Physical activity is regularly prescribed for people with multiple sclerosis (MS) and other neurologic illnesses, says John Corboy, MD, FAAN, professor of neurology at the University of Colorado School of Medicine in Aurora. “It's not just about the drugs,” he says. “Medication is very important, but we also emphasize what I call ‘good behaviors.’ Sleeping well, de-stressing as much as possible, exercising, and not smoking.”
“Medications for MS are effective and important,” agrees Lauren Gluck, MD, associate professor of neurology at Albert Einstein College of Medicine in New York. “But aspects of MS like fatigue, pain, stiffness, and impaired gait may need other strategies in addition to medication. And that's where physical activity comes in.”
Exercise can improve blood flow and circulation, loosen muscles, support joints, reduce stress hormones, and trigger positive hormones like endorphins, Dr. Gluck says. These hormones can alleviate pain, boost mood, improve sleep, and decrease fatigue. “I often recommend exercise to address these factors,” says Dr. Gluck. Anyone can do it, it can be adapted to any schedule, and it doesn't involve medication, she adds.
The benefits of exercise for people with MS are well documented: In a meta-analysis published in Frontiers in Public Health in 2024, a team of researchers looked at 40 studies on the effects of exercise on patients with MS and concluded that it significantly reduced fatigue and improved balance, walking ability and endurance, and quality of life.
Yet for many people with MS, getting started can be intimidating and overwhelming, says Michelle H. Cameron, MD, professor of neurology at Oregon Health & Science University in Portland, who suggests answering these questions first. What do you like? Do you prefer to exercise alone or with others? Do you enjoy exercising indoors or out? Do you want to exercise to music or with a video? “A lot depends on your answers,” says Dr. Cameron. “And then work with that. Rather than fixating on the fact that you used to do Zumba or play basketball, use your creativity to find other options that work for you now.”
Taking a brisk walk is a good start. For those who are less mobile or have problems with balance and gait, chair yoga is ideal, says Dr. Gluck. “It's a great way to mobilize your muscles. Another option that some of my patients love is resistance bands for strengthening.”
The key is to get up and move, says Dr. Cameron. “Thinking about exercise does nobody any good,” she says. “Doing exercise is what makes a difference. And the only exercise people will do is the one they like.” She suggests water aerobics and chair yoga. “Other options that come to mind are ballroom or square dancing for those who like to exercise with other people to music,” she says. For those who use wheelchairs and like to compete, she recommends wheelchair basketball or other wheelchair team sports.
Phil Keoghan, host of The Amazing Race and an advocate of exercise for people with MS, suggests being proactive and creative. “Find people with similar motivations and in similar circumstances,” he says. “That makes it easier to achieve your goals.” Consider group fitness classes in person, in the pool, or online. “Maybe start your own group,” Keoghan says. “You want to try pickleball? So maybe you start a group called ‘MS Has Put Me in a Pickle’ and take out your frustrations together on the court and get some exercise.”
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