Does anyone have experience with trying to get stronger on pred? At what dose can one begin to strengthen. I am doing pulmonary rehab and my breathing muscles are weak from so many years on pred. I am now in 9.5 going to 9 next week.
I saw an abstract in the Jourbal “Chest” which said muscular strength returns with tapering and exercise- but what doses?
I go swimming which helps.
I have been trying for ages and not getting brilliant results. I have got down to about 3mg and don't think that is low enough.
A gradual build up with swimming helped me but I took it slowly after the first few times doing too much and was left with upper body muscle aches.
The ideal would be maintenance exercises from the outset. Building strength is likely to depend on a lot of factors including previous history and age. Targeted and appropriate physio exercises are actually recommended in guidelines - but very rarely taken note of.
You are 100% correct; I stayed in too much because of covid and got too sedentary despite doing some Pilates on the Reformer, treadmill and bike but not enough.
I wasn't too bad during the first year or so of Covid - running around with OH. But the last 6 months lost all the benefit of the 6 months after he died because of achilles tendonitis and bursitis - both legs were out of commission!!!
I have had PMR for over three years and am currently tapering down to 2mg pred. I have lost weight during this time and experienced muscle wastage. I have been doing daily Pilates based exercises with some light weights for the last 18 months or so which has helped rebuild my muscles and strength and I walk a lot and do a little swimming. I have found the advice from a physiotherapist very helpful in developing my fitness programme not least because I also have osteoporosis and arthritis in my spine. Building up the exercise very gradually has been important and not overdoing it! I do feel a lot stronger these days though still have some aches and stiffness and fatigue.
I hope this is helpful and good lu CNN k with rebuilding your strength.
until you get below the level that body produces naturally ( less then 5-7mg/day), it is impossible to gain any muscle strength. What you can do in a mean time is maintain strength you have by doing light weight training and in general normal activity like walking/ gardening etc.
I was active almost from the start and still have hard time gaining any additional muscle mass at 0.5mg/day. At higher doses heavy lifting actually can cause muscle wasting, because pred inhibits recovery/rebuilding process for muscles. Your diet also has to be geared to muscle building - you need extra caloric intake in form of protein to support muscle building/recovery.
I actually did noticeably improve strength but not enough for my needs. I want to get off oxygen. I have less room in my chest from scoliosis deformity and the muscle weakness from steroids tipped me over. I used to hike regularly with this chest but a instrumented spine doesn’t have much “give.”
I am in a high protein low carb diet because I have reactive hypoglycemia.
As you are talking specifically about respiratory muscle strength, I would suggest that the trick is to forget about strength but do yoga exercises to improve your breathing which will in turn gradually improve posture and respiratory capacity.
There must be people who specialise in this in the US, but one person I can recommend in the UK, who does zoom classes, is a guy called Philip Xerri who specialises in yogic breathing and understands respiratory illness cause he was taught by a guy who was an ex miner (and yogi!) who had a COPD type condition through his work.
I would normally recommend pilates for general strength, but for breathing, it's got to be yoga.
Last 3 weeks been doing an at home pulmonary rehab program; I am and scheduled soon for pulmonary rehab at my hospital facility.
Ceck out James Nestor's book on Breath. Amazing info along with exercises for lungs. Good stuff - and good luck!
Pred and constipation??
pred dose and immunosuppression - teaching & covid
Reduction in pred dose 
Pred dose when travelling
Low dose Pred without ppis 
