Column: Multiple Sclerosis and Exercise

Fitness Column

Multiple Sclerosis and Exercise

Multiple sclerosis (MS) is a disease that affects the central nervous system.

Myelin, a lipoprotein that provides a protective cover for the nerves, is destroyed, leading to a disruption of nerve function. This disruption causes numerous symptoms including muscle weakness, tingling or numbness, stiffness, awkward movements, loss of coordination, poor balance, and affected gait. Additionally, MS can cause visual disturbances like loss of vision, blurred vision, or double vision, and sensitivity to heat, chronic fatigue and pain.

Because MS tends to lead to muscle atrophy and progressive weakness, exercise, particularly strength training, is important for MS sufferers. But, since MS affects the nerves that fire the muscles, care needs to be taken when designing an exercise program. Check with your physician prior to beginning or significantly altering your exercise program to get specific information on what might be best for you.

Next, consider working with a trained individual who has significant experience with rehabilitative exercise or joining a facility that has high level fitness professionals available to help you.

Because of the debilitating nature of MS and its numerous symptoms, certain precautions need to be taken in your exercise program. Increases in core body temperature often lead to increased symptoms so exercise is best performed in a cool environment. Avoid exercising outside on hot days and utilize cool packs or ice packs as needed. Drink plenty of cool liquids like water and electrolytes and wear light clothing that breathes or cooling vests or wraps.

Also, try working out during cooler times of the day. Most importantly, become aware of your body and learn to notice symptoms early. When you notice symptoms appearing that did not exist before your exercise session, slow down or stop exercising until you have cooled down.

Since balance and coordination are affected by MS, choose exercises that are both safe and effective at increasing functional strength. Exercises that involve both the large muscle groups and the smaller, proprioceptive muscles used for balance should be included in your weight-training program.

Mobility is often limited and impaired by MS so include several leg exercises to keep as much strength as possible in your legs. The stronger your legs, the less reliant you’ll be on walkers, wheelchairs, and other assisting devices. Leg strength will also help prevent “spastic paraplegia” or loss of lower extremity movement caused by muscle stiffness. This is often one of the most disabling symptoms of MS. By properly strengthening your legs, you can also help lessen the impact of an exacerbation phase of the disease where mobility assistance may be required.

Remember that MS affects the body’s ability to orderly recruit muscles. This, combined with the exacerbation and remission phases often associated with MS, means that there will be times when exercise is easier and more productive than others. Just because you can’t perform an exercise or lift a certain weight today as you may have in the past doesn’t mean that you won’t be able to in the future. Always focus on what you can do today and get the most out of your exercise session.

In addition to strength training for your entire body, flexibility exercises are needed as well. Actively stretch all functioning muscles and joints. Stretch gently each day and hold each stretch for about thirty seconds. For limited or nonfunctioning joints, engage in passive range of motion stretches to prevent stiffening or fixation of your joints.

Since MS does not affect cardiac functioning, your aerobic workout should be based on your individual capability. When physically possible, utilize standing machines like treadmills and elliptical trainers to get the secondary benefit of developing better balance and functionality.

MS can also cause the body to curl inward causing poor, and painful, posture. The inward curl stretches many of the muscles in the back. A well-designed weight-training program should focus on developing scapular retraction, scapular depression, and extension strength to correct postural inadequacies and restore proper body positioning.

Finally, the inactivity, pain, depression, and stress brought on by MS can cause a person to have a poor appetite and bad nutritional habits. This can lead to a further weakening of the body and increase the effects of the disease. Make sure you’re taking in enough calories to help retain muscle mass and that those calories are coming from foods which are nutrient rich and contain many vitamins and minerals.

While MS can be a painful, debilitating, and frustrating disease, there are things you can do for your body to minimize its affect. Exercising as much as your body will allow and a full body weight-training program to keep your strength up can help you fight the affects of the disease and maintain your mobility and lifestyle.

Kent Pegg is a certified personal trainer and the owner of the Los Alamos Fitness Center. Direct questions about the information in this column to him at 662-5232.

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