Physical Therapy: Frequently Asked Questions

Rehabilitation is an important part of your care if you have multiple sclerosis (MS). Your rehab team helps keep you healthy and able to handle the challenges that MS brings. An important part of this care is physical therapy (PT).¹

Physical therapists can help you manage your MS by giving you access to:²

• Education about physical symptoms of MS and ways to manage them
• An exercise program designed just for you and your needs
• Aids and adaptive equipment to help with tasks and keep you mobile
• Tools like massage and ultrasound to help with specific problems
• Information about community resources that can support you

You might have questions about PT, including why you need it and how long it will last. Getting answers will help you feel more confident when working with your care team.

What is the difference between a physical therapist and a physiatrist?

A physical therapist and a physiatrist may seem like the same thing. Both focus on your body's movement and function. Both treat people with muscle, bone, or brain conditions. But there are some key differences between these 2 experts.³

Physical therapists usually have a background in exercise science or sports medicine. Physiatrists are doctors who specialize in rehabilitation medicine. Physiatrists can perform diagnostic tests, order lab work, prescribe drugs, and manage complex treatment plans.³

What types of exercises do physical therapists recommend for people with MS?

There is no one-size-fits-all approach to PT for MS. PT therapies depend on a person's unique symptoms and needs. There are different types of PT exercises, based on how you perform them. The types include active, active-assisted, and passive exercises.⁴

Active

Active exercises are performed on your own. These are exercises in which you use your muscles to do something. Fully extending your knee when sitting in a chair is an example of this PT exercise.⁴

Active-assisted

Active-assisted exercises are performed with either another person or a machine. For example, you perform the same knee extension but have help from your physical therapist to do it correctly. With these exercises, you do much of the work but need some help.⁴

Passive

Passive exercises involve someone else moving your body for you. While this type of exercise does not require effort from you, it can have a lot of benefits. Movement improves blood flow and stimulates certain areas. Passive stretching also helps relieve spasticity and prevent it from getting worse.⁴

Specific types of exercises your PT might suggest include:^4,5

• Stretching – maintains flexibility, prevents contractures, and relieves spasticity
• Strengthening – improves and maintains your muscle strength
• Range of motion (ROM) – helps your joints move through their full motion
• Aerobic – strengthens your heart and lungs, improves endurance, and reduces fatigue
• Balance and coordination – reduces your risk of falling

How can exercise help me?

Many exercises can help with the symptoms of MS. Learn these exercises under the supervision of your physical therapist. Working with a physical therapist can help ensure that you are doing the exercises correctly. Physical therapists also make sure the exercises are helping improve your symptoms.⁴

Exercising may not be easy, but it will be worth it. Exercise can help with many MS symptoms, including:^1,5

• Fatigue – Aerobic exercise can help reduce fatigue.
• Spasticity – Stretching and ROM exercises can reduce spasticity and keep you mobile.
• Depression – Research shows that aerobic exercise can improve your mood.
• Osteoporosis – Weight-bearing and strengthening exercises can help prevent bone loss.
• Memory and thinking problems – Some studies have shown that exercise can help improve memory and thinking problems.

Can exercise help me walk?

Neither physical therapy nor exercise can fully heal nerve damage from MS. However, PT can help improve your ability to move within your physical abilities. Strengthening your muscles and heart is good for your overall health. Your ability to walk and do everyday tasks could also improve. Talk to your doctor and physical therapist about what goals are realistic.⁶

Why should I exercise if I use a wheelchair and cannot walk?

Everyone needs exercise, even if they are unable to walk. Staying active has many health benefits, including:^1,5

• Improves spasticity, spasms, and pain symptoms
• Helps you maintain a healthy body weight
• Improves energy
• Improves your mood
• Helps prevent other health conditions
• Improves blood flow
• Reduces the risk of blood clots from inactivity
• Reduces skin breakdown if you are unable to walk
• Helps maintain sex drive

Your physical therapist will help you find exercises even if you cannot walk. They will help you gain and maintain strength and function. PT is an essential part of rehab in people with MS. Partner with your physical therapist and doctor to make the best treatment plan for you.¹