FREQUENTLY ASKED QUESTIONS
DOES EXERCISE HELP PEOPLE WITH MULTIPLE SCLEROSIS (MS)?
It has been found that complications from inactivity can exacerbate the symptoms of MS. Although exercise is not a cure for MS, it can help prevent further complications and help with some of your symptoms, while helping you to retain fitness, muscle strength, flexibility and balance. However, you should only exercise within your own limits, which may vary from day to day. For instance, if you are having a relapse you shouldn’t try to carry on exercising until after your symptoms have ‘levelled out’, you have completed any steroid treatment and spoken to your research physiotherapist.
HOW WILL THE PRESCRIBED EXERCISES I DO HELP ME?
As well as improving your general health, exercise and physiotherapy may help with specific MS symptoms. The exercises prescribed in your individualised programme by your research physiotherapist will have been specifically given to you for your symptoms.
Fatigue is one of the most common problems for people with MS. It seems to almost go against common sense to exert yourself if you have fatigue. But exercise can bring improvements in strength, fitness and mood – all of which might help you to manage your fatigue. However, it is important to balance exercise with rest and to keep cool while you exercise, especially if you find that getting hot during exercise makes fatigue worse. Good posture can also help your body to work more efficiently, causing less strain and using less energy. This too may help with managing fatigue. For more information on exercise and fatigue please visit http://www.mstrust.org.uk/information/exercises/fatigue.jsp.
People with MS often find balance is a problem, and there can be a number of reasons for this. Changes in sensation, vision problems and MS-related damage in the brain or spinal cord can affect someone’s balance. This can cause problems with walking, as can a loss of strength in the legs, muscle stiffness and spasms. Carefully designed physiotherapy programmes can help people improve your balance and ability to walk. These programmes could concentrate on a combination of stretching, strengthening and postural exercises.
Muscle spasms and stiffness affect almost 50% of people with MS, though the effects vary from person to person. Physiotherapy, including stretching and range-of-motion exercises, is a key part of treating and managing these symptoms.
MS can affect your emotions as well as your body. If issues such as low mood, anxiety or depression do arise, exercise may help. Regular aerobic exercise has been shown to be beneficial in relieving mild to moderate depression.
WHAT SHOULD I DO IF I GET OVERHEATED?
Some people with MS are sensitive to heat, which means they notice that their symptoms temporarily either reappear or become worse when their body heat rises. This can happen when you exercise. Below are some tips to avoid overheating.
- Break up exercise sessions into smaller sections with regular breaks.
- In the summer, don't exercise during the warmest time of the day (10 a.m. to 2 p.m.). Try to exercise in the morning or evening if you are exercising outside.
- Exercise in a ventilated room, eg open a window, door or use a fan.
- Pace yourself. Become aware of your body. If you notice any symptoms that you didn't have before you began exercising, then slow down or stop exercising until you cool down.
- Drink plenty of cool fluids.
- Wear loose clothing.
WHAT IF I THINK THE EXERCISES ARE TOO DIFFICULT OR TOO EASY FOR ME?
Exercise can help ease the symptoms of MS, but it's important to take certain precautions if you want your exercise programme to be successful. The most important thing to remember is not to overdo it. You may have heard the sayings "no pain, no gain" or "feel the burn," but those approaches are counterproductive for people with MS. If you overdo it you can end up straining an already compromised muscular system, increasing pain and causing your body and mind to become overstressed, overworked, and overtired. Likewise, your exercises shouldn’t be too easy. If you think that the exercises you have been given are too difficult or too easy for you please contact your research physiotherapist who will be able to help.
HOW CAN I FIT EXERCISE INTO MY LIFE?
To be effective, exercise needs to be a regular part of your life so that it becomes part of your routine. To help you make your exercise programme part of your daily routine you should think about the best time of the day for you to exercise, and how your symptoms vary through the day, and aim to set aside a time to do your exercises.
WHAT IF I STOP DOING THE EXERCISE PROGRAMME FOR A FEW DAYS BEFORE IT IS DUE TO FINISH?
The symptoms of MS can change from day to day as well as over longer periods of time. If you notice any symptoms changing, or if new symptoms appear, you may need to adjust how much you do. For example, if you have a week or two where fatigue is worse than normal, you may decide to rest a little more and exercise a little less – to conserve energy for other tasks.
There may be times when you do not feel able to exercise, or when it would be wise to do less than usual. If you experience a relapse you should not try to carry on exercising until after symptoms have ‘levelled out’ and you have completed any steroid treatment. After your relapse your research physiotherapist can adjust your exercises and help you get back into a routine again.
Remember that there may also be reasons quite separate from your MS that stop you from exercising; for example, if you catch a cold or a urinary tract infection, or have a relapse. It is often a good idea to rest and recover from an illness rather than push yourself too hard. Whatever your reasons for taking a break from exercise, remember to start again and build up slowly. If you need to, set yourself lower targets to begin with, pace yourself and build up gradually to a level you can manage realistically. If you have stopped your exercise programme for any reason it is important to contact your research physiotherapist to let them know and to plan your return to your programme.
For further information on managing your MS please visit http://www.mstrust.org.uk/information/publications/msandme/.