Ready, Set, Go! How to Keep Kids With MS Active
The day Hannah Schnitzler, 17, noticed her legs tingling after a run, she brushed it off as tiredness from pushing her pace. That is, until the next day, when the high-school softball player, then 15, discovered her legs were completely numb. Two months later, doctors diagnosed her with pediatric multiple sclerosis (MS).
The good news for active kids like Schnitzler: It turns out that playing softball—or any sport—isn’t just possible with MS, it’s encouraged. Research shows that physical activity decreases fatigue and depression, improves MS symptoms, and reduces risk of relapse.
In fact, most kids with MS can fully participate in sports and other fitness activities with a little guidance from parents, teachers, and doctors on how to modify moves to accommodate energy levels and balance issues, says Kathleen Zackowski, Ph.D., an occupational therapist and Senior Director of Patient Management, Care, and Rehabilitation Research for the National MS Society. Looking for tips to keep your child active? Read on for expert-approved ways to get your kid jumping, kicking, and rolling.
Turn Your Den Into a Gym
After her diagnosis, Schnitzler upped her commitment to staying fit. Her workout of choice: A CrossFit-style routine she can do at home with minimal equipment, space, and time—after all, she’s a typical busy teenager! Counterintuitive though it may seem, exercise can actually help kids with MS alleviate exhaustion, says Lauren Krupp, M.D., a neurologist who treats children with MS at the Pediatric Multiple Sclerosis Center, part of Hassenfeld Children’s Hospital at NYU Langone.
Make It Fun
The No. 1 reason kids play sports? For fun, says a recent study in the Journal of Physical Activity and Health. Keep that in mind as you dream up ways to get your child moving, putting enjoyment ahead of skill when choosing an activity. “Most kids with MS are not going to want to go to the gym and do reps, they want to play a game,” says Zackowski. Start by capitalizing on kids’ love of electronics, she suggests. What child can resist picking up a Nintendo Switch controller and cutting loose to Bruno Mars?
Level the Playing Field
Once they've danced themselves silly, head for the pool. “Swimming is perfect because the buoyancy of water keeps you upright,” Zackowski says. “If a child has balance issues, they don’t have to be afraid of falling.” Water is also a great equalizer. In the pool, most kids with MS will be fine without special equipment or adaptations, while on land, braces or other devices might be needed for support. At an age where fitting in matters, water activities let kids be part of the group without calling attention to themselves.
Power Up With PT
A good physical therapist can boost your child’s enthusiasm for activity. Look for a PT who understands MS to assess your child for disease-related issues like balance and motor control, says Zackowski. Something as simple as the right orthotics or brace can make a huge difference in how comfortable your child is with exercise. Also, bring your child’s sneakers to the first appointment: Your PT can tell a lot about balance and gait from the wear pattern on the soles.
Work With Your Child’s Coach
Some MS flares cause temporary changes in vision due to inflammation of the optic nerve. If your kid is on a team, keep the coach in the loop about vision issues, says Zackowski. Kids who play softball or baseball probably won’t hit the ball the same way during relapses. If vision issues are persistent, it might be time to try a sport like running or swimming that relies less on hand-eye coordination. While tough to leave a sport they love in the short-term, it could be less frustrating in the long run.
Get to the Core of Things
They don’t need a six-pack, but kids with MS will benefit from a strong midsection, known as their “core,” says Zackowski. A strong core stabilizes the body, improves balance, and wards off problems with underdeveloped upper-body muscles—a symptom of MS. Along with traditional moves like sit ups, exercises like “the plank,” where your child gets down on all fours, then stretches out into a long line (back flat!) while resting on his toes and elbows, is great for developing core strength.
Stretching can help combat muscle spasms, another common symptom of MS (although slightly less common in kids than adults with the disease), says Dr. Krupp. Talk with your child (or coach) about the importance of spending five minutes stretching before and after exercise. Simple moves, like reaching down to touch his toes, or extending arms high overhead—first to one side, then the other—are good options. You can also help your child stay flexible by signing up for a weekly yoga practice together.
It's good advice for everyone, but especially important for children with MS, says Dr. Krupp. Heat can exacerbate symptoms, as can humidity. On top of that, some kids with MS find that their endurance (how long they can run for, say) is challenged. Both issues can be solved by taking short breaks during an activity and keeping cool: Strap a frozen water bottle to their back, try a cooling vest, and move exercise indoors if the summer heat is too much, Krupp says.
Stick With the Plan
As for Schnitzler, she has no plans to slow down anytime soon. Sure, she’s had her low points and temptations to quit, but focusing on being fit and strong keeps her going. “You need to plan out your goals, so you won’t be lost when it comes to accomplishing them,” she says. Parents, coaches, PTs, and doctors all play an important role in encouraging kids to hang tough during relapses and other trying moments. “I gain energy and confidence from having goals,” says Schnitzler. “It makes me feel better about myself.”
Pediatric MS and Risk Factors: Children. (2018). “A Scoping Review of Modifiable Risk Factors in Pediatric Onset Multiple Sclerosis: Building for the Future.” mdpi.com/2227-9067/5/11/146/htm
Pediatric MS and Exercise: Neurology. (2015). “Lower Physical Activity Is Associated with Higher Disease Burden in Pediatric Multiple Sclerosis.” n.neurology.org/content/85/19/1663.short
Exercise and Fun: Journal of Physical Activity & Health. (2014). “The Fun Integration Theory: Towards Sustaining Children and Adolescents Sport Participation.” journals.humankinetics.com/view/journals/jpah/12/3/article-p424.xml