If you have multiple sclerosis, physical exercise can be an important part of your treatment. But don’t let that word — exercise — put you off.

Published: April 19, 2021 | Updated: March 14, 2022

If you have multiple sclerosis, physical exercise can be an important part of your treatment. But don’t let that word — exercise — put you off.

Everyone should be getting exercise, regardless of your disability level. How much exercise or what type will vary, but the message here is that everyone should be exercising.

The National Multiple Sclerosis Society, which partnered with the Norton Neuroscience Institute Resource Center for presentations in the MS track of the Neuroscience Expo, recommends all people with MS complete at least 150 minutes of exercise or physical activity each week. You can break it down however you’d like as one long activity or multiple short activities, as long as you aim for 150 minutes — 2 1/2 hours — a week.

“This is going to look different for each person based on your current and changing ability levels, and some of you may require assistance from a trained assistant,” Sara said.

Related: Knowing your MS triggers can help reduce worsening symptoms or relapses

4 categories of exercise

• Aerobic: Activities that increase your breathing and heart rate
  • Strategies: Two to three times per week for 10 to 30 minutes at moderate intensity. Those who can be more intense might do aerobics five times a week for up to 40 minutes. This could be high intensity interval training, running, walking, cycling.
• Resistance: Exercises designed to increase the strength of bones, muscles and connective tissues
  • Strategies: Two to three times a week, five to 10 exercises, one to three sets with eight to 15 repetitions. This could include weight machines, free weights, resistance bands and body weight.
• Flexibility: Exercises that stretch your muscles and can increase movement and decrease pain or discomfort
  • Strategies: Do those daily, two to three sets, holding for 30 to 60 seconds. This could include yoga or stretching.
• Neuromotor: Exercises that improve balance, coordination, posture and trunk strength
  • Strategies: Three to six times per week for 20 to 60 minutes. This could be dance, tai chi, balance or yoga.

If you need some support, you can add in modifications such as a hand cycle, three-wheeled bike or walking poles. Aquatic exercises help you move in ways you may not be able to on land and keep your body cool. Seated exercises or movements may feel more comfortable and can help you maintain proper form and posture as well as help you tolerate longer periods of physical activity.

If you need a high level of support, consider a resistance breathing apparatus like an incentive spirometer that helps you take slow deep breaths to expand and fill your lungs. Do this every other day with three sets of 10 repetitions.

Flexibility — one time a day, 30 to 60 second holds with a focus on affected joints

• Upper extremities — six three-minute intervals of actively taking a joint through its complete spectrum of movements
• Lower extremities — three times a week, 30 minutes standing; could be with assistance or using a standing frame
• Core — every one to two hours, posture exercises, hold 10 to 15 seconds, such as pulling shoulder blades back, head up, straightening back

Lifestyle physical activity

These can be planned or unplanned activities that are a part of everyday life and can be achieved in short intervals. It does not need to be continuous or repetitive, so it may be easier to achieve than exercise. It’s the kind of things you’re probably already doing and not realizing you’re doing something so good for yourself.

Walking your dog, gardening or propelling your wheelchair — all are examples of lifestyle activity.

For those who need little to no support, lifestyle physical activity strategies include behavior change strategies like self-monitoring and setting alarms or calendar alerts, tracking activity through electronic devices or journaling, and increasing daily targets.

Those who need a moderate level of support can pursue those above, but modify them with equipment like walking poles to promote safety or participate in activities in a seated position.

Those who need a high level of support can consider functional movement of any kind like active weight shifting for pressure relief or participating in activities of daily living, propelling a manual wheelchair and using mobility aids such as a standing frame.