If you’ve been diagnosed with multiple sclerosis (MS), you may find yourself wondering: How will the disease affect me? How fast will my symptoms progress? Is there anything I can do to slow it down?
Here’s what we know: MS is a neurological disease that has no cure, but you can take some steps to slow its advance. Medications can help some people, but not everyone can take them. However, there is something that everyone can do from the time of diagnosis and later, and it doesn’t cost anything: Be as physically active as possible.
Exercise and MS
You might think adding more exercise to your day means you should join a gym or take up a sport. But being physically active is much more than doing those things. It also means going for daily walks, gardening, dancing, or doing simple exercises at home.
Exercise isn’t a magic cure for any disease, including MS, but it can be an important part of keeping you as mobile and strong as possible for longer.
Up until the late 1990s, the medical community thought that people with MS shouldn’t exercise. Experts believed that the exertion would worsen MS symptoms.
Luckily, a study done in 1996 found the opposite, showing that people with MS who exercised had less fatigue, better mental health, and an improved quality of life. More studies backed this up, and now doctors recommend regular physical activity.
Exercise can also help lower your risk of falling. Falls are a major concern for people who have MS. You may have had a tumble or two yourself already. If you hurt yourself when you fall, this can also affect your mobility and strength.
Need more reason to exercise?
Being physically active helps your entire body, not just what’s affected by MS. Exercise can improve your mental health and help lower blood pressure and cholesterol. It can help manage blood sugar levels if you have diabetes or prediabetes. Chronic illnesses such as these can make MS progress more quickly.
Are you ready to get started? If you’re new to exercise or extra physical activity, speak with your MS team. If you have access to a physical therapist (PT), it’s a great idea to take advantage of that. A PT can assess your strengths and areas where you could use more work. They can give you specific exercises and monitor you, adjusting the exercises as needed.
Don’t Let Fatigue Stop You
There are times you’re so tired that the last thing you want to do is exercise. Fatigue is a common MS symptom. But according to Karena Wu, PT, lead physical therapist at ActiveCare Physical Therapy in New York, exercise can actually help with your fatigue. “When you do an exercise, you’re contracting a muscle. You’re using the muscle as a pump, so you’re going to increase circulation,” she says. “You’re going to increase blood flow, and this should ideally help reduce inflammation and could potentially help with maintaining energy or increasing energy.” Exercise increases the oxygen circulating in your body, and it can also help improve sleep at night, so there’s another bonus.
But it’s important to work within your limits. You don’t want to overdo it and fatigue your muscles. “You have to find that fine line where you can push it to where you still feel good without overdoing it,” Wu says.
Timing also helps. Some people like to schedule a set time to do all their activities or exercises, but if you tire easily or you don’t have a chunk of time to put aside, doing exercises throughout the day will keep you from getting too tired, and you don’t need to schedule them in.
Wu says she’s a firm believer in doing exercises all day. You can tighten your backside while you’re standing at the hand dryer in the bathroom or brushing your teeth, do squats when you’re doing the dishes, or do leg raises while watching videos. And there’s the age-old advice of parking your car farther away from your destination so you walk a bit more or taking the stairs instead of the elevator, if you can.
Specific Targeted Exercises
Whether you choose an exercise time or you squeeze it in whenever you have a free moment, it’s all good. Wu suggests these exercises to give you a head start.
Functional exercises
Functional exercises mimic what you do every day, such as reaching for something, squatting, or lifting. These help you maintain the muscles that do these tasks.
Squats or sit-to-stand. If you can, try to do a few squats in a row. Stand with your feet about hip-width apart. Keeping your feet flat, hold your hands out in front of you and move your hips down as if you are going to sit in a chair. You can hold on to a countertop or the back of a sturdy chair if you need support. If it becomes too hard to do a squat, you can do a sit-to-stand instead. Stand with your back to a sturdy chair that doesn’t have wheels or won’t move away easily. Lower yourself to a seated position. Stand up. Both times, try using only your leg muscles, but use chair handles for support if you need.
Step-ups/step-downs. Using a stair or step, lift one foot and place it firmly on the step. Lift yourself up. Then step down. Repeat a few times, alternating feet.
Balance exercises
Balance exercises help keep your body steady and stable. Do them next to a wall or sturdy piece of furniture in case you start to fall over.
Single leg stand. Stand on one foot for as long as you can — 30 seconds is ideal. Switch feet and repeat.
Double leg stand. Stand with both feet together flat on the floor, and cross your arms over your chest. If you can stay steady like that, make it harder by moving your head. To make this even more challenging, close your eyes. Finally, if you’re steady on a flat, hard floor surface and you want more of a challenge, try standing on a piece of foam or a soft pillow. This will challenge your balance further.
Tandem stand. Stand with one foot directly in front of the other, as if you’re standing on a line. You can start with your feet several inches apart, and as you get more confident, move your feet closer together.
Stability exercises
Stability exercises work by strengthening your core muscles.
Abdominal. Standing straight, use your abdominal muscles as if you’re pulling your belly button toward your spine. Hold and then relax. If you’re unable to stand, you can do this exercise sitting down.
Isometric holds. These involve holding your muscle contractions in various positions. For example, external rotation and retraction of the shoulder. Stand next to a wall and bend your elbow at your side, 90 degrees. You want to see your forearm in front of you, but your upper arm is next to your side. Gently press the back of your hand against the wall, as if you’re trying to push it open. At the same time, try to “pinch” your shoulder blades together. Hold this position for 10 seconds or so and then repeat. If you use a wheelchair, you can do similar exercises but push against your armrest.
Other Types of Physical Activity
If doing stability or balance exercises isn’t your thing, you can do something else. Wu suggests that a more structured type of exercise that can address your whole body, such as yoga and tai chi, especially because they’re low-impact. Both these practices focus on breathing and mindfulness, which can be helpful.
Yogacan be adapted as your disease grows in both strength and tolerance (fatigue). Props like straps and blocks can help you adjust poses, particularly if any joints are painful. There are also chair yoga programs for people who can no longer get on the floor.
Tai chi is an ancient martial art that also can be adapted according to your abilities. The movements are slow and deliberate, and can be adapted or done in a chair, if needed.
Water exercises, such as swimming or water aerobics, can be another good option, as long as the water isn’t too warm (above 84 F). The advantage of water exercise is that the water supports your weight and allows you to move more freely than you can outside the water. Many people find water exercise especially helpful for sore joints and tight muscles.
Exercise Goals
The National MS Society recommends that people with MS aim for 150 minutes of moderate-intensity exercise per week, no matter what stage of disease they have. This may sound like a lot, but how you reach that 150 minutes is up to you. It can be split in several ways, and moderate-intensity exercise can mean many things.
Aside from activities like brisk walks or water aerobics, it also includes the five minutes it takes to put laundry in your washing machine and take it out again later, 20 minutes of gardening, 10 minutes of making the bed, 30 minutes of vacuuming, and so on. Some days, you may be fatigued or not feel up to being active, so you’ll do less. Other days, you’ll do more.
The bottom line is that keeping active can help you feel better overall, ease MS symptoms, and keep you safer by lowering your risk of falls. The important thing is to listen to your body. Don’t push yourself too hard, but do what you can when you can. Ask your doctor or PT for advice on the types of exercises that would be best for you and keep them up to date on any changes, so they can adjust the exercises for you.
