In the past, people with multiple sclerosis were advised to avoid exertion. Since many people with MS experienced fatigue and found their symptoms worsened when hot, it was thought best to avoid tiring activities.
It turns out that this was not good advice. Regular, moderate exercise is now known to be an important part of maintaining good health and wellbeing for people with MS. There is evidence that it can help with many MS symptoms, and also with general quality of life.
Before you begin an exercise programme, you might like to read our pages on choosing the right exercise for you and things to think about before starting to exercise.
Many studies have looked at the benefits of different kinds of exercise for people with MS. It can be hard to compare these studies, but they have generally shown exercise to be valuable for people with MS.
Moderate exercise has been shown to improve strength, mobility and bowel and bladder function for people with mild to moderate MS. Exercise is also helpful in helping maintain a healthy weight. This reduces your chances of acquiring co-morbidities, and can also reduce the impact of some MS symptoms, such as pain and fatigue.
Exercising is good for the mind and brain, not just the body. In general, exercise has been found to be neuroprotective, to improve symptoms of depression, improve cognitive processing speed, visuospatial memory, executive function and cognitive flexibility. These boosts can last for several days after exercising.
Aerobic exercises are dynamic exercises where you raise your heart rate by moving quickly. This might mean running, dancing or playing a team sport like football or netball.
Aerobic exercise is particularly good for cardiovascular health. Moderate intensity aerobic exercise has been shown to quickly improve your blood pressure and proportion of healthy fats in the blood. It also reduces the amount of fat stored in the body, and can help with weight loss.
Depending on the type of exercise, aerobic activity has been shown to improve the aerobic capacity, functional mobility, visuospatial memory, brain volume, fatigue, and quality of life of people with MS.
Dynamic workouts can also help improve your balance and co-ordination. There can be further benefits in that the deeper breathing that you do with this kind of activity can also strengthen your core muscles and posture. Aerobic exercise improves walking ability, particularly in conjunction with resistance training to strengthen the legs.
The good news is that you don't need hours of aerobic exercise to see results. High Intensity Interval Training, or HIIT, involves aerobic training in very short bursts, and is as effective in fitness and weight loss as other aerobic exercising. The theory is that you exercise as hard as you can for four four minutes, take a short break and repeat several times, focusing on a different exercise each time. For people with MS, exercising in short bursts may help you to avoid overheating. Shorter workouts are also easier to fit into busy lives.
Try to maintain regular aerobic activity, as the positive benefits reduce soon after you cease exercising.
Strength training, also known as progressive resistance training, might involve exercises where you aim to build and strengthen your muscles. You might lift weights, use your body weight to work against (such as sit-ups or push-ups), or pull against an elastic band.
Moderate strength training exercise helps with balance and posture, and also helps combat fatigue. If you do not use your muscles regularly, they become weakened and then require more energy to carry out tasks. This can lead to a cycle of decline, as an already weak muscle that is not used will become weakened further, a process known as atrophy.
Strength training improves general fatigue, cognitive fatigue, and also increases the connectivity between brain regions in people with MS. It is thought that increased brain connectivity may protect against fatigue and future cognitive decline.
The positive effects of resistance training last for several weeks after stopping.
Endurance training is training the aerobic system, improving your cardiovascular resilience and also making muscles more efficient. It would involve regular, steady aerobic exercise, such as cycling, swimming or jogging. You would typically start with shorter distances and time spent exercising, and build up to longer periods of exercise.
Over time, endurance training improves your ability to recover from exertion, although take care not to over-exert yourself too quickly.
Endurance training has been shown to provide benefits in walking ability in people with MS. When people with MS were studied doing a combination of endurance training and leg resistance training they found improvements in mobility, balance and co-ordination.
As with other forms of exercise, stopping endurance training generally results in the benefit being lost over time.