Staying active when you have multiple sclerosis (MS) is one of the best tools you have to support your overall mental and physical wellness. While exercising with MS has its challenges, finding the routine that works for your health needs can help you feel your best.

Benefits of Exercise for MS

Doctors used to advise against exercise for people with multiple sclerosis. The old belief was that physical activity could worsen symptoms or cause MS to progress. Today we understand that exercise can have tremendous wellness benefits for people with MS, though there is no evidence that exercise can slow the progression of MS. These benefits include:

• Bone density maintenance or improvement
• Improved respiratory function
• Improved muscle strength
• Improved bladder and bowel function
• Body weight maintenance or weight loss

Some of the possible mental and emotional benefits of exercise include:

• Reduced feelings of anger or depression
• Improved sense of overall well-being
• Decreased sense of isolation

A sedentary lifestyle carries its own risks. Lack of exercise can increase your risk for developing related health conditions like high blood pressure or high cholesterol, cause constipation, damage joint function, and lead to muscle weakness from disuse.

Exercise Precautions

Every person with MS is different. The right exercise routine to support your physical and emotional wellness will depend on your specific MS symptoms, your mobility, your type of MS, and your treatment plan. Your doctor is your best resource for determining which exercises will be safe and beneficial for your well-being. Always consult your health care provider before beginning a new exercise routine.

Best Types of Exercise for MS

While everyone with MS has different needs, focusing on cardiovascular fitness, muscle strength, balance, and flexibility is a good place to start. Below are a few types of exercise that are commonly recommended for people with MS.

Water exercise can be a good option for people with MS. Swimming, water aerobics, and other aquatic exercise programs are good forms of aerobic activity that can also build muscle strength. Exercising in water can help mitigate certain factors that make exercising on land challenging for people with MS. For example, the buoyancy of the water can help manage fatigue by reducing resistance and cool water can help avoid overheating. Water activity can also help people overcome mobility constraints. With the right support and safety precautions, people who normally can’t use their legs may be able to use their lower limbs in the water, which can have positive physical and psychological effects. There is also a small amount of evidence that water exercise may support cognitive function. The Multiple Sclerosis Society of America provides free resources for beginning a water fitness routine for MS.

Yoga can help people with MS improve or maintain the balance and strength needed for everyday activities like standing up and sitting down. The MS Society offers resources to help you find yoga videos and classes suitable for MS. If you’d like to practice yoga at a studio, avoid heated or Bikram yoga. You can also call ahead to confirm that your class will not be heated.

Pilates may help people with MS improve balance and mobility and manage pain. A study of 71 people with MS who did not use wheelchairs found that Pilates helped improve walking speed and distance. The British National Health Service offers a seated Pilates video appropriate for people with MS.

Tai chi is a gentle Chinese martial art involving slow, deliberate movements. In the general population, tai chi has been found to improve muscle strength and balance and lower blood pressure. In studies of people with MS, tai chi has been found to improve balance and overall quality of life.

Stretching is a great way to manage spasticity, improve flexibility, and support range of motion in your neck, shoulders, arms, legs, hips, and other joints. The MS Society offers a guide for MS stretches that can help you get started with a stretching exercise routine.

More than 13,000 MyMSTeam members indicate that they have gone to a physical therapist. Physical therapy can help people with MS find appropriate exercises and set achievable goals for an exercise program. If you are interested in seeing a physical therapist, ask your doctor for a referral.

Overcoming Barriers to Exercise

Fatigue, heat sensitivity, and mobility constraints are a few common barriers that can get between a person with MS and an exercise routine. Other challenges you may face include the unpredictability of MS and MS-related pain.

The following tips may help you better manage these exercise challenges:

• Slow your pace — If you find yourself struggling with fatigue during a workout session, slow down. You can slow your pace when doing aerobic exercise or take longer breaks between sets of weight training exercises.
• Account for every effort — When you have limited energy, the time it takes to get to and from the gym or the effort it takes get from one machine to another can take its toll. Take your commute time getting to your workout and transition time into account when planning your routine or when making goals for yourself. You can also consider home workout options.
• Stay cool — If you’re among the 80 percent of people with MS who are sensitive to heat, you may worry about raising your body temperature through exercise. You can avoid overheating by using fans, ice-cold beverages, or cooling towels to control your body temperature. You can also try a cold shower or bath before working out.
• Adapt to your mobility needs — Using a wheelchair, cane, or other mobility device doesn’t have to put a stop to physical activity. Depending on where you live, there may be exercise classes specifically designed for people with mobility limitations or people with MS. There are also many exercise routines for wheelchair users available online. The National MS Society offers a wheelchair exercise series and the MS Trust offers seated exercises. If you’d like to go to a local gym, you can use this accessibility checklist from the MS Society to ask fitness facilities about their disability accommodations.
• Find compassion — MS can be unpredictable, and your condition will likely change over time. If you have a relapse or your MS progresses, you may have to adapt your routine to meet your new abilities. This can be tremendously frustrating. In those moments when you’re feeling down, try to find compassion for yourself. No matter what adaptations you and your doctor determine are best, you are putting in the effort to support your physical, mental, and emotional wellness.
• Be mindful of pain — Neuropathy, muscle spasticity, or general muscle pain can stand between you and physical activity. While exercising when you’re in pain can be extremely difficult, staying active can actually help manage pain. Stretching exercises and water activities can be particularly beneficial if your pain is related to spasticity. While exercise can help you manage pain, your exercises should not cause pain. Talk to your doctor if you feel pain while being physically active.

Finding the right exercise program for MS is often a process of trial and error. “We sometimes have to try multiple ways until we find the right one for us,” one MyMSTeam member reassured another struggling with exercise and fatigue.

Members of MyMSTeam find that sticking with physical activity, even if it’s challenging, yields rewards for their physical and mental well-being. One member with progressive MS who uses a walker shared, “I don’t think I would be as mobile as I am without the years of exercise.” Another member commented, “When I see my exercise paying off, I feel pride.”

Learn more about Wellness and MS. Healthy eating, managing related health conditions, and adjusting to your new normal can also help improve well-being in people with MS.

Find Your Team

On MyMSTeam, the social network and online support group for those living with MS, members talk about a range of personal experiences. Exercising with multiple sclerosis is one of the most popular topics.

What exercise routines have you found helpful for your well-being with MS? How do you overcome challenges to staying physically active? Share your experiences in the comments below or on MyMSTeam.

References

1. Aerobic Exercise in People with Multiple Sclerosis — International Journal of MS Care
2. Exercise Prescription for Patients With Multiple Sclerosis; Potential Benefits and Practical Recommendations — BMC Neurology
3. Physical Activity for People with Multiple Sclerosis — National Multiple Sclerosis Society
4. Multiple Sclerosis and Exercise: A Review of the Evidence — International Journal of MS Care
5. Stretching for People With MS — National Multiple Sclerosis Society
6. Aquatic Training in MS: Neurotherapeutic Impact Upon Quality of Life —Annals of Clinical and Translational Neurology
7. Exercise as Part of Everyday Life — National Multiple Sclerosis Society
8. Yoga and MS — National Multiple Sclerosis Society
9. Pilates — Multiple Sclerosis Trust
10. Impact of Pilates Exercise in Multiple Sclerosis — International Journal of MS Care
11. Adaptive Tai Chi — National Multiple Sclerosis Society
12. Tai Chi for Health Benefits in Patients With Multiple Sclerosis: A Systematic Review — PLoS ONE
13. A Safe and Effective Workout — National Multiple Sclerosis Society
14. Pain & Itching — National Multiple Sclerosis Society