Nonrelapsing secondary progressive multiple sclerosis (nrSPMS) makes symptoms like weakness and fatigue get worse over time. Stiff muscles, numbness in your arms and legs, and trouble with your balance can all make it tough to stay active, or just get through your day.
One way you can try to safely improve your strength is using resistance bands — long, stretchy pieces of elastic.
“Multiple sclerosis can lead to a lot of unpredictable fatigue, making it difficult to lift weights consistently,” says Subha Nagasubramanian, DPT, a board-certified orthopedic specialist in Washington, D.C. “Resistance band work offers the ability to challenge muscles to maintain, and possibly enhance, strength while being relatively easy to pick up and hold on to.”
Benefits of Resistance Bands in MS
How exactly can these oversized rubber or latex bands help you?
Your muscles get stronger as they work against the tension of the band as it stretches out. Then, they also have to resist the elastic as it returns to its natural shape.
Resistance band exercises could help improve your:
- Flexibility
- Balance
- Endurance
- Strength
- Heart and lung function
- Mental health
One study found that people with MS saw their strength improve after 8 weeks of using resistance bands.
They’re also lightweight, don’t take up a lot of room in your house, and you can take them with you on the go.
“I give them to patients all the time to take to work,” says Robyn Culbertson, PT, DPT, an American Physical Therapy Association spokesperson. “If you're sitting at work, you can pull out your [resistance] band, attach it to something, and get a quick workout in.”
Getting Started With Resistance Bands
If you’re new to resistance bands, here’s how to safely get started:
Clear it with your doctor. Check in with them, just like you would before you start any new physical activity.
Talk to a physical therapist. They’ll evaluate your strengths and weaknesses, then put together an exercise program that works for you.
“It’s useful to have the support of a physical therapist who’s worked with patients that have MS, to reduce the likelihood of flaring symptoms and understand which muscles would benefit from targeted strengthening,” Nagasubramanian says.
Know your colors. Resistance bands come in different colors, based on their level of resistance. They vary by brand but generally, lighter colors have the least resistance and darker colors have the most.
There’s no set color for beginners. “For some people, a tan band might be too easy and it wouldn't really be doing much for you. But for some people, it could be too hard,” Culbertson says.
A physical therapist can help you understand which band is best for you.
Resistance Bands Exercises For nrSPMS
Experts usually suggest getting at least 150 minutes of exercise each week. But when you have MS and deal with chronic fatigue, less may sometimes be better.
When you’re beginning to use resistance bands, “start with 30 minutes twice a week and then go from there,” Culbertson says.
For each of the following exercises, aiming for 10-12 reps and no more than 15 reps can be a good goal. Your physical therapist or doctor may give you different guidelines.
Band pull-aparts for shoulder strength
- Hold your arms out front of you at shoulder height. Keep your elbows straight.
- Hold the end of the exercise band in each hand.
- Bring your arms out to either side of your body, making a T shape.
- Return to your starting position.
- Repeat.
Lateral rise for shoulders
- Seated or standing, put your feet together.
- Place the middle of a resistance band under one or both feet. Hold the ends of the band in each hand.
- Start with your arms slightly bent by your sides, with your palms facing towards you. Raise your arms straight out to the sides until they’re at shoulder height.
- Slowly move your hands back down to your sides.
Repeat.
Try not to overcompensate with your shoulder muscles, as it can increase tension in your neck and cervical pressure. Focus on keeping your shoulder blades down.
Chest press
- Start standing or seated, with your feet hip-width apart.
- Place the resistance band behind your back and hold the ends with both hands.
- Bring the band forward under your arms, with your elbows up and out to the sides and your knuckles facing forward.
- Press your hands forward until your arms are nearly straight.
- Slowly bring your arms back to the starting position.
- Repeat.
Bicep curl
- Start standing or seated.
- Place the middle of the resistance band under one or both feet.
- Hold each end of the band by your sides with your arms straight down.
- Slowly curl your hands up to your shoulders, with your palms facing upwards.
- Keep your elbows next to your sides and squeezing your upper arms.
- Slowly release your arms back down to your sides.
- Repeat.
Next, move onto exercises for your legs.
Standing leg lift
- Start standing and facing a counter or another very stable surface.
- Wrap and secure the band around your legs, just above the ankle. Note: If you’re concerned about your balance, do this exercise without a band.
- Hold onto the counter with both hands.
- Gently lift one leg out to the side, then slowly place it back down to the floor.
- Repeat.
Change legs.
Be sure to maintain a neutral spine and activate your glute muscle by lifting your leg slightly backward,
Seated leg lift
- Sit at the edge of a chair, with your feet hip-width apart.
- Wrap a band around both your legs, just above the knee. Hold the ends.
- Place your feet slightly wider than your shoulders.
- Slowly press your knees out away from each other, keeping your feet steady as your legs move apart.
- Hold for a count of 2, then slowly bring your knees back together.
- Repeat, then change legs.
Side lying clam shell
- Lie on one side. Your knees and hips should be bent around 45 degrees.
- Wrap the band around your upper legs, above the knee.
- Keeping your feet together, slowly open and close your knees.
- Repeat on both sides.
Hamstring curl
- Stand with a resistance band placed at your ankles.
- Shift your weight into one leg. Bend the other knee, like you’re trying to bring your foot towards your butt.
- Lower your foot back down to the floor.
- Repeat, then change sides.
- You could also do this lying on your belly.
Tips for Using Resistance Bands When You Have nrSPMS
As you start working with resistance bands:
Know the best way to hold them. “The most confusing part [of using them] is usually trying to position them correctly so you're working the correct muscle group,” Culbertson says. A physical therapist can help make sure you’ve got it right.
Move slowly. “Don’t just squeeze [the band] and let it snap back,” Culbertson says. When you resist it going back to its starting position, you help strengthen your muscles and improve how well you can control your movements.
Watch yourself. If you can, do your exercises in front of a mirror at home. That can help you keep an eye on your posture.
Don’t hold your breath. When something feels hard, it’s common to hold your breath. You might not even realize you’re doing it. This can cause a spike in your blood pressure. It can also make your exercises feel harder.
Remind yourself to keep breathing throughout your workout:
- Exhale slowly as you stretch out your band.
- Inhale slowly as you return it to its normal length.
- It might help you to also count out each rep aloud.
Pause when needed. Build in plenty of rest breaks. That can keep you from overheating and will help stave off fatigue.
Monitor your rate of exertion (RPE). “Sometimes MS can blunt your heart rate response to exercise, so you’re not going to see your heart rate and blood pressure go up like some other people would,” Culbertson says.
The Borg RPE scale is a list of numbers you can use to track how hard you feel that you’re exercising.
- 6 is the lowest. It means you’re at ease and aren’t making any effort.
20 is the highest. It means you’re working as hard as you possibly can.
Start your resistance band exercises at a light intensity (around 11 to 13), then go up to 15 or 17, if you can.
Keep cool. MS can make you really sensitive to heat, so make sure you work out in a cool room with a fan. Drink plenty of water before and after so you stay hydrated.
Be flexible. Your levels of fatigue will likely change from day to day. Switch up your band when you need to. “Some days, you might be really good with a stronger band, and some days you might need a lighter one,” Culbertson says.
Replace your resistance bands when you see signs of wear. They’re not meant to last forever. The more you exercise with them, the more they're likely to tear.
Once you start using resistance bands and see the benefits, you may feel motivated to stick with them. "A lot of my patients with MS realize that exercise is beneficial and movement is medicine,” Culbertson says.
