Strength Training and Myasthenia Gravis

by Rosemary Spellman | October 15, 2019

In January 2018, I was diagnosed with Myasthenia Gravis (MG), a chronic autoimmune disease which causes muscle weakness. Most folks have visual and eye symptoms, but that's never been a particular issue for me. In my case, it manifested as weakness in my arms, difficulty with speaking and slurred speech, and problems with swallowing and chewing. My anti-acetylcholine receptor antibody (AChR) bloodwork came back positive for binding and modulating (binding means that my antibodies attach to the receptors on the nerve and destroy them, modulating means that the message doesn't get to the nerve and so the muscles won't contract). I am on two medications, one specifically for MG which makes the acetylcholine stick around longer, and another which suppresses my immune system to not produce as many antibodies. I also receive monthly infusions of intravenous immune globulin which is made from donations of human plasma. The infused antibodies attach to and remove the bad ones that I normally produce.

I spent some time researching MG, the various treatment methods and its symptoms before and after I was officially diagnosed. Myasthenia Gravis is a rare disease, and unfortunately there's not very much research available for folks who are not in crisis. I managed to hunt down one article that discussed resistance training and MG, and thought that beginning a strength program might help with my symptoms. In my belly dance troupe there were two other women who had started strength training and absolutely loved it. They specifically recommended Fivex3 Training in Baltimore. I had often thought about joining the gym, but hadn't really seriously considered it due to cost and travel concerns. However, once I was fairly stable on my medication and was receiving my monthly IV infusions, I decided to visit Fivex3 in October 2018, and talk to someone about my condition and see if strength training was an option for me. There was also a raffle for their on-boarding barbell package so I thought, why not?

The owner, Emily, was very nice, and although she didn't really know much about MG, she was willing to do a bit of research to learn more about the disease. As it turned out, I won the raffle and decided I would start training in January 2019, once I had saved up enough money to pay for the initial coaching package. I also re-did my budget to see if I could feasibly add a monthly gym membership. When I finally decided to give Fivex3 a try, I also consulted with my neurologist about beginning a strength training program. She gave the okay, but reminded me to keep my expectations low and to take breaks frequently.

I wasn’t new to the gym scene. Prior to my diagnosis, I had done a little bit of weight training, but I would get bored quickly and never felt like I was making any progress. I also did not like doing exercises in a random order, and sometimes I couldn't do all the exercises, which was also frustrating. During this time, I was training at my local county recreation facility, which only had machines with pictures on them, so I already felt out of my depth. Before beginning the strength program at Fivex3 Training, I decided to read Starting Strength by Mark Rippetoe, and definitely appreciated the scientific basis for the movements and programming.

Getting Started

I will admit that I was extremely nervous on my first day at Fivex3. Halfway through the squat portion with my coach, Craig Brooks, I excused myself to go to the bathroom and cry. The squat was a very hard movement for me. While Craig was coaching me through the squat, I started having flashbacks to when I was in the hospital bathroom, and I could not not get off the toilet. I told Craig about this traumatic experience and that squats scared me. He was extremely patient and understanding, and was able to explain things in ways that made sense to me, and helped me understand that I could and would actually achieve these movements. We spent six sessions working together on the squat, bench press, press, and deadlift. Fivex3 has plenty of light bars, so I was able to start with the lightest one available which helped me gain confidence with the exercises. If it had not been for Craig’s patience and commitment to me, I don’t know if I would have continued my sessions. He made me believe I could get stronger. Eight months later, I am, and getting stronger every day.

During the eight months that I have been training at Fivex3, I am happy to say that I have had only one small MG flare up, and surprisingly, I was able to bounce back very quickly. During my sessions, I make sure that I'm actually resting after my work sets and not wandering around aimlessly. Strength training gives me an objective measure of my muscle fatigue levels, which helps immensely in terms of determining the progression of this disease. During a time in March when my neurologist and I decided to postpone an infusion to see how long my donated antibodies were sticking around, I was suddenly unable to complete my heavy squats, when the previous week I had been doing squats with heavier weight without any issues. Before that particular day of training, I had not noticed any symptoms, but during my training session, I was able to determine that I was having a small flare-up before it became a crisis. I came back to training two days later and felt much better after completing some light bench and deadlift work.

I've been able to progress on all my lifts since I've had access to microplates, and only recently had to reset my deadlift. I feel less fatigued when carrying groceries up three flights of stairs because my legs are stronger. In rehearsals, I can complete particular dance movements without as much fatigue. I take very small jumps on my lifts – 1.5 lb increases on squats, press, and bench, 2.5 lb increases on deadlifts – which is very, very conservative for squats, but that is because I find squats to be the most taxing lift for me and my condition. I train twice a week, Mondays and Wednesdays, a schedule I am able to consistently maintain. My neurologist is very pleased that my symptoms are under control, and that I am getting stronger.

Myasthenia Gravis is an incurable disease. I am so happy that I have found Fivex3 and Starting Strength, a strength training program that has allowed me to keep my symptoms under control and has made me stronger. I look forward to my weekly training sessions, and am excited to see where things go from here. I hope that anyone else with MG gets a bit of hope from reading this and looks into strength training and Starting Strength.