When you’re newly diagnosed with multiple sclerosis (MS), starting a workout routine may be the last thing on your mind. And when you are ready to exercise, you might wonder if it will make your symptoms worse or if working out is even possible when fatigue feels like such a big barrier to movement.
But research shows that not only is exercising safe when you have MS, but it may help with common symptoms, like feeling tired and weak.
“You probably already know that exercise is essential to healthy living and overall well being, but what you may not know is that it will also help in managing some of your MS symptoms, such as fatigue, bowel and bladder function, mood, cognitive function, spasticity, mobility, and pain,” says Estelle Gallo, DPT, clinical instructor in the Department of Rehabilitation Medicine at NYU Grossman School of Medicine.
On top of the physical benefits, exercise boosts your mood by releasing hormones called endorphins, one of the “feel-good” hormones your body makes in response to pain or stress. Endorphins help sharpen thinking and focus, both of which can be affected by MS.
Regular activity also helps avoid “deconditioning,” which is when the body becomes weaker and less mobile from inactivity. Even short daily bouts of movement can counteract that trend and help you feel more in control of your health.
Exercising won’t trigger relapses, and it doesn’t have to be intense or exhausting to make a real difference. What matters most is that you find ways to move, which helps work with your body and your energy levels — and you make it a habit.
Keep Things Low Impact
Low-impact exercises are activities that are easy on your joints and don’t overstrain your muscles. Good examples include walking, swimming, yoga, and biking. High-impact exercises include more intense movements such as running or jumping.
Low-impact movements work well when you have MS, and they are often less scary when you’re starting an exercise practice. Just because an exercise is low impact doesn’t mean it’s low value. Every time you stretch, walk a few minutes, or do a simple strength move, you’re investing in your body’s resilience and your own sense of empowerment.
Staying active doesn’t have to mean hitting the gym. The point is to get moving, no matter what form that movement takes. This can include movements that are already part of your regular day done more intentionally, says Gallo.
“Daily activities are a great form of exercise — walking, walking your dog, house chores, gardening, and cooking, both standing up and sitting down,” she says.
The best approach is to include a mix of aerobic exercise, strength training, and flexibility or balance workout. You can tailor any of these exercises to your symptoms, energy, and abilities.
“The best exercises are the ones that you can safely do and enjoy doing,” says Gallo.
Aerobic Exercises: What to Do
Aerobic activity is all about getting your heart rate up in a gentle way. Studies show aerobic activity can ease fatigue in the long run. Consistent aerobic movement also helps maintain your flexibility, ease stiffness, and support better balance. The more aerobically fit you become, the better your body can take in and supply your tissues with oxygen and energy.
Walking. If walking is an option for you, it can be one of the simplest forms of aerobic exercise you can do almost anywhere and any time. You can keep it inside to stay cool by walking around in your house, using a treadmill or walking pad, or even walking in place.
Swimming. Water supports your body, eases strain, and keeps you cool while you move, which is key when MS makes you sensitive to heat. Water aerobics are a stationary way to work on endurance while in a pool. Often, local community gyms will have classes you can join or free swim hours so you can do your own thing.
Stationary cycling. If balance issues are a concern, try biking on a cycle that stays in place so you get all of the cardio with none of the crash risk.
Seated aerobic movement. It’s completely possible to get your heart pumping while seated. Arm circles, repetitive punching movements, and “seated jacks” that mimic jumping jacks with arms only can all elevate your heart rate and give you cardiovascular benefits.
If you’re new to aerobic workouts, start slowly. Do short sessions — 5-10 minutes at a time — and then build up to longer stints as you can. The goal is to get around 150 minutes a week, however that works for your schedule. You don’t need to carve out a full hour for a workout. Short 5- or 10-minute bursts of movement sprinkled throughout your day can be more manageable and just as beneficial.
Strength Training: What to Do
Strength training means using resistance exercises to train and maintain your muscles. Having stronger muscles makes everyday tasks easier. Once again, you don’t need a gym membership or fancy equipment to pump yourself up. Try these options:
Dumbbells. You can find light dumbbells at most big box stores or even some pharmacies.
Resistance bands. These stretchy elastic bands are a simple way to get started and are easy to take with you on the go. Often this option works best for people dealing with tremors or spasms.
Your own bodyweight. Exercises such as squats, seated leg lifts, push-ups, sit-ups, seated dips, or calf raises tone your muscles without any equipment at all.
Household items. If you don’t own dumbbells, household items such as water bottles filled with sand or rice can work just as well.
Your goal should be to strength train a few times per week so your muscles can stay strong enough to support you in daily life. Try not to exercise the same set of muscles on back-to-back days, and use weights that challenge you but aren’t so heavy you can’t complete an exercise. Still feeling unsure? Ask an expert to get you started.
“If you don’t know what exercises to do, a physical therapist can assist you in designing an exercise regimen that best fits your needs and goals,” says Gallo.
Exercises for Flexibility and Balance: What to Do
Gentle stretching can lessen muscle tightness and ease spasticity. Balance workouts help you maintain your coordination and lower your risk of falls. Even small daily stretches — such as loosening your calves or hamstrings while sitting — make a difference over time. Some structured programs that include stretching and balance work are:
Yoga. This practice uses specific poses you hold and breath into to improve your flexibility. You can include meditation into your yoga sessions for an extra benefit to your overall wellness.
Pilates. Pilates focuses on the principles of concentration, control, centering, breathing, precision, and flowing movement to enhance the connection between the mind and body.
Tai chi. This ancient Chinese martial art is gentler than most forms of yoga and focuses on deep breathing, relaxation, and smooth movements.
Many programs offer seated or adaptive versions for people with limited mobility. Chair yoga, for instance, allows you to get the benefits of stretching and mindfulness without needing you to sit on the floor or get up.
If balance is an issue, don’t hesitate to use supports as you work to improve it. Holding onto a wall or chair while you do standing movements or doing modified versions of exercises from a seated position ensures you can exercise safely without the fear of falling.
How to Make Exercise a Habit
If you’re wondering how you’ll fit movement into your already busy day, start with these helpful tips:
Don’t overdo it. Not only is overexertion risky for your health, it’s likely to drain your motivation fast. “Pace yourself,” says Gallo. “Alternate exercise with a rest period, and rest during exercise at the first sign a movement is becoming too difficult or your fatigue is increasing.” A good rule of thumb is that you should feel like you could recover from a workout within about two hours, Gallo says. “If you feel wiped out for the rest of the day, that may be a sign you pushed too hard. Gentle, consistent movement is more effective than intense workouts that leave you drained.”
Pair movement with your to do tasks. Think about tying movement to things you already do. After brushing your teeth, do a couple of stretches. Knock out some seated leg lifts while waiting for your coffee to brew. This approach, sometimes called “habit stacking,” makes exercise feel like a natural part of your routine rather than a separate task.
Set yourself up for success. Sleep in your workout clothes so you wake up one step closer to working out. Dedicate a space for movement in your home and set it up with your gear, a mat, a fan, and whatever else helps you move.
Keep it cool. Heat sensitivity is a common concern, so planning exercise in the morning or in a cool, air-conditioned space can help. Swim in a pool that’s below 85 F so you stay comfortable. If you’re not doing a water workout, keep cold water nearby, use a fan, or wear a cooling vest as you work out.
Make it fun. Pair exercise with something you enjoy. Create a playlist of your favorite upbeat songs, save a podcast you only listen to while exercising, or put on a TV show you love during your stationary cycling. These small rewards can make movement feel like a treat rather than a chore. Social connection also helps. Walk with a friend, join a virtual yoga class, or exercise alongside a partner to add accountability and make the time more enjoyable.
Give yourself grace. Small, consistent efforts over time can add up to better stamina, less fatigue, improved mood, and more confidence in your daily life. Each day is a new chance to support your body and boost your energy. Some days you’ll do more, other days you’ll do less — and that’s okay.
A Sample Week in Motion
Now that you know the elements of exercise you need, here’s one example of how you can put together a week of workouts:
Monday. Start with a short stretch and 10-minute walk in the morning, then add a few simple resistance moves in the evening.
Tuesday. Focus on balance with seated tai chi or chair yoga.
Wednesday. Go for another short walk and pair it with some bodyweight moves such as wall push-ups.
Thursday. Work on flexibility with a yoga session.
Friday. Use your resistance bands on muscles you haven’t conditioned yet this week, and take another walk or go for a swim.
Saturday. Do something fun, such as turn on music for a dance session (seated is just as groovy).
Sunday. Rest and restore yourself for the week ahead with a gentle stretch session.
You may find it helpful to keep a journal of how you feel after each day. Noticing that you have less stiffness, a clearer head, or a brighter mood will remind you why exercise is worth the effort.
