Physical therapy and exercises like stretching are important parts of your child’s treatment for Duchenne muscular dystrophy (DMD). These approaches may be used along with treatments like medications, gene therapy, and more. Exercises can help keep muscles strong and working well. Regular, gentle exercise can also help your child use home aids like grab bars and ramps more easily.

Several types of exercise may be good for your child with DMD. For example, stretching can help muscles stay more flexible, limit or prevent contractures (when muscles or joints become stiff and hard to move), and maintain range of motion. Most of the time, your child will need your help to do the stretches the right way.

Talk to your child’s doctor or physical therapist before you start any stretching routine or change a current exercise program. Your doctor will help keep your child safe and tell you what to look for when helping them stretch. A healthcare provider will also monitor your child for signs that they should stop stretching or change their daily routine to help maintain their quality of life.

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Here are eight physical therapy exercises for Duchenne muscular dystrophy that you can try with your child.

1. Side Twist Wrist Stretch

This stretch helps loosen muscles in your child’s wrists.

1. Have your child sit up straight on a bed or bench.
2. Choose a hand to start with, then place it flat on the surface they’re sitting on with their fingers turned 90 degrees from their body.
3. Help them hold their fingers flat.
4. Support their elbow so it doesn’t collapse, though it doesn’t need to be locked.
5. Hold for 30 to 60 seconds, three times total.
6. Repeat with the other hand.

Talk to your child’s doctor or physical therapist before you start any stretching routine or change a current exercise program.

2. Seated Finger Extension

This stretch helps the muscles in your child’s fingers and hands stay loose and limber.

1. Have your child sit comfortably.
2. Choose an arm to start with, then extend it with the elbow at about a 90-degree angle.
3. Standing beside or behind your child, hold their palm with both hands.
4. Gently bend the wrist back.
5. Slide your hands slowly down your child’s hand, moving from the palm to the fingers, and gently guide the fingers toward the floor.
6. Hold for 60 seconds, release, and do this stretch one more time.
7. Repeat with the other hand.

3. Forearm Stretch

This stretch helps the muscles in your child’s forearms.

1. Have your child lie on their back.
2. Choose an arm to start with, then use one of your hands to keep the elbow of that arm against the side of their body for the whole stretch.
3. With your other hand, grasp their arm just above the wrist.
4. Bend their elbow to 90 degrees with their hand in a palm-up position.
5. Hold for 60 seconds. Release, then hold for 60 seconds again.
6. Repeat with the other arm.

Be mindful of the following stretches, which involve lying on the stomach or back, if your child has weak breathing muscles or uses a breathing machine. Always check with your child’s doctor or physical therapist.

4. Hip Flexor Stretch

This stretch helps loosen your child’s hip flexors, which are at the front of their pelvis and thighs.

1. Have your child lie on their stomach, supported by their elbows, with their feet hanging off the edge of the surface.
2. Place one hand on their hip on the side you’ll be stretching.
3. Place the other hand under the thigh of the leg you’ll be stretching.
4. Gently lift their leg, with their knee bent, 1 to 2 inches until they feel a stretch.
5. Hold for 30 seconds, then do the stretch one or two more times.
6. Repeat with the other leg.

5. Hamstring Stretch

This stretch helps lengthen the back of your child’s legs, particularly the upper thighs.

1. Have your child lie on their back.
2. Choose the leg you’ll start with, then put your hand under the knee to support it.
3. Using the other hand, gently lift their heel off the ground until they feel a stretch in the back of their leg.
4. Keep the knee straight but not locked. Your child may feel this stretch down the entire back part of their leg or only in the upper part.
5. Hold for 60 seconds, then release. Do the stretch one or two times.
6. Repeat with the other leg.

Have your child warm up if they can before stretching or exercising.

6. Iliotibial Band Stretch

This stretch maintains flexibility and reduces tightness in your child’s iliotibial band — the band of tissue running along the outside of the thigh.

1. Have your child lie on their stomach with their legs straight.
2. Stand on the side you plan to stretch.
3. With one hand, gently press down on your child’s lower back.
4. Place the other hand under their knee and lift their leg 1 to 2 inches.
5. Gently pull their leg across their body’s centerline until they feel a stretch and hold it there.
6. Hold for 30 seconds.
7. Repeat with the other leg.

7. Prone Calf Stretch

This stretch helps keep the muscles in your child’s calves flexible.

1. Have your child lie on their stomach.
2. Choose a leg to start with, then flex the knee of that leg to 90 degrees.
3. Use one hand to stabilize the lower portion of the leg.
4. Use the other hand to hold the bottom of their foot and their heel.
5. Flex the foot toward the shin as far as is comfortable, without pain.
6. Hold for 60 seconds, release, then hold for 60 seconds again.
7. Repeat with the other leg.

8. Lying Achilles Stretch

This stretch helps keep the Achilles tendon (which connects the calf muscle to the heel bone) long and flexible.

1. Have your child lie on their back with a small towel rolled up under their knees.
2. Choose a leg to start with, then hold the heel with one hand and pull gently to lengthen the leg and the Achilles tendon.
3. Gently help your child flex their foot as much as possible without pain.
4. Hold for 60 seconds, release, then hold for 60 seconds again.
5. Repeat with the other leg.

Your child shouldn’t hold their breath throughout stretching. Remind them to breathe regularly.

Tips and Muscular Dystrophy Exercise Precautions

These general stretching tips can help your child get the most out of their stretching routine.

• Have your child warm up if they can. Moving your child’s body around gently can help their muscles get ready. If that’s not possible, consider applying low to moderate heat to the muscles before stretching them.
• Encourage your child to use good form. They’ll get the most benefit from stretching when their body is in the right position. Working with a physical therapist or healthcare provider can help ensure you’re doing the stretches correctly and give you confidence to try them at home.
• Don’t push a stretch until it hurts. This can be hard when you’re stretching someone else. Come up with a signal your child can use to tell you to stop when they feel only mild tension in their muscles.
• If safely possible, tell your child to focus on breathing. Your child shouldn’t hold their breath throughout stretching. Remind them to breathe regularly. In children with breathing problems, it’s always best to check with your doctor.

Muscular Dystrophy Exercise Resources

There are several resources that can help you learn how to do DMD stretches at home. CureDuchenne offers videos on stretching to help people with DMD, providing background information and how-to videos on both self-stretching and helping your child stretch. The Muscular Dystrophy Association offers a PDF on at-home stretches for people with DMD.

Join the Conversation

On myMDteam, people share their experiences with muscular dystrophy, get advice, and find support from others who understand.

Have you or a loved one found muscular dystrophy stretches or exercises that help? How do you help your loved one with MD exercise at home? Let others know in the comments below.