Exercise Tips for those with Multiple Sclerosis
What is MS?
Multiple Sclerosis (MS) is a chronic, progressive disease of the central nervous system that results in damage to myelin - the protective coating surrounding nerve fibers that acts as insulation for the nerve impulses. The scarring, or loss of myelin, and damage to the nerve fibers results in poor electrical conduction. Symptoms of MS vary from person to person and can include fatigue, stiffness, weakness, numbness, pain, loss of balance/coordination, cognitive issues, depression, and visual problems. While the exact cause of MS is still unknown, research indicates that it may be the result of an abnormal autoimmune response to some infection or environmental trigger in a genetically susceptible individual. It effects 400,000 Americans and 2.5 million people worldwide. MS is 2-3 times more likely to occur in women and has a greater prevalence in colder climates and those with Northern European ancestry. Three quarters of individuals are diagnosed between the ages of 15-45.
How can exercise help?
Exercise is good for people with MS for the same reasons it’s good for everyone else! We know exercise decreases the risk of heart disease, decreases resting blood pressure, improves sleep, strengthens bones, increases muscle strength and endurance, and can improve energy and mood. Exercise can provide added benefits for those with MS. A study conducted at the University of Utah found people with MS who participated in an aerobic exercise program had “better cardiovascular fitness, better bladder and bowel function, less fatigue and depression, a more positive attitude, and increased participation in social activities.” (Petajan, JH, Gappmaier E, White AT, et al. “Impact of aerobic training on fitness and quality of life in multiple sclerosis.” 1996 Ann Neurol; 39: 432-441.)
Benefits of Exercise for people with MS
Increase in muscular strength
Improved circulation increasing oxygen throughout the body
Improved breathing becoming deeper and more regular
Improved flexibility and joint range of motion
Helps with weight loss and/or weight maintenance
Improves balance and gait
Increases level of independence
Increase in tolerance for exercise and daily activities
Decrease in fatigue
Decrease in muscle atrophy
Decrease in muscle tension
Decrease in swelling/edema
Promotes feelings of well-being
Reduces stress, depression, and social isolation
So how do I get started exercising if I have MS?
First things first; talk to your doctor and make sure they are on board with your plan to exercise.
Start Slowly. Begin with just 1-5 minutes of exercise and increase by 1 minute a week. It may not seem like much, but building the habit and allowing your body to adjust slowly to exercise has been shown to be one of the safest ways to begin.
Pick an activity you enjoy. You’ll be much more likely to stick with it if you’re having fun.
Recruit a friend. Having someone else to workout with keeps you accountable and more likely to keep the exercise routine going. It also has the added benefit of providing social activity at the same time.
Incorporate both aerobic exercise and resistance training. This can include activities like walking, biking or arm cycling, dancing, swimming or water aerobics. An important key to remember when strength training is “quality over quantity.” One of the simplest ways to start is with isometric exercise. Simply put, an isometric exercise is a contraction of a muscle without any visible movement. The muscle is contracted in a fixed position against an unmovable object. It can be done anywhere and for almost every muscle in the body! Plus, check out what the Journal of Applied Research found; “In fact, using isometric exercise for 6 minutes would be the equivalent muscle work of 30 to 35 minutes of gym work on commercial weight lifting equipment.” (2006)
At AIM, we prioritize resistance training with our clients because of the numerous benefits it provides. In addition to helping build muscle strength, it also helps you to maintain muscle mass, or the amount of muscles you have inside your body. This is important for weight control and defending against all the metabolic diseases that accompany weight gain. In addition, resistance training builds and maintains bone mass which helps prevent osteoporosis. Of even great importance is how resistance training improves your balance and therefore decreases your chances of falling. With proper execution, you can reap these benefits. We always recommend moving slowly, with control, and focusing on what’s taking place inside the body while performing resistance training. If you need more details on how to incorporate this, we’re here to help!
Additional notes to consider when exercising with MS
Fatigue is the most common symptom experienced by people with MS (80%) and generally is worse in mid to late afternoon. This can be a huge hurdle to overcome when it comes to exercise. It may be helpful to avoid scheduling your workout during that time of day, when you know you feel wiped out. It’s also important to monitor your exercise. If your exercise is making your fatigue worse, you may need to slow things down a bit. Take extra rest breaks during your workouts or cut back on the duration of your workouts.
Increased environmental temperatures can also cause a temporary worsening of MS symptoms so it may be best to avoid working out during the hottest hours of the day. Make sure the place you exercise can be kept cool and you wear clothing that allows your body to cool down. Water aerobics to a great option for staying cool while exercising and there are numerous class available in each county on the National MS Society webpage to choose from.
Finally, if you need help getting started or have been exercising awhile and need advice, seek out help from a professional. Talk to you doctor, a physical therapist, an occupational therapist, or an exercise professional trained in working with people with MS. All of the trainers at AIM Human Performance are Certified Multiple Sclerosis Exercise Specialist. The National MS Society- Greater DC Chapter has an entire webpage listing all the available classes in the local area and you may qualify for a scholarship to attend these classes. You can see the list here https://www.nationalmssociety.org/Chapters/MDM/About-this-Chapter/Physical-Health-Classes