6 Tips for Exercising With Multiple Sclerosis, According to Experts

For decades, people with multiple sclerosis (MS) were advised to avoid too much physical activity because it was believed that exercise exacerbated their symptoms, according to Barbara Giesser, MD, a neurologist at Pacific Neuroscience Institute at Providence Saint John's Health Center in California, who's been working with people with MS for 40 years.

"This recommendation may have stemmed from the observation that most people with MS may temporarily have exaggerated symptoms when they become overheated, as might happen with vigorous physical exertion," she tells LIVESTRONG.com. "It's now becoming clear that this advice was not only incorrect, but likely had potentially harmful consequences, because it contributed to issues like metabolic syndrome and osteoporosis, just to name a few."

Fortunately, times have changed — and so has that advice, she says. There's now abundant data showing exercise can actually alleviate some symptoms, prevent complications and possibly help slow the disease's progression.

However, some guardrails still need to be in place for exercise to be safe and beneficial if you have MS, a disease that affects your brain and spinal cord. Here are the strategies recommended by experts.

The observation that heat can worsen symptoms still holds true, but rather than avoid exercise completely, it's much better to plan workouts based on keeping your body temperature managed, according to William Kelley, DPT, CSCS, owner of Aries Physical Therapy in Florida.

"You want to do everything you can to prevent overheating," he tells LIVESTRONG.com. "That means frequent hydration with cold water, keeping the room cool, possibly wearing a cooling vest and standing in front of a fan."

Once that aspect is handled, those with MS can follow an individualized training routine and even do vigorous exercise as long as they ramp up their workouts gradually and stay at a comfortable temperature, he says.

Another way to keep cool is to make workouts much more efficient, Kelley says. Because of this, he prefers a focus on compound movements (working multiple muscle groups at once) over isolation exercises (working only one muscle group). That can incorporate not just strength but also balance and mobility work.

"It's all about getting the most you can out of every minute of that workout," he says. "Because you want to limit overheating, you need to get more out of each rep or exercise within a limited time window, so it helps to plan that in advance."

If you're keen to do a longer gym session or training regimen, that can be also be achieved by taking more and longer breaks, he adds. Another tactic is to build "exercise snacks" into the day, adds Vickie Hadge, 56, who's been living with MS since 2007. She tries to get up and move at least once an hour, even if it means just walking around the house to increase her step count.

"When I move more frequently during the day, I find that I'm less stiff, and it also improves my mood," she tells LIVESTRONG.com. "It's even better if I can get outside, because fresh air and sunshine always make me feel better as I move."

As part of her MS, Hadge developed spasticity on her left side. Up to 90 percent of people with MS will experience this symptom at some point in their lives, according to Multiple Sclerosis Trust. Spasticity is when muscles become stiff and difficult to move, which can impair mobility. To counteract that, she does gentle stretches for 15 minutes each morning and each evening.

"If I'm consistent and don't skip a stretching session, my spasticity is better controlled," she says. "I'm more flexible, my balance is better and I find it even helps me sleep better."

For those with MS, progress should be even more gradual than it would be for those without the condition, so the body can get used to higher intensity without overheating, says Rocky Snyder, CSCS, trainer and author of the strength guide ‌Return to Center.‌

Keeping a training journal that includes not just exercises but also post-workout effects — good and bad — can help you progress at the right pace.

"It's essential to keep track of how your body responds following the workout routine," he tells LIVESTRONG.com. "How did it feel for the rest of the day and the following day or two after? Provided there is minimal soreness and energy levels have not diminished, the intensity level is appropriate."

Many people with MS find workouts in a pool helpful because it can improve balance and mobility, while keeping body temperature under control, Hadge says.

"The water gently pushes back on us when we start to lose our balance," she says. "The buoyancy can help make movement easier, and the water is great for keeping us cool."

For everyone, the nervous system likes change and stimulation, Snyder says — and considering that MS affects the central nervous system, it's particularly important for those with the condition to support that system.

"Performing novel movements is one way to make this happen," he says. "Break away from the traditional, robotic mechanics you find in a traditional strength training routine and do something fun and different. Try tai chi, yoga, dancing, maybe even learn to juggle. Challenge the nervous system, because that's what can condition it to slow down the advance of your symptoms."

Many types of exercise can be adapted, adds Eve Simon, 53, who was diagnosed with MS in 2009. Because she has relapsing remitting MS — which involves symptoms becoming more intense and then lessening — she's dealt with periodic mobility concerns and finds that private sessions with trainers familiar with MS are very helpful. She's especially fond of adapted yoga that can be done in a chair, and mat Pilates that helps her with core strength for better stability.

"The best approach is to adapt to where you are today, because MS can be different every day," she says. "The main thing is just to keep moving in meaningful ways."