9 Proven Ways Exercise Can Help Manage MS
Multiple sclerosis (MS) can make any movement—let alone a dedicated workout—feel like a mountain to climb. But it’s an important one to summit.
“Exercise is key to multiple sclerosis management,” says Benjamin Segal, M.D., chair of neurology at The Ohio State University Wexner Medical Center and co-director of The Ohio State’s Neurological Institute. “Apart from improving overall health and quality of life, exercise can directly combat the symptoms of MS.”
Read on for nine ways staying active can help people with MS, plus how to get started with a new exercise routine.
You’ll Preserve Brain Function
“Underpinning all improvements in multiple sclerosis is exercise’s effects on the neurological system,” Segal says. In fact, in a 2018 study published in the Multiple Sclerosis Journal, researchers found that when men and women with MS performed twice-weekly resistance-training workouts for 24 weeks, MRI scans showed that overall brain damage from MS had not progressed. Meanwhile, certain parts of the brain had thickened. This suggests that the resistance-training program helped preserve brain tissue, and in some cases, may have even promoted brain regeneration.
Earlier findings suggest this possibility, too: A study in the journal Brain Research also showed that in patients with MS, higher levels of aerobic fitness are linked to healthier brain matter.
You’ll Build Muscle Strength and Function
That’s true even if one hand, arm, or leg isn’t working well (or at all), since exercising one side of your body can add strength all over. An Archives of Internal Medicine and Rehabilitation study found the people MS gained strength and function in one leg by working the other. This phenomenon, known as cross-education, is due to neurological rather than physical adaptations in the untrained limb.
Resistance training (with bodyweight, free weights, or machines) and swimming are effective ways to build and maintain strength in exercisers with MS, says Ashley Davis, C.P.T., a trainer with Marianjoy Rehabilitation Hospital in Wheaton, IL. The result? The ability to keep doing the things you love.
You’ll Improve Balance and Coordination
Ataxia, or a lack of voluntary muscle coordination, is common in people with MS and can manifest as unsteady walking, impaired movements, and tremor. Without exercise, these symptoms can worsen, explains Avram Fraint, M.D., a neurologist at Northwestern Medicine Lake Forest Hospital.
One study published in the journal Neurology found that people with MS who performed daily balance exercises—like single-leg stands and heel-to-toe walks—saw significant improvements in just six weeks.
Exercises that improve core strength, lower-back stability, and acts of daily living—such as lowering and raising from a chair—can also improve symptoms of ataxia in those with MS, according to research published in Disability and Rehabilitation.
You’ll Have More Energy
“Neurologic disorders can affect energy and endurance, and aerobic exercises can help combat these issues,” says Dr. Fraint, noting that fatigue can be disabling in those with MS, even outside of relapses or attacks.
One study on women with MS published in The Journal of Sports Medicine and Physical Fitness found those who performed aquatic exercise for 45 minutes three times per week improved their levels of fatigue, compared to women who stuck with their usual MS management strategies.
You’ll Protect Your Bones
Lack of regular physical activity in MS can cause both muscles and bones to weaken, significantly increasing the risk of osteoporosis, Dr. Segal says. Meanwhile, during an MS relapse, the body’s circulating levels of vitamin D can decline, further risking bone loss, according to research in the International Journal of General Medicine. The inflammation associated with MS—and long-term use of anti-inflammatory drugs like glucocorticoids—can also contribute to bone loss and the chances that, if you fall, you could break a bone, Dr. Segal says.
To improve bone strength and health, weight-bearing exercises such as walking, standing strength exercises, and yoga can be especially helpful, Davis says.
It Promotes a Healthy Weight
While corticosteroids can often help reduce the duration and severity of MS flare-ups, they can also contribute to weight gain by increasing appetite and potentially affecting metabolism and how the body stores and distributes fat, according to the Multiple Sclerosis Trust.
Regular exercise (at least 30 minutes of activity five days per week) can be one tool to help prevent or reverse weight gain, with potential effects on overall metabolic health, Dr. Segal says.
You’ll Boost Your Mood
Clinical depression is one of the most commonly felt symptoms of MS, possibly because the inflammation involved in the neurological disease can affect mental health, according to the National Multiple Sclerosis Society. What’s more, MS symptoms such as pain and spasms, fatigue and weakness, as well as bowel and urinary incontinence can be a strain on quality of life and mood, Dr. Segal says.
He explains that regular exercise may improve mental health not only by reducing the frequency and severity of symptoms, but also at a neurological level.
You’ll Have Better Bowel and Bladder Control
Aerobic exercise can help manage bowel and bladder incontinence in MS, according to the National Multiple Sclerosis Society. Meanwhile, research in the American Journal of Physical Medicine and Rehabilitation shows pelvic floor training, also known as kegel exercises, can improve symptoms of urinary incontinence in women with MS. One simple example: Sit in a comfortable position and visualize the muscles that can stop urine flow. Tighten these muscles as much as possible, then hold for three to five seconds.
While any physical therapist or trainer can get you started strengthening the muscles that control your bowel and bladder, a pelvic-floor physical therapist may be especially helpful here. Ask your doctor for a referral if interested.
You’ll Move Better and Feel Less Stiff
Muscle spasms in the legs as well as spasticity, or stiffness, in the arms and back are common in men and women with MS. This can be painful, restrict movement, and, over time, contribute to muscle disuse and degeneration. Fortunately, performing flexibility exercises can diminish, according to one 2017 BCM Neurology review.
For best results, focus on gently stretching your muscles through a full range of motion daily, Davis says. Stretching an already spastic muscle can result in further contraction and spasm, so if a muscle tenses in response to stretching, give it a few minutes to relax before returning to a gentle stretch.
Before You Begin an Exercise Program
It’s important to talk to your neurologist and potentially a physical therapist or certified trainer who is experienced working with MS patients before you start any new fitness routine. This will ensure you’re taking on forms of exercise that meet your needs and abilities, Davis says. And whichever type of activity your experts advise, always listen to your body, she adds, noting that an increase internal body temperature can temporarily worsen systems.
Take It Slow
“Think of an exercise routine as an experiment in action,” Davis says. “Take it slow, test a little bit at a time, and see how your body reacts. That information will let you know if you can push it more next time or if you need to back off the intensity.”
Showing up with cool water, sweat-wicking clothing, and a willingness to tweak your plans based on how you’re feeling in the moment can go a long way toward keeping you active and healthy.