Exercise Safety with Multiple Sclerosis

Multiple Sclerosis (MS) is a disease of the central nervous system. This system is comprised of the brain and spinal cord and, when it is compromised, it can be disabling. Essentially what happens is that the immune system attacks the protective covering on nerve fibers which disrupts the communication between the brain and the rest of the body. The affected nerves will vary from person to person, so not all people with MS will exhibit all of the same symptoms.¹  

The most impacted function with Multiple Sclerosis is movement. Numbness or weakness in the limbs, tremors, and an unsteady gait are among the most recognizable symptoms. Vision, speech, sexual, bowel, and bladder problems are also known to occur.¹

Muscle weakness, balance and coordination problems, dizziness, and difficulty breathing can make exercise a significant chore for people with Multiple Sclerosis. However, activity is still very important. Common MS treatments and inactivity can render people with this disease more susceptible to developing osteoporosis, which can make balance and coordination issues an even greater concern. This can be prevented or slowed, however, through physical activity and proper nutrition.²  

A 2004 study found that, even though cases of MS vary across patients, exercise programs designed to increase cardiorespiratory fitness, muscle strength, and mobility can enhance a patient’s quality of life while also reducing the risk of secondary disorders.³ However, it’s important to adhere to exercises that are safe.  

A publication by BMC Neurology identifies a number of practical and beneficial exercises for patients with MS. An important preface to their findings is that each exercise program should be designed to address a patient’s specific goal and should take into account a person’s baseline impairments and capabilities. Only a healthcare professional can provide the appropriate fitness routine for your needs, but generally, these aspects of training are known to hold benefits for patients with MS: 
  

1. Aerobic Training: Low to moderate intensity aerobic training is effective on cardiovascular fitness, mood, reduction of fatigue, and overall quality of life. Examples include bicycling, aquatic exercise, and treadmill walking. Rowing and running are also potential options but only for patients with proper functioning.⁴
    
2. Strength Exercises: For MS patients, supervised resistance training is safer than unsupervised training, and the use of weight-machines is safer than the use of free-weights. It is also important to prioritize the lower body because that is where the strength deficit is usually greater. Examples of strength exercises include the seated leg press, seated hamstring curls, knee extensions, shoulder press, chest press, and lat pull-downs. As a note, seated exercises are the safer option when compared to standing exercises.⁴
    
3. Flexibility Exercises: These types of exercises are important to enhance mobility and improve balance and posture. Slow, gentle, and prolonged stretching is recommended before and after exercise with a particular focus on spastic muscles (tight or stiff muscles). Yoga and tai chi classes may be options for patients with higher functioning.⁴
    
4. Balance and Coordination Exercises: Exercises that challenge balance can be very helpful. It is important that a stable support is available or that patients exercise in water. Water exercises provide support that help protect participants from dangerous falls.⁴