Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease that damages motor neurons in the brain and spinal cord. These nerve cells control voluntary muscle movement, so the disease gradually causes muscle weakness and loss of function.

How does ALS affect eating and swallowing?

ALS can weaken the muscles in the mouth and throat, making chewing and swallowing difficult. This is called dysphagia and can increase the risk of choking or food and liquid entering the airway. Softer foods, smaller bites, swallowing strategies and, in some cases, feeding tubes may help.

How can ALS affect breathing?

ALS can weaken the muscles of the chest and diaphragm, causing breathlessness, disrupted sleep and difficulty breathing while lying down. A weakened cough can also make it harder to clear mucus. Some people use non-invasive breathing support, such as CPAP.

How quickly does ALS progress?

There is no single timeline for ALS. Symptoms and their progression vary considerably between individuals, although the disease can gradually affect movement, speech, swallowing and breathing. The ALS Association says average survival after diagnosis is around three years, but some people live considerably longer.

Former NFL Star Chris Johnson Communicates With His Eyes as ALS Leaves Him Unable to Speak at 41

Q: Is there a cure for ALS?

The article states that there is no cure for ALS. However, medications, respiratory support, nutritional care and communication technology can help manage symptoms and maintain quality of life.

Former NFL running back Chris Johnson now requires help with eating, changing and other daily activities as amyotrophic lateral sclerosis (ALS) continues to progress.

Johnson, 41, was diagnosed with ALS in May 2025 at the age of 39. His wife, Brittany Johnson, has since become his full-time primary caregiver, with other family members and their four children also helping. He uses a CPAP machine for breathing support and communicates using a speech-generating device controlled with his eyes.

His experience highlights how ALS can progressively affect the muscles responsible for movement, speech, swallowing, and breathing.

What Is ALS?

ALS is a progressive neurological disease that damages motor neurons, the nerve cells in the brain and spinal cord that control voluntary muscle movement.

As these cells become damaged, muscles gradually weaken and lose function. The disease can eventually affect the muscles needed for speaking, swallowing, and breathing.

Johnson has sporadic ALS, the most common form, which accounts for about 90% of cases and generally occurs without a known family history.

How Does ALS Progress?

There is no single timeline for ALS. The disease can begin with weakness in one part of the body and gradually spread to other muscles, including those involved in movement, speech, swallowing and breathing.

Early symptoms can include muscle weakness, stiffness and cramping. Over time, some people lose the ability to walk, dress themselves, write, speak, swallow or breathe independently. However, the speed and pattern of progression vary considerably between individuals.

Johnson's progression has been particularly rapid. He initially noticed weakness in his right hand and an unrelenting cough before receiving his diagnosis. Within just over a year, he had lost his ability to speak and now relies on an eye-controlled device to communicate.

Why Can ALS Affect Eating?

ALS can weaken the muscles of the mouth and throat, making chewing and swallowing increasingly difficult. This is known as dysphagia.

When swallowing becomes impaired, food or liquid can enter the airway instead of the oesophagus, increasing the risk of choking and other respiratory complications.

People may need softer foods, smaller bites, or changes to how they eat. Speech and language specialists can assess swallowing and recommend strategies to make eating safer. In some cases, feeding tubes may be considered when swallowing becomes unsafe or inadequate.

This helps explain why Johnson now requires assistance with feeding as the disease affects his physical independence.

What Happens to Breathing?

Breathing can become difficult when ALS weakens the muscles of the chest and diaphragm. Respiratory problems are a leading cause of death among people with ALS.

Early signs can include breathlessness during activity, difficulty breathing while lying down, and disturbed sleep. A weakened cough can also make it harder to clear mucus from the airways.

Non-invasive breathing support can help some people. Johnson currently uses CPAP as part of his breathing support, according to PEOPLE.

How Quickly Can ALS Progress?

Although ALS is progressive, its course varies. The ALS Association says average survival after diagnosis is around three years, but about 20% of people live at least five years and around 10% live 10 years or more.

Neurologist Dr Merit Cudkowicz, who is treating Johnson, told PEOPLE that he has received standard ALS medications and participated in a clinical trial targeting inflammation. Cudkowicz said she believed the treatment had helped Johnson, although the disease has continued to progress.

Johnson's experience illustrates one possible course of ALS, not a typical timeline. There is no cure, but medications, respiratory support, nutritional care and communication technology can help manage symptoms and maintain quality of life.

Despite the physical changes, Johnson has emphasised that his mind remains sharp. As he told PEOPLE, ALS has changed what his body can do, but not who he is.