How to Participate in Exercise and Yoga When You Have Multiple Sclerosis

Learn how to participate in a regular exercise and yoga program when you have MS

Difficulty: Easy

Instructions

1. Why exercise?
   For those with MS, exercise is an important tool to help maintain function, mobility, and help manage symptoms such as depression, fatigue, and anger. Regular exercise can improve a loss of fitness caused by a sedentary lifestyle and be therapeutic for such MS-related problems as spasticity and poor balance. Exercise also builds a reserve of muscle strength and cardiovascular function. Then, if an attack or exacerbation of MS calls for a time-out from physical activity, the reserve is available. When the symptoms subside and the person is able to go back to a more normal life, there is a better foundation on which to rebuild. Addressing the symptoms of MS with regular exercise may help to slow the progression of the disease as one maintains or even gains more mobility.
   Your exercise regimen should contain aerobic exercise, strength training and stretching exercises. This combined with a mind-body therapy such as yoga will help to give you a balanced routine. Combining the above will help to improve your aerobic capacity and lessen the times you feel fatigued. Stronger muscles will help you maintain balance when walking and doing daily activities. The more flexible you are the less stress there will be on your joints when you need to reach and bend and move in different ways.

2. Watch out for Fatigue.
   A common symptom for those with MS is fatigue. You may find that you have more "off" days than "on" days. Also some medications can cause fatigue as a side effect. Fatigue can also be related to respiratory problems. MS can sometimes affect breathing, and when it does, even simple activities can be tiring. Lastly, sleep problems, problems falling asleep, staying asleep, or getting the right kind of sleep prevent people from feeling refreshed when they wake up.
   Tips for handling fatigue
   Plan ahead. Get adequate sleep the night before engaging in exercise. Take a 15-minute nap a few hours preceding any demanding exercise.
   Schedule physical activity for the time of the day when energy is highest. Alternate more demanding exercise with activity requiring less.
   Always talk with exercise instructors about MS before starting a new class. This will allow the instructor to support you if you need to stop and rest.
   Apply the “2 minute” rule: When feeling too sluggish for working out, commit to moderate exercise for just 2 minutes. The activity may generate the energy to continue. If fatigue persists, stop and rest.
   Avoid exhaustion. When it looks as if energy might start to fade, a 15-minute time-out may be all that’s required to recharge. Lie or sit with eyes closed and breathe slowly and deeply. Do nothing, except possibly listen to soothing music or repeat a comforting word, sound, or phrase such as “I am calm.”

3. Be careful of overheating.
   Many people with MS experience a temporary worsening of their symptoms when they get too hot, such as getting overheated from exercise. This can occur with even a very slight elevation in core body temperature (one-quarter to one-half of a degree) because an elevated temperature further impairs the ability of a demyelinated nerve to conduct electrical impulses. It is important to remember that heat generally produces only a temporary worsening of symptoms and does not cause more actual tissue damage and the symptoms are generally rapidly reversed when the source of increased temperature is removed.
   Tips for keeping cool
   - Exercise in an air-conditioned room.
   - Drink lots of cold fluids during exercise. Carry cold drinks in insulated containers that
   attach comfortably to a belt, waist-pack, backpack, or shoulder strap.
   - Become aware of your body. If you notice any symptoms that you didn't have before you began exercising, then slow down or stop exercising until you cool down.
   - Wear lightweight shoes. When the feet are cool, the rest of the body tends to be cool too.
   - Wear vests, hats, or kerchiefs that hold “blue ice” gel packs or materials that can be chilled for long-lasting coolness.
   - Dress in layers, in order to add or remove clothing as body temperature changes.
   - Lower your body temperature immediately before and/or after exercise with a cool soak in a bathtub or shower. When no showers, tubs, pools, or gel packs are handy, try running cold water over your wrists for three to five minutes or apply cold paper towels to the neck and forehead.
   -Refresh with “spritzes” of water from a plastic spray bottle—the type used for misting house plants.

Tips & Warnings

• Make sure you start slowly and always listen to your body to know what is the right intensity to work at. If something does not feel right - don't do it!
• Always check with your doctor before starting any exercise program

Resources

• Living Well Yoga and Fitness
• Medline Plus
• National MS Society