Exercising is one way that people with multiple sclerosis (MS) can boost mobility, improve quality of life, and maintain function. However, some people with the condition find that fatigue or fear of falling may prevent them from starting an exercise routine. Fortunately, there are some solutions that can help individuals with MS get past these barriers so they can engage in healthy physical activity, said physical therapist (PT) Gwynne Jones during the Multiple Sclerosis Association of America’s (MSAA) Nov. 5 webinar, “Stretch and Strengthen.”

After getting clearance from their neurologist and other MS care team members, people with multiple sclerosis can work with a PT to set a therapy schedule. How that schedule shapes up may depend on a person’s specific diagnosis and health, Jones said. “If you have had a recent relapse, your physical therapist might ask to see you one to three days a week,” she said.

For someone who is stable, a maintenance routine may be recommended, which would entail seeing a physical therapist one to three times a month. “If your symptoms have been stable for long enough, wellness checkups may be sufficient,” Jones said. “It’s recommended to have a wellness checkup every four months when you have been diagnosed with MS.”

How To Perform PT When Symptoms Get in the Way

People with MS who want to exercise may be apprehensive to start because of their symptoms. That’s why it’s important to get a doctor’s approval and to always exercise in moderation.

“Fatigue is one of the most common and debilitating symptoms of MS, and it often limits activity tolerance,” Jones noted during the MSAA event. “While fatigue with exercise doesn’t increase disease progression, it can increase any of your MS symptoms. Allow yourself to rest at your first sign of fatigue, or before that point, even if you feel good, to prevent excessive fatigue when you’re exercising.”

Jones noted that people may just need a short rest before they can continue to exercise. Some people with MS find that their fatigue levels depend on their medication cycle or the time of day. It can be helpful to pinpoint the time frames when they have the most energy and use those periods to schedule exercise.

“Alternatively, you can spread exercise throughout the day, performing short bouts every couple of hours,” Jones said. “And if exercising causes you to be fatigued, so much so that you can’t complete self-care activities, that type of exercise is too intense for you.”

Physical therapists can help people with MS modify exercises as needed if the condition causes symptoms that make PT challenging. “Be sure to start any new exercise routine gradually and allow your body enough time to rest and adjust to this change,” Jones said.