Exercise with Multiple Sclerosis

In this article, we will discuss how to exercise with multiple sclerosis (MS).

MS is a degenerative disease that affects the central nervous system. Sadly, this disease can cause physical symptoms including weakness, numbness, muscle spasticity, fatigue and difficulty performing many physical movements. There are three main types of MS, including relapsing-remitting, secondary progressive and primary progressive. Up to 85 percent of people diagnosed with MS have the relapsing form. Most people diagnosed with MS are women.

Fortunately, many new treatment therapies and medications can now help people manage symptoms and help to slow the progression of MS with more manageable side effects. Sadly, however, many people with MS stop exercising, which can exacerbate symptoms of weakness, spasticity and even loss of balance.

A structured exercise program can help people with MS maintain their functional capacities for much longer. In this article, we will show you exactly how to exercise with multiple sclerosis.

Benefits of Exercise for MS

Although many experts of yesteryear thought individuals with MS should avoid exercise, we now know that exercise has enormous benefits for people with MS. In fact, exercise reduces fatigue instead of making it worse, and may even slow disease progression.

Better Balance
Better Mobility
Less Spasticity
Better Strength
Less Fatigue
Lower Risk of Falls
Slower Disease Progression (Possibly)

Now that you understand some of the benefits of exercise with MS, let’s talk about some general guidelines to exercise safely with MS.

General Exercise Guidelines for MS

You should avoid getting too overheated when you exercise with MS. Additionally, you can aim to take breaks to bring your fatigue or body temperature back down. Finally, you should prioritize moderate intensity exercise over more strenuous routines.

Some medications may alter your heart rate response to exercise. Instead of aiming for a particular heart rate when you perform cardiovascular exercise, you can aim for an exercise intensity that feels moderately challenging. If you use the RPE scale, aim for an intensity between 4-6 out of 10.

Finally, keep safety in mind. If your balance is not very good, you may want to start with seated exercises or machine based movements to reduce the risk of falls or dropping equipment.

Resistance Training

Resistance training is a key exercise for multiple sclerosis. It can help keep your muscles strong and improve your functional capacity. You can perform full body routines, but focus on your lower body strength to maintain and build your abilities.

Resistance bands and machine based exercises can help you reduce the risk of dropping a weight on yourself due to poor balance or spasticity. However, some people with MS may be able to do exercises with dumbbells, barbells and other types of resistance.

Some good beginner exercises to focus on include seated leg extensions, seated marches, seated hamstring curls, side lying clamshell, seated chest press, seated row, seated pull apart and seated lat pull down. You can start without any weight and then progress to resistance bands or machine based resistance.

As you improve your capacities to an intermediate level, you can try squats to a box, step ups, side step ups, lying hamstring curls, glute bridges, standing chest presses, standing rows, and the seated lat pull down.

Some advanced exercisers with MS may be able to do freestanding or even weighted squats, weighted step ups, push ups, RDLs, band monster walks, dumbbell rows, hip thrusts and other resistance training exercises.

How to Progress Your Resistance Training

You can aim to increase the difficulty of your exercise routine progressively over time so you can continue making progress.

In the beginning, start with just 1 set of 8 to 10 exercises that train all your major muscle groups. As you get more advanced, progress to 2-4 sets of 8 to 10 exercises and aim to add weight as you get stronger. The last couple reps of each exercise should be challenging. You can start resistance training two times per week, but even increase to three times per week as your abilities improve.

If you need help, consult a certified personal trainer to show you proper form and progression.

Cardiovascular Training

Truthfully, cardiovascular training is very important for everyone, including for people who have MS. You can start with 3-5 bouts of 5 to 10 minutes of cardio at a time to start building your endurance. Riding a bike, using an elliptical or performing aqua aerobics can help you build aerobic fitness. Walking is another great form of cardio to build fitness.

Eventually, you can work up to 150 minutes per week of cardiovascular exercise.

Keep in mind that some medications may alter your heart rate response to exercise. Instead of aiming for a particular heart rate when you perform cardiovascular exercise, you can aim for an exercise intensity that feels moderately easy to moderately challenging. Alternatively, if you use the RPE scale, aim for an intensity between 4-6 out of 10.

You can try to work up to thirty minutes of cardio five times per week. Additionally, gardening and vigorous housekeeping can help you meet your activity goals. Cardio exercise does not need to be difficult or arduous to help you improve your heart health and fitness.

Flexibility Training

Flexibility training can also help people with MS improve muscle and joint range of motion and may even help reduce spasticity.

To start, you can try two to five stretching exercises after your resistance or cardio workout. Try to include stretches that improve the flexibility of your quads, hamstrings, glutes, calves, chest, shoulders and triceps.

Try to hold stretches for 15-30 seconds to the point of minor discomfort. If you need help getting started, you can consult my guide on how to start stretching.

Balance Training

Balance training can help you reduce the risk of falls and help you feel more confident. Additionally, training your balance may even help improve your capacity to walk and move freely and maintain your independence.

To start, you can try balance drills without too much risk of failure. Try standing on both feet with your eyes closed in front of a wall. Next, stand on one foot in front of a wall. Once that becomes easy, you can incorporate single limb exercises that stress balance like lunges or step ups.

Coordination Training

Coordination type training can also improve your functional abilities and balance. Some good examples include grapevine, walking and skipping drills incorporating changes of direction or coordinated steps. Additionally, taking dance lessons and engaging in physical activities that challenge your brain as well as your body can help you improve your coordination.

Final Thoughts

Hopefully, this guide to exercise with multiple sclerosis helped you gain the confidence and know how to start an effective exercise routine. While there currently is no cure for MS, a formal exercise routine and daily physical activity can help you feel better and stay mobile and independent for as long as possible.