Clinical symptoms usually appear in adulthood and are characterized by exercise intolerance with muscle cramps that can be accompanied by attacks of myoglobinuria. Serum creatine kinase is usually elevated and increases after exercise. Avoidance of strenuous exercise can prevent major episodes of rhabdomyolysis.
There have been several reports of a fatal infantile form of phosphorylase deficiency. The presenting features were hypotonia, generalized muscle weakness, and progressive respiratory insufficiency.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.