How important is it to exercise if you have MS? According to the National Center on Physical Activity and Disability: “In addition to improving overall health, cardiovascular fitness, range of motion, and flexibility, exercise can help one increase energy, improve balance, manage spasticity, decrease muscle atrophy, and better perform activities of daily living.” With months of research, ActiveMSers has compiled a comprehensive list of the best multiple sclerosis exercises, exercise tips and workout advice. Consult with your doctor and/or neurologist before starting any exercise program.
Top 5 Tips
1) Stretch daily. Flexibility exercises—muscle stretching and range of motion exercises (ROM)—can help prevent shrinkage or shortening of muscles and can help reduce the severity of spasticity symptoms. Dedicate 10-15 minutes of stretching every day.
2) Experiment. MS affects everyone differently, so try different ways of exercising to see what works best for you. Swimming and walking are popular, as are horseback riding and biking (try a three-wheeled Delta trike). Adaptive ski programs can be a great way to enjoy the cool outdoors (New Mexico has one of the best programs in the US: www.adaptiveski.org).
3) Stay cool. Heat, while it won’t trigger an attack, can exacerbate your MS symptoms. Go to the gym when it’s cool, exercise in the morning, consider snow sports, and put swimming (regardless of how you look in bathing suit) on your list.
4) Train in bursts. Fatigue or weakness can come on quickly. Space out your “hard” exercise with frequent breaks. Mini workouts all combined produce essentially the same benefits as one long one.
5) Remember, MS is BS: multiple sclerosis is beatable someday. Optimism when fighting an incurable disease is essential to good mental health. You want to be ready when that cure comes—and it will in our lifetimes—with the healthiest body and mind possible.
Prep Work
Start slowly. Nothing crashes a multiple sclerosis exercises program like going out full guns and wiping yourself out for a week. Easy does it, even if it means just a few minutes a day. A fellow MSer wrote me about going from 5 minutes of exercise a day to 50 minutes a day!
Listen to your body. With MS, it is easy to go over that fatigue edge. How can you tell if you’ve overdone it? If you still feel ucky and tired two or three days after your exercise, bingo, you’ve worked out too hard and need to dial it back.
Wear the proper shoes. If stability is an issue, you’ll want a tennis shoe that will maximize balance. See a professional at a specialty running store to get the right shoe for you.
Spend money on shoes. Sorry bargain hunters, Payless ShoeSource is not where you’ll find the right shoes for working out. My sister works for Puma Running and swears by this. Go to a high-end running store (not in the mall). You’ll get the right shoes … and shoes that are truly new (shoes degrade with time, which is why they are so cheap at discount stores). Expect to spend $90-$130.
Let your clothes breathe. Synthetic performance clothing wicks moisture and keeps you dry and cool. Traditional cotton also breathes well and can help you stay cooler while you exercise, but it isn’t the best solution in humid areas. The benefit of synthetics is maximized if you are participating in outdoor sports where the breeze becomes your best friend (and potential enemy if you are wet).
Wear tights. There is some evidence that high-tech performance clothing—compression tights that fit snuggly—can decrease muscle fatigue and improve endurance by up to 10 percent. CW-X is the brand for skiers, although there are many other manufacturers including Segoi, X-Bionic, and Patagonia.
Invest in a pedometer. Researchers have found that people walk more in a day if they are keeping track of the number of steps they take. Unless you are in a wheelchair, this is a great way to build up your exercise, even if you never leave the house. Those little walks from the couch to the kitchen can add up! Be sure to keep a diary and write down the number of steps you take each day.
Prep Work (cont.)
Stay close to home. The closer the gym is to your house, the more likely you are to go to the gym. That also means less driving, fewer minutes out of your day wasted, and less stress worrying about fitting in a workout. Also look for a fitness center with a pool, an essential extra for MSers.
Consult a pro. Your health insurance will likely cover the cost of you seeing a physical therapist, who can customize an exercise program to your abilities and show you proper ways to stretch and workout. When you go to the appointment, be prepared with a list of questions and a list of what you think you can and cannot do physically.
Research local programs. The National Multiple Sclerosis Society (www.nmss.org) has offices all over the US and many of them offer exercise programs and classes geared to those with MS. Give them a try; you might meet some great new friends and get fit to boot.
Alternate strength training. Don’t strength train the same set of muscles on back-to-back days. For example, do legs Monday, Wednesday and Friday and do arms Tuesday, Thursday and Saturday.
Remember the meds. You might need to work your exercise program around your medications. Interferons, for example, can make some folks feel icky the next day. Plan around your icky times—don’t just plow through them.
At the Gym/Pool
Time your parking. Gyms are notorious for filling up handicapped parking spaces due to seniors working to get in shape, too. If finding a spot is tricky for you, check the class schedule and avoid going to the gym during times when classes for senior citizens are being held (unless you are in the class, of course!).
Ask for a discount. Many fitness centers and ski areas offer deep discounts to those with disabilities or diseases. If it means saving a few bucks, don’t be shy about busting out that MS card. If anyone asks, I keep a note in my glove box … or I just awkwardly walk for them. Ha!
Look up to stay cool. Before you start working out on a cardio machine, look up. You’ll want to park yourself closest to the ceiling fans, floor fans, and/or air conditioning vents. If it is winter, you’ll want to avoid areas that blow hot air.
Check your ego at the door. No, maybe you can’t perform like you once were able to. And while that can be immensely frustrating, it’s better to put your ego in check and just get to working out doing what you can do today, not wishing what you could do yesterday.
Use the facilities. Incontinence problems are common with MS. Use the bathroom before exercise and if you feel that urge during your workout, you know the drill. Stop and get to a restroom. Don’t try to finish those last four minutes on the elliptical machine.
Stretch before and after. Don’t rush into your workout. Limber up your body by slowly warming up. After your exercise session, take time to cool down with 10-15 minutes of stretching.
Class work. The best programs for flexibility and balance include yoga, tai chi, and Pilates. They are taught at many gyms. Try each one and see what you like best.
Pretend you’re a senior. Exercise classes geared for senior citizens are usually at a slower pace, ideal for the MSer with strength and mobility issues. Don’t be shy—you’ll be friends with your new classmates in short order.
Inform your instructor. Whether you are taking a yoga or Pilates class, let your instructor know about your multiple sclerosis. He or she likely will have ways your modify poses, etc., to better suit your ability.
At the Gym/Pool (cont.)
Break out the cane. It makes no sense to work out trying to stay healthy if you fall and bust your hip because you were too vain to use a cane. You absolutely do not want to be put out of commission for months, so if you need a cane, use it.
Seek support. Exercise machines that offer support, like upright or recumbent bikes, tend to be more comfortable and safe to use (especially if you have balance and coordination issues) than those machines that require your full body weight like treadmills.
Mix it up. If you do just one cardio exercise or stick to just a few weight machines, you could create muscle imbalance. Plus, it’s just boring. Keep changing your program to keep your body on its toes and your motivation at its peak.
Seek pool temps of 80-85 degrees. Some pools can get over 90 degrees, which will do your MS no favors and ramp up symptoms. Pools tend to be coolest in the early morning. If your local pool is too hot, it can’t hurt to ask to turn the temp down.
Get wet. The best part about exercising in the pool is that you can work your body in so many different ways. Swim laps, participate in water aerobics, or get creative and invent your own ways to get your body moving (throw a Nerf ball and then run after it).
Count to 30 (or longer). If your body is anything like mine, my leg strength wanes after doing 10-15 reps of leg weights or doing cardio leg work. Give your legs a chance to recover before popping up to the next machine to lower the risk of falling. Someone wants to work in? Tell ‘em to wait.
Scout a path. If you are a bit wobbly on your feet, before you start walking from one piece of equipment to another, scout a clear path ahead of you and look for grab points so you can catch yourself if you start to teeter.
Adapt your workout. Some days the legs don’t want to cooperate, so do arms. Fatigue is running you down? Avoid heavy cardio. After a recent attack that zapped my leg strength, I did that arm spinny cardio thingy. While it might not have been dazzlingly entertaining, it worked up a sweat.
At the Gym/Pool (cont.)
Monopolize a machine. Normally this would be poor gym etiquette, but if you are in a chair or mobility is a serious issue, screw etiquette. It’s best to grab a machine that does many different types of exercise and hog it. That will minimize the need to move around, maximizing your energy.
Use toe straps or wear bike shoes. With my feet pretty numb, wearing toe straps while I bike keeps my legs from flying off the pedals and allows me to go at a faster cadence. Some exercise bikes work with bike shoes, which are even better than simple straps and my number one choice when they are available.
Choose wisely. If you lose strength doing cardio exercises, making yourself unbalanced, you’ll want to work out at the “ends” of the gym, so you can reach a wall or a place to sit easier instead of having to navigate behind a two dozen treadmills immediately after your workout.
Wash your hands. With the amount of people in the gym smarming the exercise equipment, it’s smart to wash your hands frequently, especially after your workout (and before you get in your car). Getting sick while you have MS can trigger an attack and good hygiene is the number one way to avoid colds.
At Home
Lie down in front of the TV. Seriously, roll out a yoga mat and get to work on the ground. Watch American Idol, curse at Simon, and do floor exercises. Abdominal crunches are obvious, but there are a host of other exercises (and stretches) that can be done from your tummy or on your back.
Meet the cable guy. For at-home exercises, many people don’t know that their cable company offers dozens of exercise programs for free on demand. You’ll find everything from yoga to boot camp. Call your provider to find out about programs in your area and then try the lot of them.
Dis drop foot. That’s when your foot “drops” when you walk, causing you to stub your toe and trip. You’ll want to work out that muscle on your shin, also called the tibialis anterior. You can do it sitting down: keep your heels to the ground and lift your toes. You can also try walking on your heels (better be careful you don’t fall) or use equipment at the gym that targets that muscle.
Do your home work. Working out at home is cheap, convenient, and darn easy. Since MS can make even getting out of the house tricky at times, take advantage of staying in (where you can regulate the temperature yourself) and doing what you can. Some light free weights and a floor can make all the difference.
Take advantage of your surroundings. Your house has lots of natural supports beyond its walls, from doorjambs and hallways (perfect for two arms) to couches, chairs and doors. I don’t do any standing stretches without firmly planning my hands on something solid.
Train your brain. Remember that no matter how you feel, exercise will not make your MS worse (although it could temporarily amplify your symptoms). If it’s not a good day, take a break and remind yourself that tomorrow is around the corner. Exercise your brain instead: do a crossword or Sudoku.
Beware of resistance bands. While they are extremely affordable, resistance bands can be dangerous if you have moderate to severe spasticity (muscle tightness). Take care when using them—you absolutely don’t want to tear any muscles to save a few dollars.
Think Outside the Box (Actually, Just Think Outside)
Take a hike. Walking and hiking are excellent low-impact exercises if you are capable. I play games when I walk in my neighborhood, like counting dogs, lawn ornaments, or Nissans (hey, I’m the editor of a Nissan magazine).
Hit the slopes. Winter sports, such as skiing, snowboarding, adaptive skiing, ski biking, and even curling are great for the MSer. You stay cool and all of these activities allow you to go at your own pace.
Go biking (or triking). And you thought having a trike was only for those five and younger. Today’s three-wheeled bikes are a different breed and perfect for those of us with weaker legs or balance issues. Their stability is unmatched. As for the style, we recommend Delta (one wheel in front, two in back) over Tadpole (two wheels in front, one in back), due to the ease of getting in and out of the seat. Also watch the weight: cheaper Deltas can get quite heavy and may be near impossible to lift singlehandedly.
Take advantage of mornings. The a.m. has several advantages for MSers. First, it’s usually the coolest part of the day. Second, you are most likely to be fresh earlier in the day (fatigue tends to be worse mid afternoon). Third, you can check off exercising from your to-do list before its lunchtime! Cool evenings are also a welcome respite from the midday sun.
Get thee to thy ballroom. Tisha, a fellow ActiveMSer, swears by ballroom dancing. Makes sense, because your dance partner can add stability even if you have two left feet like me. Plus it’s a heck of a lot easier than the Hokey Pokey. Stick your left foot out and shake it all about? Unless you want dance floor carnage, dream on!
Hop on a horse. A number of MSers give thumbs up to therapeutic riding. There are likely programs in your area that are geared to the total beginner.
Try water sports. Anything on the water tends to be cooler than on land. The world is your oyster, so try scuba diving, snorkeling, surfing, kayaking, whitewater rafting, canoeing, water volleyball, water basketball, water Frisbee, well, you get the idea.
Be creative. There are hundreds of ways to work your body, from golf to hang gliding to paintball. Let your mind wander and don’t be afraid to try something new. You just never know what kind of passion you’ll have for a sport until you’ve tried it.
Anywhere, Anytime
Wear a cooling vest. ActiveMSers has a detailed buying guide of cooling vests, which can help tame symptoms brought on by heat. It’s a great way to stay cool both outdoors and indoors.
Hold your stretches. For stretching to have some level of therapeutic effect, you need to hold your stretches for at least 15 seconds, which will help maintain flexibility. To improve flexibility, hold your stretches for 30-45 seconds. Stretching should not be painful.
Use trekking poles. Their benefit when hiking is obvious, but I’ll use mine in the house doing a cardio workout on the TV. Heck yeah I can still do jumping jacks (in my own special way). Be sure you put on the rubber stoppers, though, or you’ll tear through the floors in no time. Trekking poles also allow you to work your upper body when walking on pavement, even though you may get some strange looks. But I get that anyway just by walking, so no matter.
Tighten the tummy. You use your abdominals every day, yet they are so easy to overlook in an exercise program. Make a point to work your abs, which is the one muscle set that can take daily exercise.
Turn up the tunes. Studies have shown you work out harder and longer if you listen to music. I prefer up-tempo music when I’m doing cardio work. My favorites? Techno albums The Fat of the Land (The Prodigy) and Vegas (The Crystal Method).
Use your ears. If eyesight is an issue (or even if it’s not) and music doesn’t rock your boat, listen to books on tape (or mp3) while you exercise. You’d be amazed at how time flies in the middle of a suspenseful novel, even if you hate that darn exercise bike.
Get into the beat. A recent multiple sclerosis study on walking found that people were able to walk with more coordination if they walked to a predictable beat. Now walking around with a metronome might prove a bit impractical, so perhaps try finding music that gets you into a steady walking rhythm.
Get a partner. It’s always more fun to work out with another, regardless of activity. Enlist your significant other, a friend, or a fellow MSer (post on our forum that you are seeking a workout partner).
Anywhere, Anytime (cont.)
Drink a slushy. Actually, any cold drink will help you stay cool, but the icier the better. Also it makes sense to hydrate yourself regularly throughout your workout instead of at the end all at once to maximize cooling.
Experiment with sports drinks. I’ve read that they’ll hydrate you well and potentially lessen the need urinate mid workout. But I haven’t done an extensive “how bad do I need to pee” test to confirm this.
Enjoy a break. Every exercise guru suggests you take at least a day off every week to give your body a full 24 hours of rest. You deserve it!
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