Can You Exercise With ALS?

Although amyotrophic lateral sclerosis (commonly known as ALS or Lou Gehrig's disease) causes nerve damage that leads to progressive muscle weakness, it is still possible—and might even be beneficial—to exercise when you have this condition. Though exercise won't slow the disease's progression, it can potentially improve your quality of life.

However, it's important to know what types of exercise are appropriate to avoid unwanted side effects.

This article discusses exercise with ALS—benefits and risks, types of exercise, how to perform exercises safely, and what the research says.

Person in a wheelchair working with a healthcare provider to exercise

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Benefits and Risks of ALS Exercise

There are both potential benefits and significant risks of exercising with ALS, but more research is necessary to confirm the effects of exercise on people with this condition.

Exercise is likely more beneficial in the early stages of ALS before significant muscle damage occurs.

Possible benefits of exercise with ALS can include:

  • Improved sense of well-being
  • Decreased risk of depression
  • Decreased anxiety levels
  • Improved ability to perform daily tasks

Risks of exercise with ALS can include:

  • Increased fatigue
  • Muscle cramps
  • Muscle twitching
  • Muscle pain/soreness
  • Difficulty performing daily tasks

How Much Is Too Much?

It's normal to feel tired right after a workout. However, if you have ALS and your fatigue lasts more than 30 minutes after exercising, you are doing too much.

Recent Research on Exercising With ALS

Current research highlights the controversy around whether exercise is good or bad for people with ALS.

Some research suggests that intense exercise can increase the risk of developing ALS for people who are genetically predisposed to this condition. Other research indicates that exercise speeds up muscle damage in people with ALS.

On the other hand, some studies suggest that exercise can slow the progression of motor nerve damage from ALS.

However, most research is performed on non-human subjects (such as mice or rats) or based on information obtained from medical records rather than real-time information from individuals with the disease. Studies on human subjects often only include small numbers of people with ALS, making it challenging to apply the findings to all people with the condition.

Types of Exercise

Aerobic activities, stretching, and resistance training may all be appropriate for people with ALS depending on the stage of the disease; each has its potential benefits.

Aerobic Exercise

Aerobic exercise increases your heart rate and breathing pace to improve your heart and lung health.

Examples include:

  • Walking
  • Jogging
  • Cycling
  • Swimming
  • Elliptical machine


Stretching exercises improve flexibility and help maintain range of motion. Stretching can help reduce the risk of injury and falls and improve your ability to perform daily tasks that require movements like bending over or reaching overhead.

Strengthening Exercises

Strengthening exercises apply resistance to the muscles to make them stronger. You can perform these exercises using your body weight or other strengthening equipment, such as dumbbells or exercise machines.

Tips for Exercising Safely With ALS

Before you begin any exercise with ALS, talk to your healthcare provider. Certain types of exercise may or may not be appropriate for you, depending on the stage of your disease and other medical conditions you may have.

It's also essential to set safe and healthy exercise goals. For this reason, many people with ALS work with a physical therapist for an individualized exercise plan.

As ALS progresses, assistive devices (such as a cane or walker) are often necessary to perform daily activities and exercise safely. A physical therapist can determine when these devices are needed and train you in their use.

Listen to Your Body

Listen to your body when exercising with ALS. If something causes pain, stop immediately. If exercise increases your overall fatigue or makes it difficult to perform daily tasks, talk to your healthcare provider about alternative activities.


Exercising with ALS is a controversial topic. It can be beneficial for people with ALS, but it can also have adverse side effects. Research on this topic is lacking, and studies that do exist are often performed on non-human subjects or small sample sizes. Working with a physical therapist will ensure that the type and amount of exercise you perform is appropriate for your current stage of ALS.

Frequently Asked Questions

  • Can intensive exercise cause ALS?

    Intensive exercise by itself does not cause ALS. However, some studies suggest that intensive exercise might increase the risk of developing ALS in people who are genetically predisposed to this condition.

  • Does strength training help prevent muscle atrophy?

    Strength training helps prevent muscle atrophy (shrinkage) in healthy individuals. However, it will not prevent muscle atrophy caused by ALS. This disease affects the motor nerves that cause muscles to contract.

  • How can you improve your mobility with ALS?

    Mobility can become challenging as ALS progresses. Assistive devices, such as a cane, walker, or wheelchair, can help improve mobility as muscles become weaker.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Julian TH, Glascow N, Barry ADF, et al. Physical exercise is a risk factor for amyotrophic lateral sclerosis: convergent evidence from Mendelian randomisation, transcriptomics and risk genotypesEBioMedicine. 2021;68:103397. doi:10.1016/j.ebiom.2021.103397

  3. Yi J, Li A, Li X, et al. MG53 preserves neuromuscular junction integrity and alleviates ALS disease progressionAntioxidants. 2021;10(10):1522. doi:10.3390/antiox10101522

  4. Tsitkanou S, Della Gatta P, Foletta V, et al. The role of exercise as a non-pharmacological therapeutic approach for amyotrophic lateral sclerosis: beneficial or detrimental? Front Neurol. 2019;10:783. doi:10.3389/fneur.2019.00783

  5. Harvard Health Publishing. The 4 most important types of exercise.

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.