The high level of complexity underlying the heterogeneous pathophysiology of neuromuscular diseases is a fundamental limiting factor in understanding the role of physical activity in their onset and/or clinical evolution. To overcome this difficulty, it is essential to rely on and deep knowledge of the aetiology and on the physiological adaptations to physical exercise, in order to predict how they can impact on the clinical history of each disease. This paper illustrates the possible strategies of intervention in some neuromuscular disorders, through the analysis of their supposed pathogenic mechanisms. Nevertheless, no clear conclusions can be inferred so far.