If you have multiple sclerosis (MS), simply getting through the day may feel like an uphill climb. Working out may be very low on your list of priorities. Yet, fitting in some exercise — when you feel up for it — can actually help improve symptoms and slow down the condition's progression.
How MS Affects Movement
MS causes inflammation in the central nervous system, which damages the protective coating that covers nerve cells (called the myelin sheath) and allows them to send signals effortlessly. This ongoing damage ultimately slows down the messages from your brain and spinal cord that instruct your muscles how to move.
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"As a result, you may experience weakness, pain and impaired sensation, where you can't feel where your joints are in space," Abby McKeown, DPT, physical therapist at Rush University Medical Center, tells LIVESTRONG.com. "You might also have visual changes such as double vision, trouble with coordination, balance issues and fatigue."
The Benefits of Exercise for MS
When you're exhausted, dizzy and wobbly, exercise is probably the last thing you feel like doing — but it can actually improve your symptoms for the long haul. (Although you may want to consider exercising with a workout buddy for safety's sake.)
"Research shows a correlation between increased aerobic capacity and preservation of the central nervous system structures that are disabled during MS," McKeown says. "Exercise can't necessarily reverse the damage that has already occurred, but it can slow the progression of the disease and has been shown to [help protect] the structures that are still intact."
For example, a May 2015 study in Therapeutic Advances in Neurological Disorders found that physical activity helps with symptoms of MS and prevents complications. "Exercise can decrease depression and increase quality of life, muscle strength, balance, aerobic capacity and cardio function," McKeown says.
On top of that, a March 2020 review in BMC Neurology revealed that physical activity significantly reduces fatigue associated with MS.
With all of that in mind, we asked McKeown to share a short-and-sweet at-home workout for people with MS.
Talk to your doctor before beginning any new workout program if you have MS. They can help you determine if these exercises below or any others are appropriate and helpful for you, depending on where you are in the course of the condition.
Try This 10-Minute Workout
For this sequence, McKeown selected exercises that strengthen the quads, glutes and core. "Keeping these muscles [strong] is important because they are necessary for performing functional daily activities, like standing up out of a chair and climbing stairs," she says.
People with MS should aim to do resistance training 2 to 3 days per week, each time doing 5 to 10 exercises and performing 1to 3 sets of 8 to 15 repetitions of each exercise, according to July 2020 research in the American Journal of Physical Medicine & Rehabilitation. You want to choose a weight that allows you to finish that last set comfortably — the goal is to get in a good pump, but not completely exhaust yourself.
If two to three workouts a week feels overwhelming, don't worry: Even just a little physical activity helps, according to the Mayo Clinic. This brief body-weight workout is a great place to start. If you're feeling good, you can also supplement it with a short walk, McKeown says.
“Monitor how your body responds to the exercise and how fatigued you feel,” McKeown says. “Remember that while temporary increased fatigue is a normal response to exercise, it should improve over the next few hours — and over time, controlled exercise might actually increase your energy.”
Depending on how you respond (and your doctor's guidance), consider doing fewer reps or sets, doing only some of the following exercises or spreading them throughout the day.
"This is a great exercise to start with because it engages a lot of muscle groups — glutes, quads, core — in one action," McKeown says.
- Lie on your back with your knees bent and your arms next to you, palms facing down.
- Engage your core and squeeze your glutes as you lift your hips up off the floor until they are in line with your knees, parallel to the ground.
- Slowly lower back down.
- Optional: Hold the pose for 5 to 10 seconds at the top.
- Do 2 sets of 10 to 15 reps.
“For more challenge, cross your arms over your chest,” McKeown says.
2. Straight-Leg Raise
This targets the deep core muscles, which work to stabilize the spine and keep the back safe and healthy, as well as the quads, McKeown says. You use both of these muscle groups in everyday activities.
- Lie on your back with one knee bent at 45 degrees, with your foot flat on the floor.
- Extend the opposite leg straight out, toes pointed up to the ceiling. Contract your core as you lift your leg up off the floor until it’s even with your opposite thigh.
- Slowly lower back down.
- Do 2 sets of 10 on each leg, alternating legs in between sets.
“Try to keep your knee as straight as you can while lifting your leg to engage your quads even more,” McKeown says.
"People with MS may find it harder and harder to perform activities such as getting off the toilet or bending down to pick something up," McKeown says. Squats support the muscles involved in these everyday, functional movements.
- Stand in front of a stable surface or heavy piece of furniture that won’t move (think: kitchen counter, dining table, bathroom sink).
- Position your feet shoulder-width apart or slightly wider, toes pointed forward. Keep your fingertips on the surface for balance, but don’t load your weight on them.
- Bend your knees and lower your hips, as though you were going to sit in a chair.
- Lower as deeply as you can without your heels popping off the floor (but no lower than chair height), and then stand back up.
- Do 2 sets of 15 reps.
“Avoid the most common mistake people make when doing squats: bending your knees in front of your toes,” McKeown says. “Your knees should stay behind your toes." Focusing on sitting backwards like you're lowering onto a seat will help you get this right.
"I love this functional exercise for MS because it translates into day-to-day life," McKeown says. "As people get more fatigued, stairs can become daunting." This move is designed to keep you feeling strong.
- Head to a stairwell and place your hand lightly on the railing for balance and safety. Put one foot on the step above.
- Step up with your other foot to meet it, squeezing your butt as you step up.
- Then step down with the opposite foot, straightening your knee as you step down.
- Do 15 reps on one leg, then switch and do 15 more with the other leg.
5. Single-Leg Standing
"Single-leg balance is important if you have to step over or around something. Even walking involves repetitive single-leg standing," McKeown says. "In addition, this exercise works everything up the chain: ankles, knees, hip extensors and core."
Balance exercises like single-leg standing are also essential because they target slow-twitch muscle fibers. "Slow-twitch muscle fibers are involved in endurance exercise and prolonged contractions," McKeown says. "The other exercises in this routine rely on fast-twitch muscle fibers, which are used during explosive movements, like stepping up a stair or lifting your child."
- Rest your fingertips on a stable surface, like a counter.
- Lift one leg a few inches behind you, knee bent just enough that your toes aren’t touching the floor.
- See how long you can stand on one foot. “Aim for 30 seconds, and then work up to 60 seconds or more,” McKeown says. “For an added challenge, hover your fingers slightly above the surface.”
- Do 3 to 5 reps on each side, alternating sides.
This is an easy exercise to incorporate throughout the day. “Try to keep your leg lifted while brushing your teeth or during an entire commercial when watching TV,” McKeown says.
6. Quadruped Leg Lift
"You get a lot of bang for your buck with quadruped because it incorporates many muscle groups [and] involves a lot of core stabilization, which is especially helpful for MS," McKeown says. "Many of the deficits you see, including muscle weakness and balance impairments, start with your core — if your core is weak, it is harder for your limbs to function properly."
- Start in an all-fours position, with your hands directly under your shoulders and knees under your hips. Your back should be flat, like a tabletop.
- Engage your abs and then lift one leg and kick it straight back so that your knee and toes are pointed down and your leg is parallel to the floor.
- Do 2 sets of 15 reps, alternating legs.
If this is too challenging, start with just 10 reps or 1 set.
If you're looking for more of a challenge, add a balance component by extending the opposite arm straight forward when you extend your leg, McKeown says.
- Therapeutic Advances in Neurological Disorders : "Exercise in the management of persons with multiple sclerosis"
- BMC Neurology: "The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis"
- American Journal of Physical Medicine & Rehabilitation: "Exercise training guidelines for multiple sclerosis, stroke, and Parkinson’s disease: Rapid review and synthesis"
- Mayo Clinic: "Exercise and multiple sclerosis"