood. Try a beginner yoga class or video to start. You can try out simple poses and balance exercises and evaluate how they feel for your body.

Walking, resistance-band exercises, and yoga are great low-impact ways to stay active.

As with walking or resistance training, it’s important to take yoga slowly and set realistic expectations for yourself. For example, a personal trainer interviewed by Conquer Myasthenia Gravis recommends telling your yoga instructor (if you take a class) you’re planning to stay for 10 minutes to try it out, then increase time as you can.

Some types of yoga may be more focused on stretching. Many MGteam members recommend stretching as a good way to get moving, especially if you’re feeling tired but still want to do something for your body. “My advice for the exercise is to try stretching first. My fatigue is also overwhelming,” one member said, responding to another’s comment about exercise and fatigue.

Another commented that stretching is a type of movement that’s low-key but beneficial: “I just printed a doc with stretching for MG patients — neck, arms, legs, and ankles. Felt pretty relaxed after a few, and stretching is not using up too much energy.”

Celebrate Movement

Getting started with exercise may be intimidating, but remember, you can take it slow. Being physically active is one way to celebrate your body and feel better in it too. Getting more exercise may help you feel more empowered to raise awareness about life with MG or participate in MG Awareness Month.

The bottom line is that it’s possible to have an exercise routine by taking it step by step and listening to your body. Be kind to yourself and talk to your neurology provider if challenges come up. Even small steps toward being more active are worth celebrating.

Join the Conversation

On MGteam, people come together to share their experiences with myasthenia gravis, get advice, and find support from others who understand.

What kind of exercise have you found safe and satisfying with myasthenia gravis? Let others know in the comments below.