6 Best Exercises to Boost Wellness When You Have Multiple Sclerosis

A pool workout, whether it’s swimming, water walking, or water aerobics, can be great cardio if you have MS. Water can help people with MS stretch tight muscles and improve flexibility, according to the NMSS.

“Use water weights, wet belts, noodles, and other pool equipment to get an effective cardio workout,” says Amy Rauworth, a registered clinical exercise physiologist at Lakeshore Foundation in Birmingham, Alabama.

Ambient heat can worsen MS symptoms, so make sure the water in the pool isn't too warm. The National Multiple Sclerosis Society recommends a water temperature between 80 and 84 degrees F.

“Strength training is shown to be beneficial for people living with MS because it helps you perform daily activities,” says Reilly. Working major muscle groups in your lower body (quads, hamstrings, glutes) can help improve or maintain strength with walking, standing, balance, and muscular endurance.

Reilly recommends these three exercises for varying fitness levels to improve leg and glute strength.

Advanced Option: Wall Squat

• Stand about a foot away from a wall, with your back to the wall.
• Lean back so your shoulders, torso, and hips are flat against the wall.
• Slowly slide down the wall, bending your knees and keeping your upper body flat against the wall so that your thighs are parallel (or nearly parallel) to the floor.
• Hold for about five seconds and then push with your legs to return to the starting position.

Begin with about five repetitions until you familiarize yourself with the movement and you know how far down you can slide and still push up with good form. If your knees bother you, don't slide down as far.

Once you feel comfortable doing 10 to 12 repetitions, you can consider adding hand weights for an additional challenge.

Moderate Option: Sit to Stand

This is a functional movement you do in everyday activities from getting up from the toilet to getting out of bed, explains Reilly.

• Sit tall in your chair, feet shoulder-width apart with a 90 degree bend in your knees.
• Hinge at the waist as you shift your weight forward.
• Push through your heels as you stand, squeezing in the quads and glutes.
• Use a chair or countertop for added balance and assistance when standing.
• Slowly sit back down and repeat 10 to 15 times (add weight for an extra challenge).

Seated Option: Leg Extensions

• Sit up tall in your chair, feet shoulder-width apart and flat on the floor.
• Lift your right knee and extend your right foot forward, toe pointing up to the sky.
• Squeezing the quad, hold for a few seconds.
• Using your hamstrings, pull your heel back to the starting position and switch legs.
• Repeat 10–15 times per leg.

Working major muscle groups in your upper body (deltoids, biceps, triceps, pectorals) will improve or maintain their strength, says Reilly. You use these muscles to carry objects and perform other daily activities, she says.

Many exercises are designed to work upper body muscle groups (biceps curls, push-ups, chest presses, triceps extensions, rows). Below is an example of how to strengthen your upper body with shoulder press options using free weights, cans of soup, resistance bands (Reilly recommends TheraBand resistance bands), or body weight.

Advanced and Moderate Option: Standing Shoulder Press

• Stand tall with your feet shoulder-width apart, core engaged.
• Hold weights (3–10 pounds) at your shoulders with wrists facing forward.
• Exhale as you press weights to the sky, extending arms vertically.
• Inhale as you bring the weights back to the starting position.
• Repeat 8–12 times.

Seated Option: Seated Shoulder Press

• Sit tall in a chair, feet shoulder-width apart and flat on the floor, core engaged.
• Hold weights at your shoulders with wrists facing forward.
• Exhale as you press weights to the sky, extending arms vertically.
• Inhale as you bring weights back to the starting position.
• Repeat 8–12 times.

Compound Exercises

Compound exercises are when you work multiple muscle groups at the same time, says Reilly. “The benefits of compound exercises are you burn more calories, improve muscular coordination, and elevate your heart rate,” she explains.

Reilly recommends combining these lower and upper body exercises:

• Advanced Wall Sit/Squat + Shoulder Press
• Moderate Sit to Stand + Shoulder Press
• Seated Alternating Leg Extension + Shoulder Press

Neuromotor exercise training integrates various motor skills, including balance, coordination, walking, agility, proprioception (awareness of your body's position in space), hand-eye coordination, and postural stability. The goal is to prevent falls and improve or maintain independent movement, says Reilly. “Neuromotor exercises also include dual tasking or using a combination of skills such as focusing on posture while walking or tossing a ball while sidestepping,” she explains.

Agility Drills

Agility drills are a great way to get in a cardio workout while also working on coordination, agility, changing direction, and proprioception, says Reilly. “Focus on quality, not speed, and remember safety is key,” she advises.

Advanced or Moderate Option: Around the World

Note, this agility exercise can be done walking, jogging, or even when using adaptive equipment like a cane.

• Run/walk forward a few feet.
• Shuffle/sidestep to the right a few feet.
• Jog/walk backward a few feet.
• Shuffle/sidestep to the left a few feet.
• Reverse the direction; repeat for 2 minutes.

Seated Option: Hand-Eye Coordination With a Tennis Ball

This type of exercise is a great way to work hand-eye coordination and arm strength along with proprioception and dexterity, says Reilly.

• Sit up tall in a chair, feet flat on the ground.
• Grab the tennis ball in your right hand, extending arms out wide with palms facing forward.
• Bring both arms together in front of you, exchanging the ball from right hand to left hand in front of your chest.
• Open arms wide again, squeezing your shoulder blades together.
• Perform 1–20 repetitions.

“Core strength is important for people living with MS because it helps with balance, coordination, gait and overall stability,” says Reilly. Here are two exercises to strengthen the core muscles in the abdominals, the obliques, and the back.

Planks

• Lie facedown on the floor or an exercise mat.
• Prop yourself up on your elbows and toes, keeping your body straight from the crown of your head to your toes.
• Elbows should be directly under your shoulders.
• As you hold this position, squeeze your glutes, quads, and abdominals while keeping your back flat (imagine you are a table with your favorite beverage sitting on your back).
• Hold for 10 to 15 seconds.
• Return to the starting position and rest for 10 to 15 seconds.
• Repeat 3–5 times.
• Increase to 20 seconds as you get stronger.

Modified Planks

Traditional planks are tough for many people. If they are for you, try modified planks, supporting yourself on your knees rather than your toes.

• Lie facedown on the floor or an exercise mat.
• Prop yourself up on your elbows and your knees.
• Keep your body straight from the crown of your head through your torso to your knees.
• Hold this position for 10 to 20 seconds.
• Repeat 3–5 times.

Seated Core: Russian Twist

The Russian twist is a seated exercise that also strengthens your core muscles with spinal rotation. For additional coordination, punch your hand to the opposite side of the body.

• Sit comfortably in an armless chair or on a bench.
• Lean back slightly, engaging your abdominal muscles.
• Bend your elbows and hold your hands together in front of your body.
• Exhale as you twist to the left, punching your right arm to the left side of your body. Inhale back to center. Exhale as you repeat on the other side.
• Begin with five repetitions on each side. Rest and repeat 2–3 times. To increase intensity, increase your repetitions from 5 to 10, then 12.

There are two different types of stretching: dynamic and static. Dynamic or movement-based stretches, such as walking kicks or alternating knee hugs, are a great way to warm up the body before working out.

Static stretching, in which you hold stretches for more than 20 seconds, can help you improve or maintain range of motion and flexibility, and may help with spasticity, says Reilly. These stretches may be performed once the body is warm or as an option for cooldown.

Reilly recommends the following stretches for hamstrings and calf muscles, which can be done from a seated or standing position.

Advanced Option From the Floor

• Sitting on the floor, extend your right leg in front of you and let the sole of your left foot rest against your right inner thigh. Inhale.
• Exhale as you bend forward, reaching for the ankle of the extended foot, keeping your knee straight. Breathe through the stretch and hold for 20 to 30 seconds.
• Repeat on the other side.

Seated Option

• Sit tall on the edge of a chair.
• Extend your right leg forward, heel on the ground, toe pointing up. Inhale.
• Exhale as you hinge at the waist and bring your chest toward your thigh.
• Reach toward the calf, ankle, or toes of the extended leg until you feel a stretch in the back of your leg (hamstrings).
• Breathe through the stretch and hold for 30 seconds.
• Repeat on the other side.

4 Tips for Exercising When You Have MS

MS is an unpredictable disease, and every day is different, which can make staying active challenging, says Reilly. Here are her four tips for overcoming some of those barriers.

1. Find a workout buddy. A workout partner provides accountability and community. This could be a friend, coworker, loved one, child, or someone from a support group.
2. Be consistent. Find a physical activity you enjoy (dance, yoga, walks, bike rides, water aerobics — many fun activities count) and start incorporating it into your routine.
3. Give yourself grace. MS is unpredictable. It’s important to be physically active, but there are some days when symptoms like extreme fatigue can make that difficult. Give yourself grace and permission to rest or modify exercise moves.
4. Set SMART goals. In other words, goals that are specific, measurable, attainable, relevant, and time-bound (SMART). An example of a SMART goal is: “I am going to do 10 upper body, 10 lower body, and 10 core moves every day this month.” This will give you something to work toward and make activity a consistent part of your routine. “Remember, any movement is good movement, and make sure to celebrate what you are able to do today,” says Reilly.