MS and exercise: part three - a Q&A with physiotherapist, Henriette

Henriette Poulsen is a physiotherapist who spent ten years working at an MS therapy centre, before returning home to her native Denmark. Henriette has been answering some common questions about exercise and MS for us, but you can also find more information on her blog MS ideas and exercise.

There is growing evidence that being outside has a positive effect on our health. Therefore, there are all sorts of reasons to find ways to be active outdoors. You could try a hobby such as weeding your raised beds or something more traditionally exercise-related.

If you want to try outdoor exercise, I would recommend that you do it with at least one other person. Don´t forget to take some water, your mobile phone (if you have one) and put on layers of clothing so you can easily adapt to the temperature.

You will also need to do some research before you get started. Look for areas with plenty of shade from the sun in summer months as MS symptoms can get worse if you feel too hot. Investigate the area for any fall risks and make sure there are places you can take breaks. Are there benches available? How far is it between them? Check out what toilet facilities are available. Is there disabled parking? How far is it from the car to your chosen area? You don’t want to feel fatigued before you even start the exercise. How uneven is the ground? Do you need a walking aid?

Depending on your mobility, you could even use nature to help with parts of your exercise. A tree, for example, can be used as a support, and leant upon if you need a little rest. 

Always remember to keep safety in mind. We often tend to rush when completing an exercise routine but when it comes to outdoor exercise, I would encourage you to slow down. Make use of your senses. During stretching, why not pay attention to the plants/trees and notice the sounds around you? Take a deep breath and look up at the treetops while holding the stretch. Be present. 

If you require a lot of concentration when exercising, you may need to focus only on the activity and not so much on what is going on around you. In that case, you could use short breaks as an opportunity to take in your surroundings.

This is likely due to a rise in body temperature. Consider what clothes you wear and opt for breathable materials and layered clothing. You could experiment with putting your exercise clothes in the freezer beforehand, so they are cold for a little while when you exercise. 

If you run indoors, try and do it in a well-ventilated room. Outside, you can take advantage of shady areas if it’s hot and avoid running in the middle of the day when it is warmest. 

Experiment with intervals by alternating between walking and running. It can be a little scary to experience your symptoms becoming worse, but this is usually short-term and can be common in people with MS. 

Most importantly, remember to get enough to drink and take regular breaks.

It’s easy to become engrossed in unhelpful thoughts and worries, especially at the moment.

In general, many people find that a walk outside in green spaces helps with their state of mind. You could also try different types of exercise that involve both body and mind, such as Pilates and yoga, to see if they help with your mental health. The pace is a little slower, and the exercises require concentration on what you are doing rather than what else is going on in your life. The focus on breathing can be de-stressing in itself for some people.

• MS and exercise: part one - a Q&A with physiotherapist, Henriette
• MS and exercise: part two - a Q&A with physiotherapist, Henriette
• MS and exercise: part four - a Q&A with physiotherapist, Henriette
• MS ideas and exercise - Henriette's latest blog post