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I recently gave a presentation to a post polio group on a post polio syndrome exercise program – especially as it relates to members of that group with osteoporosis or low bone density.

Post Polio Syndrome Treatment Overview Exercise Program

New research is indicating that polio spread wider than the visible part of the body affected by polio. This has implications for exercise that runs counter to recommendations for the general population.

We encourage the general population to push through their exercise program. This advice does not work for a post polio survivor where rest plays a crucial role. As a result the Physical therapy prescribed post polio syndrome exercise program must be different than a general therapy exercise program.

Polio Paradox

This topic is covered in Dr Richard Bruno’s book, The Polio Paradox.

Post Polio Syndrome Exercise Program

Hi, I’m Margaret Martin at MelioGuide and today, I’m going to share with you exercise prescription for a very special population, and that population is the post-polio group.

So years ago, we used to be really concerned about survivors of polio. And then, as they grew up, we really focused our attention and rehabilitation on their affected limb. We now know from research that their affected limb was not the only muscles that were affected.

Polio Paradox

In the Polio Paradox by Dr. Richard Bruno, we have come to realize that not only the arm or the leg that we see symptoms of the polio in their bodies were the affected muscles, but rather all of their muscles in their body were affected, just to a much lesser degree.

And so now as they age and as post polio syndrome develops, what the symptoms of pain and fatigue and decreased function, are all coming about because all the muscles were affected to some degree.

And so, when we look at polio what initially happened, the virus attacked the motor neurons and so the nerve, a motor neuron is a single nerve innervating muscle fibers.

post polio

How Polio Affects the Muscle System

So let’s show, as an example, the average individual would have one nerve of stimulating five muscle fibers. Well once somebody had the polio virus at a young age, the body was very clever and said, “Well, I still want to function. I still want to walk. I still want to do things.”

So this one nerve can, instead of only innervating five muscle fibers, the healthy nerves that were remaining, start to innervate five more and five more and five more. And so that one nerve, now had a much bigger load to carry.

It was carrying many more muscle fibers.

But as people age, these motor neurons are getting fatigued.

Exercise Harder is Not the Prescription for a Post Polio Syndrome Exercise Program

If people with polio follow the prescription of work harder, exercise harder, go to the point of fatigue, get out there and work, you will actually cause yourselves more damage and more harm.

So the recommendation for a post polio syndrome exercise program is to do only non-fatiguing exercises.

You would do only half as many repetitions to a point that if you know that at ten repetitions, you start getting pain or weakness or fatigue, then your prescription is only five repetitions, and this is so very important that you’d listen to your body and work to the point of any of these symptoms.

If you have a muscle that does not have any anti-gravity strength, meaning you can’t lift against gravity, then not even non-fatiguing exercises should be prescribed for those muscles.

Advice for Post Polio Survivors

So for those of you who managed to give a talk to in the outer chapter of post polio survivors, and you’re wanting to have more backup when talking to your therapists or your trainers, please have them listen to this blog and encourage them to read the Polio Paradox by Dr. Bruno, so that you get the support that you need to stay as strong as you can and stay as functional as you can through the rest of your lifetime.

So this is all for MelioGuide today. I’m Margaret Martin.

Osteoporosis Guidelines

For more information, check out my Osteoporosis Guidelines.


February 10, 2016 at 10:42pm


Hello Sir,
Now my age 21 yrs and I was effected by polio at the age of yrs at the right leg . there is any possibility to rebuilding my legs muscles

October 27, 2016 at 7:43pm

Adam Yusuf

I'm in my 50's and have had left leg muscles wasted from a childhood and polio affected.

I need to do exercise and would want to know more about specifics of how and would appreciate some guidance in this regard, equally there isn't much support group here and especially people who are affected to share past experience etc.

August 1, 2020 at 10:47pm

Shirley A. Taylor

I was hospitalized when I was 5 years of age, about 1954, following my polio vaccine, and remember I couldn't walk or feel my legs for a while in the hospital. My parents are both deceased and there are no medical records from then. But at age 60 I began the path of severe osteoporosis, have had 16 breaks. Dentures, lost all my teeth right before the poor bone density test. I am currently receiving Prolia shots. I am in southwestern Pa. with no advice or care from PCP or part h o surgeons to follow up on me. I just came upon your site and wealth of knowledge and information! I am amazed. Could a polio vaccine and possi bmp my maternal grandmother with osteo have led to my circumstance now? I've always wondered. 2 sisters and 1 brothers but no osteoporosis with them. Thank-you.