A Runner’s Guide to MS: How to Keep Logging Miles Safely
There’s no running from MS—but running may be a powerful way to combat symptoms like fatigue. Here’s how to do it safely.
For many, running is more than just feet pounding on the pavement—it’s a zen-like ritual and a self-care essential. If running is a part of your regular routine, getting a multiple sclerosis (MS) diagnosis may leave you fearing the loss of this activity. But the good news is that many people keep up with running after being diagnosed with MS—it may just take some extra safety precautions and creativity. Whether you’re hitting the treadmill or the trail, we’ve got the tips you need to stay safe while you keep up with your favorite exercise ritual.
Why Exercise Is Important With MS
You may fear MS will mean an end to chasing that runner’s high—and in fact, many people with MS reduce their amount of physical activity because they are afraid their symptoms will get worse. But current research shows that regular exercise is majorly beneficial for people with MS, according to a 2017 study in BMC Neurology.
“People with MS have symptoms like fatigue or weakness, which can make it hard to exercise, and you might feel like you shouldn’t,” adds Kathy Zackowski, Ph.D., an occupational therapist in Baltimore, MD, and scientist who serves as senior director of Patient Management, Care and Rehabilitation Research for the National MS Society. “But data really show that having a regular exercise routine can help reduce fatigue as you slowly gain strength and endurance.”
Beyond improving MS-related fatigue—one of the most common symptoms—exercising comes with other advantages for people with MS, too, says Jacqueline F. Rosenthal, M.D., a neurologist at the Andrew C. Carlos Multiple Sclerosis Institute in Atlanta, GA. “It helps to maintain strength, improve balance, and lessen spasticity, which can then reduce or even prevent functional limitations due to underlying motor impairment.” Other benefits include:
It boosts your mood. “Staying active [can help] to improve underlying mood conditions such as anxiety and depression,” Dr. Rosenthal says.
It improves and preserves functioning. Exercise can help boost your cardiovascular fitness, endurance, bone health, flexibility, and overall quality of life with MS, per the 2017 study. It can even help improve MS symptoms like bladder and bowel functioning issues, according to the National MS Society.
It combats other conditions. Exercise also helps prevent medical conditions associated with cerebrovascular disease, which can be more common in people with MS, Dr. Rosenthal says.
Tips for Running Safely
While MS can make it difficult to run as smoothly as you once did, running is still possible—as long as you can do so safely, says Zackowski. (Falling and hitting your head is not the result you want!) Whether you can run safely really depends on your unique MS symptoms, adds Dr. Rosenthal. “For example, if you have a foot drop that is present all the time, then running would most likely never be a ‘safe’ option due to risk of falls,” she explains. “On the other hand, a patient may only start to experience a sense of foot drop after running a certain distance, such as a couple of miles, or if overheated. It may take time to learn what activities are tolerated best, and this will differ dramatically from one person to another.”
Part of continuing to run safely with MS means working to stay strong in other ways, Zackowski says, whether through strength training or other forms of aerobic exercise. “I would make sure you are doing aerobic exercise that’s not just running,” she says. “If you can keep yourself strong by cross-training with something, like high-intensity interval training (HIIT), you might have fewer longer runs but maintain the pace you had before.”
Running safely also means considering the impact of heat: Some people with MS find heat aggravates their symptoms, which can be an issue if you’re overheating while running or doing other exercise. So don’t skimp on hydration, and consider other cooling strategies, too, suggests Zackowski. “Drink cold water before you exercise, take a cold shower before, exercise with a fan blowing on you, or wear cooling garments,” she says. In fact, the National MS Society has a handy list of cooling products to try on their website (including discount codes), ranging from personal misting devices to cooling vests or neck wraps you can wear on your runs.
Another tip is to consider a device that stimulates the muscles while you’re exercising, such as a WalkAide, says Zackowski. While she notes there’s no evidence behind this yet, she says it may be worth a try in folks struggling with certain movements involved in running.
“The idea is these devices provide an extra little electrical pulse that makes your muscle fire in your calf, for example,” she says. “Some people with MS have difficulty lifting their toes when they bring their foot forward with each step, and this is often called 'foot drop.' You can raise your foot higher, but that’s energy consuming, so then you wouldn’t run as fast. I’ve recommended people use these devices, and you can use them when you are running to help keep you running.”
The Bottom Line
Because your safety is on the line, it’s always a good idea to work with a professional to figure out the best ways to keep running safely with MS. That might mean seeking the advice of an exercise physiologist or trainer who has experience working with people with MS, says Zackowski, or consulting with a physical and/or occupational therapist to come up with a personalized exercise routine and adaptations that work for your unique symptoms.
So while your running routine may need some creative adjustments and modified expectations, MS doesn’t have to mean an end to logging miles. “It’s really important to set goals for yourself, because that way you can see the progress,” Zackowski adds. “You may not be making the progress you did [before MS], but don’t be frustrated by the slower speed—document the results you do have so you can remind yourself, ‘I am making progress, this is working, it’s just going to take a little longer and I have to be careful.’”
- Study on MS and Exercise: BMC Neurology. (2017). “Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations.” ncbi.nlm.nih.gov/pmc/articles/PMC5602953/
- Benefits of Exercise for MS: The National MS Society. (2020). “Benefits of an Exercise Program.” nationalmssociety.org/For-Professionals/Clinical-Care/Professional-Education/Intro-to-MS-for-Fitness-Professionals/Module-3
- MS Rehab Information: The National MS Society. (2020). “Rehabilitation.” nationalmssociety.org/Treating-MS/Rehabilitation