By Ed Lash
Probably the most important reason for people with multiple sclerosis (MS) to be exercising is that exercise tends to put the various body systems back into balance. And since MS seems to be a disease of an immune system out of balance, it seems that exercise should be of paramount importance. Not only that, but one doctor said that stress is what puts the immune system out of balance in the first place, and exercise is believed by many experts to be the best stress management technique.
If you are not already exercising, it may be wise to consult your physician or physical therapist who can write an exercise prescription. Because MS can affect people so differently, an exercise that works wonderfully for one person may not work at all for another. Also, the right exercise program will vary depending on the degree of a person’s disability. Another advantage to seeing a physical therapist is that helping people to become more mobile is exactly what they do.
To be effective, some exercise must be done regularly. The schedule I like best is one that’s recommended by many experts, and starts with some form of wake-up exercise which may take only a few minutes. You pick a few exercises that you feel are best for you, and start with a small number of each, say 5 or 6. After a week or two, increase each exercise by one. Every week or two, add another one, and gradually increase every week or two until you get to an amount you feel you can handle on a regular basis, and which you feel is doing you some good.
When you feel comfortable after a number of weeks or months, adding two or three 10-minute bursts of exercise throughout the day is beneficial, such as walking, hiking, lawn work, house cleaning, swimming, cycling, dancing, sports-the list is endless. Pick the one, or ones, that suit you the best, but don’t overdo it.
Creativity and innovation may have to be used in special instances. I know one person with MS who wanted to cycle but couldn’t get up on his stationary bike. He eventually was able to figure out a way to peddle while seated in his wheelchair. Where there’s a will, there’s a way. Drs. Robert Herndon and Richard Rudick, in their article entitled “Fatigue and MS”, argue that “working to the point of fatigue may help in improving endurance. However, burning the candle at both ends, getting inadequate rest and sleep, is a prescription for trouble in MS and occasionally leads to the occurrence of new signs and symptoms.”
Most important in any exercise program is to start at a level you feel comfortable with, without strain or pain, gradually increasing in both quantity and frequency. Overdoing, or a sudden large increase in exercise, however, may have a negative effect.
The MS Society’s “Facts & Issues” pamphlet entitled REHAB: It’s an Outlook! makes an important point about the fact that not all muscles are affected by the demyelinative MS process. Some remain intact. But once some function is lost, a person tends to cut down on movements. Those healthy secondary muscles then can atrophy from disuse. “It is these muscles we focus on in therapy”, says Iris Kimberg, MS, OTR, RPT. “For example, there are three muscles that bend your elbow. Yet only one may be affected by multiple sclerosis. Since that may be the primary mover, the patient may stop trying to bend his elbow, and he will develop disuse atrophy in the other two. Those are the ones we’ll work on.”
To sum it all up, I’ll quote from the MS Society’s Maximizing Your Health: “All this really means is that, if you have MS and are embarking on a program of exercise, you should plan ahead carefully, get professional guidance in setting up your plan, but by all means pick a physical activity you can enjoy, and do it!”
Note: Self-help is not intended to replace medical treatment. It should be used together with the help of appropriate professionals in a team effort.
Ed Lash is a United Spinal member who lives in Trumbull, Connecticut. He can be contacted by e-mail at edlash.ms.selfhelp@juno.com, or by phone at 203-445-0118.
