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Exercise and MS

Regular exercise is important for everyone, but it’s also helpful in managing some of the symptoms of multiple sclerosis (MS).

In the past, MS patients were advised not to exercise out of concern that it might worsen their symptoms. However, more recent research into the potential benefits of exercise for people with MS shows that those who get regular aerobic exercise (i.e. exercise that causes a raised pulse rate) are not only fitter and stronger, but also have better bladder and bowel function, less fatigue and depression, and a more active social life.

Medical scientists now think that exercise can, with respect to MS:

- Improve the general health of people with milder MS.
- Help people with more severe MS to stay more mobile.

- Help manage some MS symptoms (see below).
- Improve muscle strength and fitness.
- Help maintain goal weight.
- Help protect the brain and maintain cognitive ability. There is strong evidence that aerobic fitness has a protective effect against MS. A 2010 study published in the journal Brain Research found that brain scans of fitter MS patients showed less damage in parts of the brain that show deterioration from MS.

How exercise can improve MS symptoms

- As exercise improves strength and fitness, it often helps alleviate fatigue.
- Exercise is proven to help lift mood and fight anxiety and depression.
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Physiotherapy, walking and aerobics can help improve balance and walking.
- Physiotherapy, including stretching and range-of-motion exercises, is fundamental to treating and managing muscle spasms and stiffness.
- A continence advisor, MS nurse or physiotherapist can assist with pelvic floor exercises for bladder control. Research suggests that regular exercise may also help with bowel control.

Types of exercise for MS patients 
MS affects people in different ways, so what is appropriate varies among individuals. Exercising doesn’t necessarily mean playing a sport; it also includes such activities as walking on the beach and gardening – to name just a couple of examples. Find an exercise you enjoy – you will be more likely to stick with it.

Exercises might include:

- Strengthening, e.g. gentle work with weights.
- Aerobic, e.g. cycling, swimming, hiking.
- Stretching (this helps keep muscles supple and relaxed).
- Range-of-motion exercises, e.g. moving arms, legs, wrists and ankles in wide circular motions.
- Passive stretching (where a physiotherapist or carer helps to move your limbs).
- Posture exercises (these help keep your body correctly aligned to reduce strain on muscles and joints).

Getting started
If you haven’t exercised for some time, or plan to increase the amount of exercise you’ve been doing, speak to your doctor first.

Consider consulting a physical therapist or physiotherapist, preferably one with experience in MS, about designing an appropriate programme for you.

Also:
- Start to gradually accustom your body to a new activity.
- Include an initial warm-up and some gentle stretches.
- Also include a cool-down period after your exercise session to help avoid muscle stiffness.

Any exercise programme should ideally be tailored to the individual in terms of their physical condition and medical history, and this is especially true for someone with MS. As the disease progresses, and changes in symptoms and capabilities are experienced, the exercise regime should be adjusted accordingly.

Although there’s no evidence that exercise worsens MS (on the contrary) or that it causes relapses, it’s not advisable to start or continue exercising during a relapse. Always get your doctor’s go-ahead before getting back into your routine again after a relapse.

MS, heat and exercising
Many people with MS are sensitive to heat. If you find that you are, then follow these suggestions for staying cool while exercising:

- Plan exercise periods to avoid the hotter parts of the day, and monitor yourself while exercising to avoid over-exertion.
- Avoid heated swimming pools.  

- Break exercise sessions into shorter bouts, with regular breaks.
- Try taking a cool bath before exercising. This may allow you to exercise comfortably for longer. Have a stock of cold drinks available while exercising, and sip on these at intervals.
- Ensure indoor exercise venues are well ventilated: make use of open doors and windows, through-drafts, and fans.


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