Physical Therapy Is Key for ALS Patients

As “Euphoria” star Eric Dane, also long beloved as Dr. McSteamy on “Grey’s Anatomy,” publicly shares his battle with ALS, many are curious about this diagnosis and how people live with it.

The key is understanding that ALS patients don’t recover, but physical therapy — provided by an expert trained specifically to help neurology patients — can lead to a higher quality of life for a longer period of time.

Understanding ALS

ALS stands for Amyotrophic Lateral Sclerosis. It’s also known as Lou Gehrig’s Disease, named for a renowned baseball player who went public with his battle at 36 years old in 1939.

It’s a progressive disease that causes you to lose control of your muscles. It involves your spinal cord and your brain, so you’ll be unable to direct your muscles’ movements. Eventually the muscles will become paralyzed.

Each patient’s symptoms start differently, although always related to skeletal muscle weakness. First you might start speaking differently or struggle to hold an object in your hand. Challenges will continue in various parts of your body, from limbs to, ultimately, the muscles used to breathe. No cure has yet been discovered.

Stretch, Strengthen, Balance, Repeat

While most people undergo physical therapy to get better, ALS PT patients have a different goal: to stay as strong and flexible as possible for as long as possible. The mantra: If it moves, we move it. It’s best to work with physical therapists who are board-certified in neurology, as they have a deep knowledge of what you need. Those PTs should be part of a multidisciplinary team including other specialists, as well.

The physical therapy exercises for ALS patients fall under a few categories:

• Stretching. PTs stretch muscles to help them be as flexible as possible. As the muscles lose range, they contract, causing spasms and contractions, which are often painful. Your physical therapist might teach family members how to stretch your arms and legs to keep you comfortable. Yoga, tai chi and relaxation techniques fall under this category.
• Aerobics. Aerobic exercise such as swimming, cycling or even walking is important too, to keep the heart pumping robustly. You’ll also learn how to recognize when you’re working your heart too hard or not enough.
• Strength. You’ll work with weights in the early days, but rarely heavy ones, or elastic bands. You might also learn functional training, such as to squat five times every time you rise from a seat, just to keep those muscles working well for when you leave a sofa, bed, toilet or car.
• Balance. Any weakness in the body throws people off the center of gravity, so you’ll learn how to avoid falls and recover when you take a tumble. That might involve walking on surfaces that aren’t flat, changing directions quickly and negotiating obstacles. You might even practice while connected to a ceiling safety harness so you can master techniques without risk.
• Equipment. As you become more dependent on equipment, the focus will shift to matching you with the right cane, walker, customized wheelchair or power wheelchair. You might even train to use a wheelchair controlled by your eye movements.

It’s a Group Effort

While physical therapy is crucial for ALS patients, it is not the only assistance they need. In addition to the neurologist, other specialists provide crucial services.

• Occupational therapists will teach you how to accomplish small tasks such as buttoning your shirt or putting on shoes, perhaps using a low-tech gadget. They’ll also recommend equipment such as grab bars and shower chairs for bathing, and help you avoid fatigue by helping you identify how to schedule your day so you don’t exhaust yourself with morning activities.
• Speech therapists will help you speak as long as possible. They’ll instruct on how to use devices such as voice amplifiers or tablets that speak words that you type. They might also assist with swallowing strategies to stay safe despite weakening neck and throat muscles.
• Respiratory therapists will step in to provide breathing recommendations regarding breathing machines.
• Dietitians will explain what to eat to stay strong.
• Social workers will help you navigate mental health counseling plus Social Security and Medicare coverage.
• Groups including The ALS Association provide a variety of resources.

Take advantage of specialists so you can remain independent and comfortable as long as possible. These therapies, all together, can help you maintain strength and flexibility while also boosting your mood, avoiding or easing pain and encouraging a positive attitude.