An informational resource about Cushing’s Syndrome as a service to the community by HRA Pharma Rare Diseases

Exercise guide

This short guide has been designed for people living with Cushing’s syndrome. It contains a number of simple and effective exercises that can be done at home without the need for any equipment. The exercises are designed to help with rehabilitation, symptom relief and general health and wellness and have been developed in collaboration with a physiotherapist, The Cushing’s Collaborative Community and HRA Pharma Rare Diseases.*

*It is important that you consult your treating physician or care team, your physiotherapist or a personal trainer familiar with Cushing’s syndrome before embarking on any new programme of exercise to ensure it is suitable for you.

1. Warm up - Marching
Standing on the spot, march for 1 minute. Aim to lift your knees to be in line with your tummy and move your arms along with the rhythm.

After 1 minute of marching, rest for 20 seconds.

Then complete 1 minute once more.

Rest for 20 seconds before moving on to the next exercise.
2. Wall push up
Start by standing on the spot.

Extend your arms out and put your hands on the wall in front of you, about shoulder width apart and the same height as your chest.

Gently bend your elbows so that your face comes towards the wall, keeping your legs straight, and then push back to the starting position.

Ensure your shoulders stay relaxed during this exercise.

Complete 10 wall push ups as described above. Rest for 20 seconds. Repeat this exercise 2 more times with a 20 second rest between sets.
3. Open the gate
Start by standing on the spot.

Bend your leg and bring your knee outwards as though you are opening a gate.

Make sure you squeeze your tummy and bottom muscles when you are completing this exercise.

Complete for 30 seconds, moving your left and right legs alternately. Rest for 20 seconds. Complete 30 seconds 2 more times with a 20 second rest in between each set.
4. Step up
Stand in front of a low step with your feet shoulder width apart.

Place one foot firmly on the step. Push through the heel, bringing the other foot onto the step. Slowly return one foot to the ground, and then the other.

Complete 5 step ups with each leg leading first (10 overall) and then rest for 20 seconds.

Repeat this two more times with a 20 second rest between each set.
5. Backwards Lunge
Start by standing on the spot.

Bring one leg behind and drop your back knee towards the ground.

Bring your feet a safe distance away so you can balance – it’s okay to hold onto something for balance if you need it.

Try not to touch your back knee to the floor, or let your front knee go over your toes.

Keep your back straight, tummy tucked in and arms at your side for balance.

Complete 5 dips with your left and right legs behind you (10 overall).

Take a 20 second rest after you have done 10 lunges.

Then complete this exercise 2 more times with 20 second breaks in between each set.
6. Chair Squat
Start by standing on the spot with a chair close behind you and your feet hip width apart.

Gently bend your knees and push your bottom backwards to sit on the chair.

Try not to use your hands on the chair, instead hold them out in front of you.

Aim to go from standing to sitting over 3 seconds and back up over 3 seconds (this will help build better control of your muscles).

Complete 10 chair squats and then rest for 20 seconds.

Repeat 2 more times with a 20 second rest between sets.
7. Heel Tap
Start by standing on the spot with your feet hip width apart.

Bend one knee so your foot comes towards your bottom.

Tap the same side hand with your heel whilst balancing on the other leg.

You can put your hands on your hips, out to the side, or upwards to maintain your balance.

Complete 5 times with each leg (10 overall) and then rest for 20 seconds.

Complete this 2 more times with a 20 second rest between sets.
8. Fire Hydrant
Come into a 4-point kneeling position on the floor (make sure your knees are well supported with cushions, a soft blanket or yoga mat).

As you did with ‘opening the gate’, bend your knee and bring your leg outwards.

Make sure you squeeze your tummy in tight and you should feel your bottom muscles working hard.

Try to keep your body parallel to the floor during this exercise.

Complete 5 times with each leg (10 overall) and then rest for 20 seconds.

Repeat 2 more times with a 20 second rest between sets.
9. Tip toe
Start by standing on the spot with your hands on a chair or other supportive surface to help you balance.

Bring yourself onto your tip toes and hold for 3 seconds.

Then slowly lower your heels back down to the floor.

Make sure you squeeze your tummy and bottom in, keeping your head up.

Complete this 10 times then rest for 20 seconds.

Repeat this exercise 2 more times with a 20 second rest in between sets.
10. Cool down – Child’s pose
Come into the 4-point kneeling position on the floor.

Bring your knees hip width apart. Slowly bring your bottom back towards your heels, maintaining a straight back and hands flat on the floor.

You should feel a stretch in the front of your hips and bottom. Hold this stretch for 30 seconds.

Come back into 4-point kneeling and repeat this stretch 2 more times.

The importance of exercise for people living with Cushing’s syndrome

Exercise is important for people living with Cushing’s syndrome.1,2 It’s important to be able to exercise frequently and consistently (little and often), which is the purpose of this guide. It helps enable you to complete a top-to-toe workout in your own home 2-3 times per week, or however many times you are able.

The workout is simple to follow and easy to remember. But challenging enough to have a real benefit when completed every day – just start at the top and finish at the toes!

The first time you try this exercise programme, you may not be able to finish all of the exercises. This is absolutely fine; however, it is very important to complete the warm up (marching) and cool down (child’s pose).

How do I know I’ve worked hard enough?

During your exercise session, you should be working hard enough to know that you’re exercising, but still be able to maintain a conversation throughout.

After each session, you should rate your effort level on a scale of 0 (being at rest) to 10 (being the most out of breath you can be). Try to keep your session to about level 6.

If you feel fatigued for more than an hour after your exercise, or really sore the next day, you have probably worked too hard, and should reduce your effort next time by lowering the number of reps (repetitions of each movement) or the number of sets (the number of rounds of each exercise) you do. Conversely, if you feel like the exercises were not challenging enough, aim to increase your reps by 5 in each exercise, rather than increasing the number of sets.

Most importantly though is to enjoy yourself, smile, and be proud that your body can do things you didn’t know it could do!

If you have other conditions as well as Cushing’s syndrome which may affect your ability to exercise (such as problems breathing or a heart condition), seek further advice from your doctor about how much exertion you should feel during exercise.

Expertise and guidance courtesy of a practising physiotherapist.



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