Reviewed by: HU Medical Review Board | Last reviewed: April 2023

Exercise is repeated, planned physical activity. It can take a variety of forms, from high-intensity daily workouts to tasks such as gardening. Regular exercise has many benefits. Although it can be hard with a chronic condition like multiple sclerosis (MS), sticking to an exercise plan can benefit your overall health.1,2

Exercise can:1,2

  • Improve mood
  • Reduce the risk of heart disease
  • Keep your brain working well
  • Strengthen bones

Exercise and MS

In addition to general health benefits, exercise can improve MS symptoms. In people with MS, exercise can:1,3-6

  • Decrease fatigue
  • Fight depression
  • Help with walking issues
  • Improve bladder and bowel function
  • Reduce weakness or balance issues
  • Decrease stiffness (spasticity)

More research is needed, but some experts believe exercise also can protect nerve cells against damage. These theories suggest that exercise can slow the progression of MS. Exercise can also be done alongside physical or occupational therapy. Each provides different benefits when planned well.1,7

Types of exercise

The most common types of exercise are aerobic activities, strength training, and stretching. Aerobic exercise is anything that increases heart rate. For some people, a brisk walk can get their heart rate up and serve as a good workout. For others, a run might do the trick. Strength training builds muscle strength through resistance from weights, bands, machines, or your own body weight. Each person’s plan will be different.1,3

There is no agreement on which type of exercise is best for MS. The main goal is to create a plan that works for you and then stick to it. However, common exercise ideas include:1,3-5

  • Stretching
  • Walking, running, or jogging
  • Biking
  • Swimming or water aerobics
  • Gardening or other yard work
  • Yoga
  • Pilates
  • Weight lifting (within personal limits)
  • Dancing
  • Balance training
  • Tai chi or qigong

Creating and sticking to a plan

The amount of time a person should exercise each week can vary. There are several recommendations for exercise frequency for people with MS. Doctors often recommend doing some form of aerobic exercise for 30 minutes 2 to 4 times a week. Stretching can be done daily. Strength training can be completed a couple of times a week.1,3,5

Start slow and find activities that bring you joy. Other tips for starting and sticking to an exercise plan include:1,3,4

  • Be open to adjusting your routine as symptoms change.
  • Continue to find activities that challenge you while still being enjoyable.
  • Be active with friends, and hold each other accountable.
  • Regularly check in with your doctor or physical therapist to monitor your progress and address any concerns.
  • Set realistic goals and reward yourself when they are achieved.
  • Prioritize being safe and avoid pushing yourself beyond your limits.
  • Warm up, cool down, and stretch well whenever you exercise.
  • Ask for help when trying something new, and be open to trying new activities.

Along with exercise, eat a balanced diet and drink plenty of water every day. You also can make a log to keep track of your exercise routines, goals, and successes.2

Staying mindful of body temperature

One other thing to remember when being active is to keep track of your body temperature. MS symptoms can quickly worsen when a person gets too hot. This is called Uhthoff's sign (Uhthoff's phenomenon). If you experience sudden changes in vision or muscle weakness when exercising, this may be the cause. Typically, heat-related symptoms go away within a day. Sometimes it can take only a couple of minutes. This is what separates heat-related symptoms from a true MS relapse or progression.6,8

Ways to avoid Uhthoff's sign include:1,3-6,8

  • Resting regularly when being active
  • Avoiding working out in the hot sun
  • Taking cold showers
  • Drinking cold drinks
  • Using cool packs when being active
  • Swimming or doing water aerobics if it is hot outside

Current research suggests that exercise can have benefits for anyone with MS, from mild to severe cases. However, it is important to create a safe plan before starting anything new. Talk with your doctor and physical and occupational therapists about your symptoms, limitations, goals, and other health conditions. They can help you create the right exercise routine for you.9

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