If you expected it and knew what to look for, it would be possible to detect the first outward signs when a DMDer begins to stand and walk. He is usually late with that. He waddles a bit, and falls more often than most children. And he has a particular way of getting up from lying down on his back: first he turns over on his stomach, then he sits up, gets his legs under him, and pushes himself up against his own legs, knees and thighs. That is called the Gower's Sign, after the doctor who first noted it. But it is very easy for the parents and the family doctor to dismiss it: kids often are a bit clumsy when they learn to walk, and they all do funny things.
Getting up doesn't get any easier over time, though, also because the muscles at the back of the neck don't seem strong enough. Sooner or later you will also notice that your child can't run as fast as the other children, and that the best he can do is a clumsy lope. Jumping is hard for him to do, as well: he tries, but his feet look like they are glued to the floor. That is puzzling, because his calf muscles often look so big and hard you'd think he was a body builder.
The pediatrician may notice during checkups that the tendon reflexes in the upper limbs and knees are absent.
Your child will continue to have a wide gait and to look flat-footed, and will start to walk with his heels slightly off the ground. Parents will sometimes see an orthopedist about this, who may talk about pigeon toes and prescribe corrective shoes.
Some DMDers have sudden mysterious leg pains early on, usually in the calf muscles. These start suddenly, last for two or three days, and then slowly go away.
By age three or four, parents may also note that their son does not scamper up the stairs like other children, but takes the steps one at a time, usually with the same foot leading for every step. His belly will stick out and his back will be curved inward; that's called lordosis.
You may tell yourself that "he's just a bit late, just a bit clumsy", but all these discrepancies from the norm don't even out over time. At some point worried parents will tell their doctor about it, and get him alerted.
By the way, don't blame yourself afterwards that you didn't see it earlier. Hindsight is 20/20, and also, not all DMDers show all symptoms at the same age. You may hear people say that the later symptoms of DMD show up, the slower the condition will progress. Every child is different, however, and predictions are very hard to make.
Don't sue your doctor right away, either. A child with DMD will show up maybe once during a doctor's career, and that makes it hard to pick up on the signs right away.
