Specialist neuro-physiotherapist Liz Betts offers some advice on staying fit when you have MS
There has been a dramatic change in attitude when it comes to exercise and MS. I trained as a physio in the 1970s and back then we were telling people not to exercise because there was a fear it might make symptoms like fatigue worse.
Now there is evidence to show that exercise does in fact help with the maintenance of MS symptoms: fatigue has actually improved when people are on an exercise programme, and it can also help with things like weakness, balance and spasticity. There’s the feel-good factor with it too, as the release of endorphins will improve your general wellbeing.
I try to give people the confidence to give exercise a go. It doesn’t have to mean going to the gym or going out for a run; it could be something as simple as housework or a walk. It’s all about making it easy; making it part of a daily routine.
“Try to make exercise part of your daily routine”
If you are in a wheelchair, while you are watching the TV you could use advert breaks to do some exercise: why not try some arm jogging while you are watching the meerkats? Or some balance work when you are putting the kettle on? Just a minute of arm jogging with a bit of gusto will improve heart rate and get you breathing deeper. There is growing evidence to show that doing short bursts of exercise, rather than one great long burst, will improve fitness, so for people with MS, when fatigue is a factor and heat can be a factor, exercising like this can really help.
If you want to get fit but are not sure how to get started, the exercises on the MS Trust website and the Move it for MS DVD with Mr Motivator are a good way to begin. My advice would be to start slow and start small - don’t think you’ll be like Kadeena Cox immediately! If you are physically able to, there’s no reason why you shouldn’t join the gym or a go to an exercise group: Pilates, Tai Chi and yoga are all really good for core strength and balance, but make sure you inform the instructor about your MS, as you might need to sit out the odd thing. If you haven’t done exercise for a very long time, it’s always best to speak to your GP first to check there aren’t any underlying problems.
I have seen many people with MS benefit from regular exercise over the years. One of the guys featured on the Move it for MS DVD has walking difficulties, but he still tries to exercise every day. He once said to me: “You get diagnosed with this and lots of doors shut to you, but lots of other doors open.”
Ann was diagnosed with relapsing remitting MS in June 2014, aged 51. To stay active, Ann attends a deep water exercise class
I had my first symptoms in September 2012 just before my 50th birthday. I had numbness in my neck which extended to my fingers and into my right leg. I went through a multitude of tests before diagnosis. Eventually MS was diagnosed.
I first experienced water exercise over 20 years ago when my children were small. After diagnosis I felt sure that exercising in the water would help my mobility so tried a shallow class, with my feet on the pool floor. This was great. I could keep up with the other class members and work with the support of the water. I didn’t have to worry about losing my balance or falling over. However, as soon as I left the pool I struggled to walk and didn’t feel safe driving. I changed to the deep class which I find suits my needs much better.
"I would encourage anyone to do a deep water class: it will leave you feeling invigorated, not exhausted and is a great social activity"
I can exercise for a full 45 minutes alongside folks of all ages and abilities. It is nice to feel on an equal basis with the other participants. The class is not specifically for those with MS and the exercises can be adapted to suit the individual, whatever issue they may have.
I work in an upright position in deep water wearing a floatation belt. As well as supporting you, the water takes away the gravitational effect on the body giving you a feeling of weightlessness. The buoyancy provides support for my weaker limbs and I find it much easier to work in water than on land. I have noticed an improvement in my balance and I am able to change direction as I walk without feeling quite so wobbly. Other people have commented that I seem to be moving with more confidence and I have recently started walking a mile a day to increase my fitness level and sense of wellbeing. I find I can only walk for 20 minutes before becoming decidedly wobbly, whereas I can keep moving for twice as long in the water. I’m not a heat lover and the water keeps me cool as I exercise, however hard I work.
I would encourage anyone to try a deep water class: it will leave you feeling invigorated, not exhausted and is a great social activity. The experience I have had has been very positive and the instructor recently shared the benefits of water exercise at an MS awareness day on the Isle of Wight: ‘We exercise in water to improve our function on land’. I think this sums up my experience beautifully!
Carol was diagnosed with MS in 2003. To stay active, Carol attends weekly Zumba and Pilates classes
I was diagnosed with MS in May 2003 following muscle weakness in my right side causing problems with mobility and fine motor skills. It is likely, however, that I had been experiencing symptoms since I was about 17: fatigue in afternoon classes and an episode of dysphasia where I knew what I wanted to say but could not get the correct words out.
I have not always been someone who enjoys exercise. When I was at university I was friends with people who were training to be PE teachers and they called me a physical illiterate as I have hopeless hand-eye co-ordination. Of course it may have been down to MS! In 2003, after my diagnosis, I decided that I needed to be fitter in order that I might hopefully recover from any subsequent relapse quickly. I started swimming as I could do that whilst my muscles were uneven and I believe it helped rebuild my strength.
"My advice to other people with MS looking to get fit would be to choose something you enjoy!"
A physiotherapist advised me to start Pilates to build up my core strength and I try to do this once a week. I believe it has helped with my balance and posture. I also enjoy Zumba. In my current class the teacher knows that I will do the low impact option; my aim is to keep moving for 45 minutes, not to do perfect moves!
My advice to other people with MS looking to get fit would be to choose something you enjoy! Don’t wait for someone else to go with you. My experience is that most people are friendly and everyone is more concerned with what they are doing to look at and judge other people. Do what you can and know your limits; it’s no good overdoing it and being unable to do anything later or the following day!
Coleen was diagnosed with MS last year. She takes part in yoga, pilates and PiYo classes to stay active.
I was diagnosed with MS in February 2016 following a severe breakdown in mobility and fine motoring skills. Following this diagnosis, I spent five weeks in hospital and soon realised that I needed to embrace an exercise regime to help me cope with the maintenance of MS symptoms, including fatigue. It was likely that I had been experiencing symptoms since I was in my late teens and I am 61 now!
I decided that I needed to be fitter and having had to retire from my job as principal of a pupil referral unit, I had time to put together an exercise plan. Yoga was my first port of call, and thanks to the help, support and knowledge of Caroline my instructor I quickly added Pilates to my regime. After 18 months of this I have added PiYo and spend most weekdays engaged in one of the above. I cannot praise Caroline and Jenny (my PiYo instructor) enough for their constant input.
"I am fitter, lighter and calmer"
My core strength, balance and posture have continued to improve. Other people in the group are aware of my diagnosis, and many have their own demons they are fighting through an exercise regime. Usually a coffee and a chat in the Health Club restaurant follows the class, giving us a blend of exercise and social relaxation that has such a positive and invigorating outcome.
All staff at the Health Club are friendly welcoming and professional. They are without any judgemental and challenging attitudes to members, regardless of their ability.
Fatigue is obviously a symptom that hits me but I believe I have more strategies and tools in my toolbox to deal more positively with MS. I am fitter, lighter, calmer and I hope better suited to be able to recover from future relapses.
Five top tips for staying active
- Don’t overdo it. Listen to your body when it tells you to stop.
- Everyone can feel lethargic in hot or humid weather, but with MS the effect is often exaggerated. Try using a fan or a cold water spray when exercising or have a cool bath before you start.
- Remember to breathe! It might sound obvious, but you’d be surprised by the number of people who hold their breath when they exercise.
- Have a trigger to remind you to exercise. Maybe when the adverts or weather come on the television, or when waiting for the kettle to boil.
- Choose an exercise that works for you. Everyone is individual and some people like to exercise in a group setting - in a class or as part of a team. Others like to work individually whether that is at the gym, swimming pool or at home.
You can find more advice on staying active and exercises to help improve balance, posture and strength, here.