Physical Therapy for Multiple Sclerosis: MS-Focused Techniques for Improving Mobility

Stretching and moving your body are important for everyone. Incorporating exercise into your daily life can do a lot to keep yourself healthy and lessen your risk of injury and developing chronic conditions or diseases. This is especially important for individuals who have been diagnosed with multiple sclerosis (MS) because, unlike some other chronic conditions, MS can be quite varied. There is no clear-cut roadmap for how MS will affect you, and because it attacks the central nervous system, it can affect just about any part of your body.

This is why making an effort to incorporate physical activity and exercise into your routine is crucial for managing your symptoms. If you have particular trouble with balancing or strength-building exercises, attending physical therapy sessions can be an excellent way to get personalized guidance and modifications.

Why Are Mobility Exercises Important for Individuals with Multiple Sclerosis?

So, how can exercise play a role in managing symptoms of MS? Many MS patients avoid exercise, thinking that it will only aggravate their symptoms and cause more fatigue. However, this is actually not true. Working to improve mobility through stretching and balance exercises and building or maintaining muscle strength through strength exercises can be an extremely effective way to help your body function at its best rather than giving in to fatigue and weakness.

Each person’s MS treatment is going to be different simply because every person’s experience with the disease is different. This said, working to improve your balance, muscle strength, mobility, and flexibility through various forms of exercise can play a critical role in helping you to do what you want to do in life. Ideally, you would want to incorporate a mixture of stretching, balance training, strength building, and aerobic exercise into your schedule, but if you can only spare a small section of your day, we recommend focusing on the following exercises to get started.

MS-Focused Techniques to Improve Mobility and Quality of Life

Here, we’ll dive into some mobility and strengthening exercises that can help you manage symptoms of multiple sclerosis.

Keep in mind you should only do exercises that feel good. When you push yourself too far (or feel pain while performing exercises), you risk injury, which can make it harder to exercise later on. If you are unsure of how to perform an exercise or are looking for personalized guidance, you should consult a physical therapist like those at Revo Rehab.

Now, without further ado, here are a few of the best exercises for MS patients. We have broken these exercises into two categories: stretching and strengthening.

Stretching

Stretching exercises are crucial for maintaining (and improving) range of motion and flexibility. As you get older, you will naturally become less flexible. But, when you pair this lessening flexibility with worsening symptoms of MS, you may be unable to do the things that you want to in your daily life. In other words, making an effort to improve your range of motion can help lessen the impact of some of the spasticity-related and otherwise stiffening symptoms that many MS patients struggle with.

Knee-to-Chest

This stretch targets a number of commonly tight areas for MS patients, including the back and hamstrings. This is a good exercise to do first thing in the morning, as it can help release some tightness from the previous night.

To perform this exercise, follow these steps.

1. Lay on your back on the floor or another flat surface.
2. Bring one knee into your chest while your other leg remains outstretched.
3. Hold your knee to your chest for 30 seconds-1 per minute. You can hold this position for longer if it feels good.
4. Change sides, and repeat if desired.

You can also bring both of your knees to your chest at the same time if that feels good.

Spinal Twist

This is a great exercise for maintaining spinal mobility and improving rotational flexibility in the back.

To do this exercise:

1. Start by laying flat on your back, in bed, or on the floor.
2. Bend your knees and place your feet firmly on the floor.
3. Slowly lower your knees to the left side of your body while you turn your head to the right.
4. Hold this position for 30 seconds-1 per minute.
5. Change sides, and repeat if desired.

If this is not enough of a stretch for you, you can try the classic supine twist exercise. The main difference that the supine stretch brings is rather than bending both knees, you only bend your top knee. This means that your lower leg (the leg that you are twisting on top of) is straight, and your upper leg (the leg that you are stretching) is.

Shoulder Flexion

Excess tension and muscle spasms are common in the shoulder area for MS patients. This simple stretch can help lessen the pain of these involuntary muscle spasms and help increase your range of motion in the shoulder.

To perform this exercise, you must:

1. Start by sitting on the edge of your bed, in a chair, or on something where you feel stable.
2. Reach both of your arms up to the ceiling.
3. Hold this position for 20-40 seconds.
4. Repeat if desired.

You can also do this exercise one arm at a time, but be sure to stretch both arms.

Cervical Rotation

Like the shoulders, our neck can hold a lot of tension. Additionally, we require a certain range of motion from our cervical area to perform daily life tasks, such as driving or even looking between different monitors or screens at work.

To do this stretch simply:

1. Sit somewhere where you feel comfortable and balanced.
2. Gently turn your head to the left as if you are looking over your shoulder.
3. Slowly turn to the right, and repeat five times.

Do this exercise very slowly and gently. Our necks are delicate and incredibly important. You will need to be extremely careful during this exercise to ensure that you are not pushing yourself too far or causing an injury.

Strengthening

Strengthening exercises refer to more than the typical strength-building exercises that you may be thinking about when you hear the term. These exercises also include valuable balance training and coordination exercises, as these are both critical for managing common symptoms of MS — lack of balance and coordination.

Bird-Dog

This exercise is a perfect option if you only have a few minutes. It works the entire core (including your hips and deep core muscles) and helps you maintain better balance and posture.

To perform this exercise:

1. Get into the quadruped position (on your hands and knees).
2. Engage your abs and look slightly forward.
3. With a neutral spine, lift your left arm and right leg so that they form a line with the rest of your body.
4. Hold this position for a slight pause, 3-5 seconds if you can.
5. Slowly lower your arm and leg back to your starting position.
6. Repeat with the right arm and left leg.

This makes one rep; you will want to do at least two sets of 6-8 reps of this exercise with 30-60 seconds of rest in between sets to get the best results.

Sit-to-Stand

You can think of this exercise as an assisted squat. Rather than squatting back onto thin air, this exercise focuses on a more real-world activity: getting up from a chair. This activity can be hard for MS patients, especially if they have been losing mobility.

To do the sit-to-stand exercise, you must:

1. Begin by standing directly in front of a sturdy chair with your feet somewhere between hip and shoulder-width apart.
2. Hold your arms straight out in front of you and engage your core.
3. Slowly bend your knees and sit back in the chair.
4. Pause when you are sitting on the chair.
5. Then press through your feet and raise yourself back to standing.

This is one rep of this exercise. Perform two sets of 10 reps with 30-60 seconds of rest between each set.

Single Leg Stand

This exercise is undoubtedly a balance training exercise. Any form of single-leg balancing work is necessary for improving and maintaining mobility and walking strength — both things that MS patients tend to struggle with.

To do this exercise:

1. Begin by standing with your feet firmly on the ground about hip-width apart.
2. Lift one foot an inch off of the ground while keeping your torso upright. If you need to hold on to a counter or wall to keep your balance at first, that is alright.
3. Hold this position for 10-15 seconds before lowering your foot to the ground.
4. Repeat on the other leg.

Continue this exercise until you have completed five stands on each leg.

Glute Bridge

Glute bridges are a great exercise for strengthening your core and improving balance. This exercise focuses on your hips and core. This said, you should feel the burn primarily in your glutes.

To perform this exercise, follow these steps:

1. Start by laying on your back with your knees bent and your feet firmly planted on the floor.
2. Place your arms on the ground beside your hips and brace your core.
3. Push up through your heels and squeeze your glutes to lift your hips off the ground. Aim to get your body to form a straight line from your shoulders to your knees.
4. Pause for a second or two at the top of your bridge before lowering down slowly.

This is one rep of the glute bridge exercise. To get the best results, aim for two or three sets of 10 reps, with 30-60 seconds of rest between sets.

Stationary Lunge

Lunges are a great way to work on your core, hips, knees, and ankles all at the same time. Keep in mind that even stationary lunges require some balance, so make sure you feel comfortable with the single-leg stands before attempting lunges.

To perform the stationary lunge:

1. Begin by standing tall with your arms at your sides.
2. Step back with your right foot and place it on the ground with your heel lifted.
3. From here, bend your front knee to slowly lower yourself as far as feels comfortable. Your back knee will bend, too; this is good. Just ensure that it is hovering over the floor rather than touching it. Ideally, this would result in a 90º bend in both your front and back knees.
4. Pause here for a second or two before pressing through your front foot to raise yourself back to standing.

This is one repetition of this exercise. Complete 8-10 reps on this side before switching to the other side. At first, you may want to aim for one set, but after you have gotten the move down, aim for 2-3 sets with 30-60 seconds of rest in between each one.

How to Get Started with Mobility Exercises

If you are looking for ways to improve your mobility, we strongly recommend trying some of the exercises listed above. However, if you are uncomfortable with trying these exercises on your own or you are simply looking for additional guidance and customized exercises, reach out to a physical therapy clinic like Revo Rehab.

At Revo Rehab, we offer physical therapy that focuses not only on stretching and strengthening (as mentioned above) but also balance and coordination, gait training, and posture correction. So, if you want a personalized physical therapy plan with the best exercises for your unique needs and abilities, get started with us today at Revo Rehab.