How can exercise help with MS?

By Jamie EskeReviewed by Nancy Hammond, MD

1. Benefits
2. Aerobic exercises
3. Progressive strength training
4. Yoga
5. Tai chi
6. Water sports
7. Balance exercises
8. Safety
9. Summary

Exercise has a range of benefits for people with multiple sclerosis. It can, for example, help improve strength and mobility and boost mental well-being.

In previous years, doctors recommended that people with multiple sclerosis (MS) avoid too much physical activity, believing that it could make fatigue and other symptoms worse.

However, research has since revealed that exercise can, in fact, improve MS symptoms over time.

In this article, we discuss the best exercises for MS, their benefits, and tips for staying safe while exercising.

How can exercise help with MS?

Regular exercise can help people with MS improve their mobility, muscle movements, and overall quality of life.

MS is a progressive inflammatory disease that damages the myelin sheaths that coat nerve cells. An estimated 2.3 million people worldwide have MS. The symptoms come and go over time and can include numbness or tingling in the limbs, muscle weakness, and fatigue.

Regular exercise helps support a healthy body and mind. It can reduce the risk of disease and chronic health conditions, such as heart disease and diabetes.

The results of a systematic review published in 2019 suggest that aerobic exercise and physical therapy can improve many areas of life for people with MS, including physical symptoms, mental health, and social functioning.

For people with MS, regular exercise can help:

• improve mobility
• improve muscle movements and flexibility
• improve the overall quality of life
• reduce the risk of MS-related complications
• reduce the risk of mental health conditions, such as depression

The National Multiple Sclerosis Society note that the benefits of exercise extend to improving cognition — exercise may help a person overcome certain cognitive challenges associated with MS.

More generally, exercise can also:

• boost heart health
• improve lung function
• raise energy levels
• improve mood
• increase the strength of the muscles and bones

Consult a doctor before starting an exercise program. They may recommend working with a physical therapist at first.

The physical therapist can design an individualized exercise program based on a person’s specific symptoms and their current health status. They can also teach people how to perform exercises correctly to avoid injury.

The following sections look at 6 of the best exercises for people with MS.

1. Aerobic exercises

Aerobic exercises are dynamic activities that increase the heart rate. This form of exercise is especially good for improving lung capacity, strengthening core muscles, and improving balance and coordination.

Aerobic exercises can improve the ability to walk, especially when the person also does strength training for the legs.

People with MS may benefit from high-intensity interval training, which many shorten to HIIT. This form of aerobic exercise involves doing short bursts of intense physical activity, then resting. The rest periods prevent a person from overheating, which can cause flares of MS symptoms.

A 2017 review found evidence to suggest that low- to moderate-intensity aerobic exercise can provide the following benefits to people with MS who have mild to moderate disability:

• higher energy levels — less tiredness
• better mood
• better heart health
• increased quality of life

2. Progressive strength training

A person with MS should work with a physical therapist to find the best strength exercises.

Strength training can improve muscle strength, posture, and balance.

Fatigue due to MS can impact muscle strength and endurance, making it difficult to find an appropriate strength training program. Working with a physical therapist can help people find the exercises and methods that work best for them.

People who have MS may want to consider a progressive strength training regimen. This can help prevent overworking of the muscles, which can result in worsening symptoms.

During a progressive strength training program, people start with light weights and minimal repetitions. They slowly increase the amount of weight or the number of repetitions as they build more muscle over time.

People can develop a personalized exercise routine with the help of a physical therapist or a personal trainer who specializes in MS.

3. Yoga

Yoga is a mind-body practice that incorporates various breathing, stretching, and meditation exercises. Yoga improves flexibility and strength while promoting a calm, harmonious mindset.

The physical and psychological effects of yoga can benefit people with MS. Building flexibility and strength may improve MS symptoms, such as stiffness, muscle weakness, and loss of mobility.

People can modify any yoga pose to suit their needs at the time. At different points, people can stand, sit in a chair or wheelchair, or lie on the bed or floor to perform yoga poses, breathing exercises, and meditation.

The researchers behind a small-scale 2017 study found that yoga was one of the six most popular complementary treatments for managing MS symptoms. They found that an 8-week yoga program improved physical performance and quality of life for 14 adults with MS.

The National Multiple Sclerosis Society offers some useful advice for practicing yoga with MS.

Working with a qualified yoga teacher, especially one who specializes in MS or adaptive yoga, can help people find the poses that work best for them.Multiple sclerosis: What you need to knowThis article provides an overview of multiple sclerosis, including its causes, symptoms, types, and treatments.READ NOW

4. Tai chi

Adaptive tai chi provides a useful and gentler alternative to yoga. This martial art focuses on deep breathing and slow, gentle movements.

According to the National Multiple Sclerosis Society, tai chi can help improve balance, lower blood pressure, and reduce stress. However, they note that studies have not looked specifically at these effects in people with MS.

5. Water sports

Water sports provide several benefits to people who have MS.

The temperature of the water helps prevent the body from overheating, which can worsen MS symptoms. Also, the feeling of weightlessness combined with the subtle resistance of the water creates an excellent environment for low-impact exercising.

Beyond swimming, people can perform various types of exercise in the water, including:

• weightlifting
• balance training
• walking
• stretching

6. Balance exercises

Balance exercises help improve coordination. Because these low-intensity activities put minimal strain on the body, many people can perform them.

Examples of balance exercises for MS include:

Heel and toe raises

• Stand with the feet hip-width apart while holding onto a wall or railing for stability.
• Rise onto tiptoes and hold the position for a few seconds.
• Slowly lower the feet back to the floor.
• Carefully shift the weight to the heels and hold this position for a few seconds.
• Alternate between rising onto tiptoes and rocking back onto the heels.

One-leg stands

• Stand upright with the feet hip-width apart and use a wall, railing, or piece of heavy furniture for stability.
• Lift one foot so that it hovers slightly above the floor, and hold the position for 30 seconds.
• If comfortable and for an added challenge, lift the arms to the sides or raise them overhead.
• Repeat this exercise on the other foot.

Heel-toe walking

• Start by standing upright and using a wall for balance.
• Carefully walk forward, placing the heel of one foot directly in front of the toes of the other foot.
• Try taking a few steps forward and backward.

How to exercise safely with MS

A person should stay hydrated during exercise to avoid overheating.

Regular exercise can improve MS symptoms. However, people can feel negative effects when starting a new exercise program.

Also, overworking the body can lead to severe fatigue, stiffness, and muscle spasms.

The National Multiple Sclerosis Society warn that fatigue after a workout should not last longer than 2 hours. Doctors recommend that anyone who experiences this level of fatigue reduce the intensity, frequency, or duration of their workouts.

People should stop exercising if they experience:

• excessive fatigue
• lightheadedness or dizziness
• overheating
• confusion
• loss of balance or coordination problems

Consider the following safety tips while exercising:

• Stay hydrated to avoid overheating.
• Use a wall or railing for extra stability when performing balance exercises.
• Stretch before and after each workout to prevent injury.
• Pay attention to the surrounding environment.
• Slow down and make sure to complete all exercises using the correct form and technique.

Summary

MS is a progressive inflammatory disease that affects the central nervous system. Exercise can help improve muscle tone, balance, strength, and mental well-being.

Exercises that can help reduce MS symptoms include:

• aerobic exercises
• strength training
• yoga
• tai chi
• water sports
• balance exercises

People should talk to their doctor before starting a new exercise program.