If you have multiple sclerosis (MS), you may feel tired and weak and struggle with balance and coordination. These symptoms might make it harder to stay active, but exercise can help you manage your symptoms and improve your quality of life.
Lamees Alzyoud, MD, a neurologist with Banner - University Medicine, explained more about how exercise can help with multiple sclerosis and how you can exercise safely with MS.
How exercise can help
“Exercise can help in multiple ways. It can promote wellness overall and help with cardiovascular health. From an MS standpoint specifically, it can help with symptoms like fatigue, muscle spasticity and cognitive impairment,” Dr. Alzyoud said.
Here are some ways exercise can make a difference:
- More mobility and strength: Exercise strengthens your muscles, improves your coordination and enhances balance. It can lower your risk of falls and help you stay independent.
- Less fatigue: Fatigue is a common symptom of MS and it may be the one you struggle with the most. Exercise boosts your energy levels, helps keep your heart and lungs healthy and improves your sleep. “You might feel like you’re too tired to exercise, but when you do it helps,” Dr. Alzyoud said.
- Better mental health: With physical activity, your body releases endorphins, which are natural mood boosters. Exercise can improve your mood, lower stress and anxiety, help you manage frustration and reduce your risk for depression.
- Increased flexibility and range of motion: MS can cause muscle stiffness and make it harder for you to move. Stretching exercises, such as yoga or gentle Pilates, can help loosen tight muscles and improve flexibility so you can move more freely and have better control over your body movements.
- Improved bladder and bowel function: Staying active can help keep these systems working more smoothly. Activity stimulates your digestive system and can help reduce constipation, while exercises that strengthen the core and pelvic floor muscles can help with bladder issues.
“There's emerging data that exercise can also help with improving disability levels in the long run. But we don't have strong evidence to support that yet,” Dr. Alzyoud said.
Best types of exercise for people with MS
Different types of exercise help in various ways. “We tailor our exercise recommendations to each person’s disability level,” Dr. Alzyoud said.
Depending on your ability, you may want to include:
- Aerobic exercises: Activities like walking, swimming and cycling increase your heart rate, improve circulation and help the body use oxygen more efficiently. They are great for keeping your heart healthy, boosting your mood and improving your stamina.
- Strength training: Weightlifting, resistance band workouts or bodyweight exercises help you maintain muscle strength and endurance and support your mobility and balance. “Resistance training is very important for people with MS, so we recommend it two to three times a week,” Dr. Alzyoud said.
- Stretching and flexibility exercises: Stretching, yoga and Pilates lengthen tight muscles, so they may help reduce muscle stiffness and improve your range of motion.
- Balance and coordination exercises: Balance practice, Tai Chi or exercises to strengthen your posture can improve your stability, coordination and awareness of your body. They may reduce your risk of falls and help you feel steadier on your feet.
- Water-based exercises: Swimming and aqua therapy are helpful because water supports your body and reduces the strain on your joints and muscles, so you can move through your full range of motion with less pain or discomfort. The resistance of water also helps build muscle strength and endurance.
Safety when you’re exercising with MS
It’s always smart to start a physical activity program slowly and build up gradually, and that’s especially important when you have MS. If you overdo it, you could make fatigue and other MS symptoms worse. Start with light exercises and short sessions and increase as you get stronger and build endurance.
Listen to your body for signals that it’s time to slow down or take a break, like fatigue, overheating or worsening symptoms. If you start feeling dizzy or tired or you have a flare-up in symptoms, stop and rest. Adjust your routine based on how you feel each day.
If MS makes you sensitive to heat, try exercising in an air-conditioned space or pool – or early or late in the day when temperatures are lower. You can also use fans, cooling vests or cold towels to keep your body temperature down.
“Heat sensitivity could make your symptoms worse, but that should not keep you from exercising,” Dr. Alzyoud said. “Cooling strategies will help and exercise will help improve symptoms.”
Before starting any new exercise routine, talk to a health care provider or physical therapist. They can help you design an exercise plan that works for your needs, symptoms and fitness level. “Early consultation with physical therapy is very helpful for knowing what’s safe,” Dr. Alzyoud said.
Modifications and tools
Making modifications and using adaptive tools can help you stay safe and comfortable, so your exercise routine fits your abilities even when your symptoms fluctuate. You may find it helps to:
- Break your workout into shorter sessions throughout the day instead of one long session.
- Do seated exercises if standing feels too hard.
- Use walkers or canes for support during walking or balance training to reduce your risk of falls.
- Work out on an exercise bike to get your heart rate up without putting too much strain on your joints.
- Build muscle strength with resistance bands, which make it easy to adjust the intensity of your workout based on your strength level.
When to avoid exercise
Sometimes, it’s best to skip or modify your workouts to protect your health. If you’re having a flare-up, it’s important to rest and let your body recover instead of pushing through a workout.
Exercise during a flare-up could make your symptoms worse and make it harder to recover. “If you’re having a relapse or new neurological symptoms you haven’t had in the past, it’s better to seek medical attention and make sure you recover,” Dr. Alzyoud said.
You might want to try some gentle stretching or relaxation exercises if you feel like you can or take a complete break if you need to.
Exercise may feel out of reach on days when you feel extremely fatigued. Choose a light activity, such as a short walk or gentle stretching, if you feel up to it. Exercising when you're very tired could make the fatigue worse or lead to an injury.
How health care providers can help
Providers can help you find ways to use exercise to manage your symptoms and improve your quality of life.
Physical therapy can help you manage MS-related symptoms like weakness, stiffness and coordination issues. A physical therapist can help you create an exercise program that helps you improve strength, balance and mobility and reduce muscle contractions and fatigue.
Health care providers can help you develop a fitness plan that works for your needs and abilities and factors in your MS symptoms. They can help you create a plan that you can adjust as your symptoms change.
If you notice that you have increased weakness, balance issues or numbness after exercise, stop and consult your provider. You might need to adjust your workout or give your body more time to recover. Your provider can help you modify your plan.
The bottom line
If you have multiple sclerosis, staying active can help keep you mobile and strong, support your mental health and fight fatigue. Be sure to listen to your body and make adjustments if you need to.
A health care provider can help you put together a safe workout plan that fits your abilities and goals. To connect with an expert who can help, reach out to Banner Health.
