The muscle weakness is mainly in the 'proximal' muscles, which are those near the trunk of the body, around the hips and the shoulders. Weakness typically starts proximally in the lower extremities, then moves distally. Weakness in the upper extremities tends to appear later. This means that fine movements, such as those using the hands and fingers, are less affected than movements like walking.
The symptoms usually start around age 1-3 years, and may include:
#Difficulty with walking, running, jumping and climbing stairs. Walking may look different with a 'waddling' type of walk. The boy may be late in starting to walk (although many children without DMD also walk late).
#When you pick the child up, you may feel as if he 'slips through your hands', due to looseness of the muscles around the shoulder.
#Toe-walking
#Frequent falls
#The calf muscles may look bulky, although they are not strong.
As he gets older, the child may use his hands to help him get up, looking as if he is 'climbing up his legs'. This is called 'Gower's sign'.
#Some boys with DMD also have a learning difficulty. Usually this is not severe.
#Sometimes, a delay in development may be the first sign of DMD. The child's speech development may also be delayed. Therefore, a boy whose development is delayed, may be offered a screening test for DMD. However, DMD is only one of the possible causes of developmental delay - there are many other causes not related to DMD.
