LOWER BODY EXERCISES
Strengthening the lower body through exercise for people with CMT
For people with CMT, lower body strength is vital to maintain, and if possible, increase, due to muscle wasting, also known as muscle atrophy, that can occur. Atrophy can occur when a muscle is not used, and in people with CMT, this may be deliberate, due to regular exercise being challenging, or indirect, due to the mechanisms of the legs working differently and therefore leaving some muscles left unused, or not used enough to combat atrophy.
THE LOWER BODY
What is meant by the lower body, and what are the impacts of CMT on it?
The human body is a complex machine, with even the smallest part comprising of many different muscles and bones. Below are six of the main muscle groups of the lower body that should be considered by anyone with CMT looking to improve their lower body strength through exercise.
The quads (quadriceps) is the large muscle mass that runs along the upper part of the front section of the leg and extends from the top of the leg down to the sides of the knee. This muscle tends to be tighter in people with CMT.
The hamstring refers to one of three muscles located on the upper back of the leg and runs from the thigh to the knee. As with the quads, the hamstrings tend to be significantly tighter in people with CMT.
The calf muscle covers the lower portion of the back of the lack, comprising of two larger muscles, and attaches to the Achilles tendon.
CMT Impact: Significant muscle weakness
CMT Impact: Muscle weakness, potential strength imbalance in hamstring muscles (medial and lateral hamstrings)
CMT Impact: Severe asymmetric atrophy, can result in knee hyperextension
Glutes refers to the three muscles that form the buttocks; the gluteus maximus, medius, and minimus, and plays an important role in straightening the leg.
In regard to the lower body. the abductors are muscles located on the outside of the upper thigh that pull the legs together when they contract and help to stabilise the hip joint.
The leg adductors group of muscles on the inside of the thighs with their main function to bring the legs together and turning the hips toward the midline of the body.
CMT Impact: Minor atrophy
CMT Impact: Potential atrophy
CMT Impact: Potential atrophy
References (Click to Expand)
Stilwell G, Kilcoyne RF, Sherman JL. Patterns of muscle atrophy in the lower limbs in patients with Charcot-Marie-Tooth disease as measured by magnetic resonance imaging. J Foot Ankle Surg. 1995;34(6):583‐596. doi:10.1016/S1067-2516(09)80083-5
Bachasson D, Temesi J, Bankole C, et al. Assessement of quadriceps strength, endurance and fatigue in FSHD and CMT: benefits and limits of femoral nerve magnetic stimulation. Clin Neurophysiol. 2014;125(2):396‐405. doi:10.1016/j.clinph.2013.08.001
Berciano J, Gallardo E, García A, Ramón C, Infante J, Combarros O. Clinical progression in Charcot-Marie-Tooth disease type 1A duplication: clinico-electrophysiological and MRI longitudinal study of a family. J Neurol. 2010;257(10):1633‐1641. doi:10.1007/s00415-010-5580-x
Berciano J, Gallardo E, García A, Infante J, Mateo I, Combarros O. Charcot-Marie-Tooth disease type 1A duplication with severe paresis of the proximal lower limb muscles: a long-term follow-up study. J Neurol Neurosurg Psychiatry. 2006;77(10):1169‐1176. doi:10.1136/jnnp.2006.093443
LOWER BODY EXERCISE TIPS
Below are a few tips for getting started with lower body exercises focusing on CMT
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