It is important to choose the right exercise option for you. The benefits of exercise only last while you stick with the program, so choose an activity that you enjoy. Some people prefer to participate in competitive group activities, such as versions of team sports that have been adapted to fit the needs of people with MS. Other people prefer exercising without a team or a partner. Try different exercise options, and see what fits your lifestyle.
Aquatic activities are usually considered the most appropriate form of exercise. The advantages of water activities over other options are:
- The natural buoyancy of water counteracts the effects of gravity, and allows movements that may not be possible on land for people with balance problems.
- Water provides enough resistance for an aerobic workout for both the upper and lower body.
- Water helps reduce body heat and prevent overheating.
Some people with MS, especially those with muscle tightness, find yoga to be a relaxing form of exercise. The deep breathing and meditation done in yoga also contribute to stress relief.
Tai chi is an ancient Chinese martial art that can be described as a series of graceful motions that resemble ballet. It can help improve strength, flexibility, and balance without hurting the joints.
Weight training is another option. Routines can be adapted to fit individual abilities, but keep in mind that a full weight training session is often too tiring to do. Try alternating with upper body exercise one day, and then lower body exercise the next day.
There are many other forms of physical activity for people with MS. These can range from simple activities (for example, hobbies such as gardening) to exercises with specific workout equipment.
Most exercise books and videos are geared towards the general public, and may not be appropriate for people with MS. Please consult your physical therapist or healthcare professional to determine whether these books and videos are right for you.
The term "hot water" has a whole new meaning when it comes to people
with MS. Even small increases in body temperature of only 0.5°C can result
in a worsening of symptoms. People with MS must be extra careful to avoid overheating
General tips for keeping cool are:
- Before exercise, cool your feet and legs in a tepid bath for 20 to 30 minutes.
This will prevent your body temperature from rising above normal during physical
ctivity. If a bathtub is unavailable, take a cool 20-minute shower. Also try
running cold water over your wrists for 3 to 5 minutes when no showers,
tubs or pools are available.
- Wear lightweight shoes.
- Dress in layers so that you can remove clothing as you exercise.
- During exercise, wear cooling headbands, vests, or neck wraps. Simple "home-made"
cooling garments can be made by sewing pockets onto clothing and putting "blue
ice" gel packs into the pockets.
- Refresh yourself with sprays of water from a plastic bottle.
- Include rest periods in your workout.
- Have cold drinks on hand and sip them to prevent overheating or dehydration.
Keep in mind that you should drink about one cup (250 mL or 8 ounces) of fluid
every 15 to 20 minutes during exercise. If you drink coffee, caffeinated tea,
soft drinks or alcohol, you will need to drink even more fluids since these
beverages can cause you to go to the bathroom more often and lose more water.
- Consider aquatic activities in water that is ideally 26° to 29°C,
or 80° to 84°F.
- Exercise indoors (ideal room temperature less than 21°C or 70°F)
or outdoors only when the weather is cool. Avoid outdoor activities between
10:00 am and 4:00 pm.
- Use air conditioners, electric fans, or a battery-powered handheld mini-fan.
- Alter the time of day of your workout.
- Take time to cool down and rest after your workout.
- Avoid spending time in hot, steamy locker rooms.
The health risks associated with physical inactivity are well known in the general population. Along with the risk of chronic conditions (such as osteoporosis, diabetes, cardiovascular disease and cancer), the lack of exercise can also result in muscle weakness, fatigue, depression, and sleep disturbances. The symptoms of MS are similar to the consequences of physical inactivity, so people with MS may have even more problems with tiredness, mood disorders, and sleep disturbances.
MS symptoms are unpredictable and can vary greatly from person to person. Symptoms that affect exercise ability include:
- extreme tiredness
- shaking and loss of coordination
- muscle stiffness or spasms
- poor balance and unsteadiness
Not all people with MS will experience all symptoms, and often the symptoms will improve during periods of remission. This means that different people will have varying exercise ability at different times.
It may seem surprising that physical activity benefits people with MS. However, research studies show that regular activity results in better physical functioning and general health. In particular, aerobic exercise increases cardiovascular fitness, and arm and leg strength; at the same time, aerobic exercise also reduces depression and fatigue, and promotes a more positive attitude. When an MS attack or exacerbation occurs, the increase in muscle strength acquired through exercise can help provide a stronger foundation for recovery.
The key to any exercise program is moderation. Either too much or too little physical activity can be harmful. All people with MS should consult their doctor or healthcare professional before starting any exercise program.
Four words sum up the key to staying active: start low, go slow. Physical fitness
is a lifelong goal, so don't expect too much too soon. Begin with a shorter
session, and then exercise a little longer each time. Moderate exercise for
20 minutes everyday provides the same health benefits as vigorous workouts.
Learn to tell the difference between the feeling of a stretch and pain. Stretch
is acceptable, but pain is not.
All people with MS should consult their doctor or healthcare professional before
starting any exercise program. People at all levels of disability can benefit
from exercise programs that are tailored to meet their individual needs. Your
doctor or healthcare professional will be able to assess your current fitness
level, and recommend the best activities for you.
A proper warm-up will help you get the most out of exercise and prevent muscle
spasms. Take 5 to 8 minutes to warm up, by moving your head, shoulders,
arms, wrists, hips, legs, ankles, and feet in a circular motion. Gently stretch
the muscles that you will be using during your workout, and take 5 to 6 deep
breaths while holding each position. All movements should be done slowly and
evenly, since moving quickly can increase muscle spasms or stiffness. Consult
your pharmacist or healthcare professional to ensure that you take your MS medications
(especially medications for muscle spasms) at the best time in relation to exercise.
Exercise should be planned for a time when you have the most energy. Some people
find early morning best; others prefer to exercise once in the morning and once
in the afternoon or evening. Get enough sleep the night before your workout,
and take a 15-minute nap if necessary a few hours before exercising. Keep in
mind the following helpful hints:
- Use the "2-minute" rule. Exercise for 2 minutes if you are feeling tired.
After 2 minutes, you might have enough energy to continue. If you are still
feeling tired after 2 minutes, stop and rest.
- Avoid overdoing it. A 15-minute quiet time-out (lying or sitting still with
your eyes closed) may be a simple solution to recharge your batteries.
- Always talk to your exercise instructor or partner/team about MS so they
will understand if you need to take a break.