Debunking 3 Myths about Exercising with Multiple Sclerosis

This week (3/9/2020 - 3/13/2020) is Multiple Sclerosis Awareness Week.  Here at Premier Physical Therapy we regularly provide treatment and ongoing rehabilitation to patients with multiple sclerosis.  When it comes to MS, there are some common misconceptions in regards to exercising. We want to address three of them today! The overall misconception is that exercise should be avoided in those diagnosed with multiple sclerosis. However, exercising actually provides many health benefits and can improve symptoms. Here are the myths, and our answers, about exercising and living with multiple sclerosis.

1.      Exercise leads to increased fatigue

a.       Historically, it was believed that exercising with MS will lead to more fatigue. However, research shows that the opposite is true. A study concluded that those with MS who adhered to an individualized exercise program were actually able to lower their levels of fatigue. When performing cardiovascular exercise, such as the recumbent bike or the elliptical, working up to 30 minutes of exercise would be beneficial. In order to reach a full 30 minutes, starting out small is best, which means 5 minutes of cardiovascular exercise at a time. Before you know it, you’ll be able to do more than you thought possible!

b.      It is important to remember the 2-hour rule after exercising. If you have not fully recovered to your normal energy level in less than 2 hours after exercise, you have done too much. Exercise should be modified to make sure you can recover from fatigue in less than 2 hours. Your workload should be increased gradually, making sure to adhere to this rule. Long term, research demonstrates that fatigue levels decrease with consistent exercise!

2.      People with MS should not strengthen their muscles

a.       Exercises to strengthen muscles are important to allow a person to function more independently and to improve quality of life! The Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis suggest that those with a mild to moderate disability should do strength training for large muscle groups twice a week.

b.      Keep in mind that overexertion or performing exercises incorrectly can lead to excessive fatigue. A good rule of thumb is to do 4 sets of 4 repetitions of each exercise with rest breaks to avoid unnecessary fatigue.  Choosing a moderate to heavy weight for you, (85% of a 1 rep-maximum,) is safe to do and will allow for gains in strength. Overall, strength training is encouraged for those with MS and effective at improving functional mobility.

3.      Exercising will make symptoms worse

a.       Exercising mindfully will not lead to a worsening of MS symptoms! Instead it has the ability to improve symptoms and other physical limitations. A study found that moderate-intensity exercise, over a period of time, can improve standing balance and the ability to have a more normal walking pattern. These two outcomes, combined, indicate a decreased risk of falling.

b.      So let’s say you’re convinced now, and you’re looking for activities to get you moving…swimming and yoga are two safe forms of exercise. Swimming allows for movement to be performed easily without falling, and the cool water helps to prevent overheating. Yoga can improve strength, flexibility and balance, lower stress, and aid in reducing spasticity.

We hope we’ve convinced you that exercise and physical activity promote community independence, general health, and daily function in those with MS. If you’re looking for some further guidance, our staff here at Premier are well trained to treat multiple sclerosis. We would love to walk you through exercises to manage symptoms and to work towards living a more independent lifestyle!

Resources:

Karissa L. Canning and Audrey L. Hicks (2020) Benefits of Adhering to the Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis Beyond Aerobic Fitness and Strength. International Journal of MS Care: January/February 2020, Vol. 22, No. 1, pp. 15-21.

Susan L. Kasser, Jesse V. Jacobs, Jeremy Sibold, Avery Marcus, and Laurel Cole (2020) Using Body-Worn Sensors to Detect Changes in Balance and Mobility After Acute Aerobic Exercise in Adults with Multiple Sclerosis. International Journal of MS Care: January/February 2020, Vol. 22, No. 1, pp. 1-6.

Herb I. Karpatkin, Evan T. Cohen, Sarah Klein, David Park, Charles Wright, and Michael Zervas (2016) The Effect of Maximal Strength Training on Strength, Walking, and Balance in People with Multiple Sclerosis: A Pilot Study. Multiple Sclerosis International: Volume 2016.

Nancy Holland and June Halper. Multiple Sclerosis: A Self-Care Guide to Wellness, 2nd Ed. 2005.