Should people with multiple sclerosis exercise?

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Definitely, says Tanuja Chitnis, MD, assistant professor of neurology and director of the Partners Pediatric MS Center at Massachusetts General Hospital for Children. In fact, she routinely recommends exercising two to three times a week to people living with MS as a part of a healthy lifestyle. And exercise has been found to have a number of benefits for people with multiple sclerosis, helping to control common symptoms of the disease such as fatigue, depression, and even bladder and bowel dysfunction.

Before starting any MS exercise program, however, it is wise to consult with your doctor. He or she may also recommend that you meet with a physical therapist who can develop a program of exercises that are specifically tailored to address your?multiple sclerosis symptoms?and to help you build strength and flexibility where you need it most. MS Exercise: Getting Started?
When starting an MS exercise program, remember to have fun, take it slowly, and listen to what your body is telling you. Jumping right in can lead to injury or fatigue, which may discourage you from maintaining?your MS exercise routine?over the long term. Your body can tell you if you're working too hard or if you can afford to turn up the intensity. If you experience pain during a workout, stop and check with an expert who can recommend an alternative to the exercise. MS Exercise Classes?
Check with your local MS support group or the?National Multiple Sclerosis Society?for help in finding fitness centers near you that have specific MS exercise classes geared to?mobility-impaired?people. If you don't have any MS exercise classes in your area, most instructors are willing to work with you to help meet your needs. Check in with the teachers before the beginning of the classes, and they can demonstrate alternatives to the movements or postures that might be difficult for you.

Some specific types of exercise you might want to try include:

• Yoga.?This ancient regimen is a great way to stay flexible and has also been shown to have scientifically proven benefits for people living with MS. Yoga classes are offered at a variety of levels, from gentle to moderate to high intensity. When starting any new exercise routine, it's advisable to start slowly. If the intensity of the class is not clearly described on the schedule, call ahead to find out which class would be right for you. Another advantage of yoga is that it is highly modifiable. A good teacher can show you alternative postures if you explain your limitations before class.

Some styles of yoga, including "hot yoga" and "Birkram yoga," are practiced in hot rooms. Since people with multiple sclerosis can suffer from heat intolerance, it is a good idea to avoid these styles.

• Tai chi.?The National Multiple Sclerosis Society (NMMS) reports that people with multiple sclerosis have used tai chi as a way to improve balance, and studies non-specific to MS indicate that tai chi can help not only with balance but with blood pressure and heart health as well. A staple of Chinese fitness, tai chi uses a series of slow, controlled movements to build muscle tone and increase flexibility. NMMS recommends tai chi for its adaptive nature. In fact, wheelchair tai chi is gaining in popularity in China and other countries.

• Aquatics.?Water aerobics and other aquatic fitness programs are a great way for people with multiple sclerosis to exercise. Bodies are buoyant in water, which takes weight off the joints and allows for a greater range of movement. Exercising in water has an added benefit for people with MS: The cool temperature of the water can allow you to extend your workout without risk of overheating.

No matter what exercise you choose, one of the most important steps in any exercise program is the very first one: get moving!

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