A fitness goal — whether it’s walking or jogging a local 5K, training for a charity bike ride, or simply walking farther without needing a rest — can provide a sense of purpose and progress. If you’re living with multiple sclerosis (MS), you might think that achievements like these are out of reach. Symptoms such as fatigue, weakness, and issues like heat sensitivity can make it hard to predict how you’ll feel from one day to the next.
The good news is that having MS doesn’t mean that a training plan or a fitness goal is off the table, but the path to achieving them might look a little different than it does for someone who doesn’t have MS. Even more important, experts say the payoff for these efforts could be improved mobility, mood, and quality of life.
If staying fit is something that’s important to you, find out what the experts say about how to set a fitness goal that feels meaningful, realistic, and doable for you, as well as how to overcome the challenges MS can bring.
How Exercise May Help With MS
Training for and reaching a fitness goal won’t just boost your confidence; it’s likely that it will also improve your overall health.
“Exercise has many benefits, including improvement in cardiovascular and respiratory fitness, strength, and balance,” says Christopher Lock, MD, a clinical associate professor and neurologist who specializes in MS at Stanford Medicine in California.
“It may also have neurological benefits — we know exercise can increase the production of molecules that promote nerve health and brain plasticity.”
Evidence suggests that people with MS who exercise regularly see a reduction in fatigue and symptoms of depression, and are better able to maintain mobility.
Even though research on whether exercise changes the course of the disease is still ongoing, in general, there’s evidence that people with MS who move more tend to feel better, function better, and live more independently.
1. Assess Your Current Fitness and Activity Level
To get where you want to go, it helps to know where you’re starting from.
A physical therapist who specializes in MS can help you safely assess your strengths and weaknesses and recommend exercises tailored to your abilities that can help you achieve your goal, says Erin Kienlen, RN, an MS patient navigator at Banner University Medical Center in Phoenix, Arizona.
“For example, if balance is an issue, you might begin with supported standing exercises or aquatic therapy, which reduces stress on your joints and helps you build endurance,” she says.
You may find it helpful to set intermediate goals to serve as stepping stones toward a larger goal.
“Remember that you don’t need to start out with the expectation that you have to run a marathon. Just getting out and doing what you are able to do is key,” says Kienlen.
2. Check In With Your Healthcare Team
Before diving into a new routine, it’s a good idea to discuss it with your neurologist or MS care team, says Lock.
In general, Lock says he “would definitely encourage people with MS to exercise and to set a fitness goal.”
“There are no specific restrictions or harmful effects of exercise for people with MS, and exercise will not cause a flare-up or progression,” he says.
If you’re a newbie at the activity you’re interested in trying, check in with your primary care doctor or the appropriate specialist on your healthcare team to ensure there are no other medical contraindications, such as heart conditions, that would affect what’s safe for you to do, says Jai S. Perumal, MD, an assistant professor of neurology and faculty at the Weill Cornell Multiple Sclerosis Center in New York City.
3. Set a Goal That Is Personally Meaningful
A fitness goal is one of those decisions where it’s okay to make it “all about you”: Your fitness goal doesn’t have to look like anyone else’s.
Behavioral researchers note that people are more likely to stick with goals that are personally meaningful and self-chosen. For example, maybe you have a close friend or family member with breast cancer, and you want to participate in an upcoming charity walk. Or maybe there’s an activity you particularly enjoy, and you want to be able to do it more often or more easily.
If you’re unsure of how to set a goal that makes sense for you, talking with a health coach or exercise professional familiar with MS can help you set more specific and realistic goals using the SMART framework — which stands for specific, measurable, attainable, relevant, and time-bound.
Some examples of possible fitness goals include:
- Get 30 minutes of movement on most days.
- Build up to swimming laps at your community pool.
- Participate in a local charity bike ride.
- Be able to hike or golf with friends again.
What’s most important is to keep moving forward and not get overwhelmed with the planning phase.
“Exercise is beneficial for MS, no matter what form it takes,” says Kienlen. You can always refine your goal — or change it entirely — as you go along.
4. Revise or Refine Your Goal if Necessary
A well-designed exercise program should account for your age, fitness level, and any limitations caused by MS; it’s not one-size-fits-all. Once you’ve set an initial goal, it’s okay to revise it or break it down into smaller, more achievable steps.
Old-school exercise mantras like “No pain, no gain,” aren’t a good idea. Instead, adopt a “listen to your body” approach.
“People with MS should be as active as they can and proceed at a pace they’re able to manage,” says Dr. Perumal.
For many people with MS, timelines that work for the general population like “run a 5K in three months” may not be useful. Instead, focus on building from your starting place at a pace that’s manageable. You might aim to walk five minutes longer each week, or to complete an extra yoga session by the end of the month.
That doesn’t mean that you should never aim to walk or jog a 5K. But rather than set a too-aggressive time span for achieving it, it’s safer to start small, such as a walk around the block five times a week, and gradually increase to what you are comfortable with, says Kienlen.
5. Check Whether You Have the Gear and Facilities You Need
Do a quick reality check: Does your goal match your resources? If you want to swim laps but there’s no accessible pool nearby, maybe start with chair-based exercises or a walking program. If heat is a problem, do you have access to an air-conditioned facility, or can you work out in the early morning, when it tends to be cooler?
You can often find creative workarounds:
- Try before you buy. Some community centers rent or lend adaptive gear like recumbent bikes or walking poles.
- Join a group. Many cities have accessible fitness programs — from mall-walking clubs to tai chi classes in local parks.
- Go virtual. Online exercise videos designed for people with MS can help you move at home and stay motivated.
- Plan for safety. If you don’t feel comfortable exercising alone, ask a friend to join you, or look for community fitness partners.
6. Anticipate Barriers and Ways to Overcome Them
Life with MS can be unpredictable, so expect bumps along the way. The most common barriers almost always have workarounds.
Fatigue The No. 1 reported symptom of MS is fatigue, says Kienlen. “It may sound counterintuitive, but beginning an exercise program can actually help reduce fatigue.”
But that’s not true for everyone. Sometimes people with MS can feel fatigued for a day or two after more vigorous exercise or exertion, says Lock.
“This is not harmful and is a temporary effect, but it is probably good to find a comfortable level of exercise and to gradually increase this if possible,” he says.
Pain or Discomfort If land-based exercise hurts, try aquatic therapy. “The water supports your body and relieves pressure on your joints,” says Kienlen.
And if aquatic exercise isn’t an option, look for other solutions. Maybe doing a variety of activities instead of just one would place less stress on specific body parts while still promoting fitness.
If your own efforts to resolve pain and discomfort during exercise don’t help, consult an expert such as a physical therapist. Perhaps you need to strengthen certain muscles or try a different technique to accomplish what it is you want to do.
Heat Sensitivity An increase in core body temperature can temporarily worsen MS symptoms, a reaction known as Uhthoff’s phenomenon.
“Many people with MS are heat sensitive, so keeping cool can help. There are cooling vests and other types of clothing available, and cold drinks, hydration, shady locations, and a hat can help. Exercising in a cool room, or outside at cooler times during the day can also help,” says Lock.
Lack of Support Ideally, your friends and family will be supportive of your efforts to stay healthy and be physically active. But if they’re not, or they don’t want to join you in your activity, look to your community.
“Try local groups that walk in the mall, bike, or do tai chi in the park,” says Kienlen. Exercise with others can be more enjoyable and help you stay accountable. And you’ll feel supported by your new friends who have similar goals.
Relapses or Bad Days It’s normal to feel discouraged if symptoms flare up, but don’t give up, says Kienlen. “Movement, no matter the intensity or length of time, is beneficial.”
During a relapse, rest and recovery come first, but once you’re feeling better, a physical therapist can help you safely restart.
7. If Problems Arise, See Your Doctor
If at any point in your training you have an MS relapse or are experiencing new symptoms like weakness, spasticity, or vision changes, you should check in with your doctor as soon as possible.
“We always advise patients to contact us if they are having new or progressing symptoms, such as new weakness, to assess whether this might be a relapse and would benefit from a course of steroids or a treatment that would manage their specific symptoms,” says Lock.
If pain, fatigue, or mobility challenges are keeping you from making progress toward your goal, talk to your healthcare provider about potential solutions. Medication adjustments, assistive devices, or a referral to a physical or occupational therapist can make movement easier and safer.
Working with professionals familiar with MS can also help you fine-tune your plan as you go along. And remember, exercise doesn’t replace medical treatment, but it can be an important part of your overall MS management plan.
The Takeaway
- If you have multiple sclerosis (MS), a fitness goal can boost your motivation, confidence, and overall health, but it’s important to tailor your plan to your current abilities and symptoms.
- Regular exercise can improve strength, balance, and energy levels, and may even support nerve and brain health, though research is still ongoing on whether it changes the course of MS.
- Check in with your healthcare team before starting a new activity, and consider working with a physical therapist or trainer who understands MS to ensure your program is safe and effective.
- Fatigue, heat sensitivity, and mobility challenges can make progress unpredictable, but with flexibility, pacing, and support, most people with MS can safely pursue and reach meaningful fitness goals.
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