Exercises for multiple sclerosis: which ones help to live better according to science?

Moving, walking effortlessly, or simply holding an object firmly are actions that are often taken for granted… until the first signs of multiple sclerosis (MS) appear. This chronic disease interrupts communication between the brain and the body, largely due to the wear and tear of myelin —the protective layer that covers the nerves— and gradually makes everyday activities that once seemed automatic more difficult.

In Mexico, this reality already affects more than 20,000 people, according to the Ministry of Health, and it is known to be more common in women due to genetic factors. Given this situation, exercises for multiple sclerosis have become an essential tool to maintain mobility, reduce symptoms, and improve the quality of life for those facing this challenge.

“Physical activity in general is beneficial for maintaining mobility and can also help with non-motor symptoms such as depression,” says Sarah Bell, a physical therapist at Mass General Brigham, specializing in working with patients who have neurological disorders like MS.

How exercise helps those living with multiple sclerosis

One of the most common symptoms of MS is fatigue, which affects approximately four out of five people with this disease, according to the National Multiple Sclerosis Society. Other symptoms may include blurred vision, dizziness, spasticity (muscle stiffness), weakness, tingling, loss of balance, depression, and heat sensitivity.

“When people suffer any deterioration of the myelin, the electrical stimulation from the brain that tells the muscles what to do is interrupted,” explains Bell. Although exercise does not repair damaged myelin, it can help protect the regions of the brain that are still intact, which supports mobility and independence.

Studies have shown that exercise improves walking ability, balance, fatigue, and quality of life. In particular, the impact of physical activity on multiple sclerosis can make a significant difference in the overall well-being of those living with this condition. For example, a well-designed program can decrease chronic fatigue and increase endurance for daily efforts.

What types of exercises are best?

Sarah Bell divides the best recommended exercises for multiple sclerosis into four main groups, each with its specific benefits:

1. Aerobics

Aerobic exercise helps reduce fatigue and improves cardiovascular health, which is important since people with MS have a higher risk of heart disease. Bell recommends achieving about 150 minutes of moderate activity per week. Interval training —alternating periods of effort with rest— can make this routine more tolerable for those suffering from intense fatigue. Walking, using a stationary bike, or swimming are good options.

2. Stretching

Regular stretching is key for those with muscle spasticity. By working the calf muscles, hamstrings, and hip flexors, stiffness can be reduced and pain alleviated. Bell suggests performing 3 to 4 stretches of 20 to 30 seconds each, repeating them several times a day, and consulting with a physical therapist for a personalized plan.

3. Strength training

Strengthening muscles is crucial when MS weakens the limbs. Resistance with light weights or elastic bands, performed 2–3 times a week with rest days, can also help regulate spasticity and improve overall muscle function.

4. Balance and agility exercises

Designed to prevent falls and improve coordination, these exercises are best guided by a physical therapist. At home, one can practice standing on one foot for 30 seconds. Increasing the difficulty by closing the eyes or using uneven surfaces enhances the challenge. Taking lateral steps and gently turning also helps develop stability and control.

Bell emphasizes that: “Fatigue is often one of the symptoms that limit activity levels in people with MS.” Therefore, she advises starting with short sessions —for example, 10 minutes three times a week— and gradually increasing the time and intensity.

For those who have difficulty maintaining balance, using canes, ankle braces, or supports can reduce the risk of falls and facilitate movement. She also recommends choosing times of day when energy levels are higher for exercising and using cooling techniques such as cooling vests or cold water to prevent heat from exacerbating symptoms. “If your body temperature rises, symptoms will worsen,” explains Bell.

How to start an exercise program safely

Before starting, it is essential to consult with a physical therapist specialized in physical therapy and exercise for patients with multiple sclerosis. This professional can develop a plan that takes into account your functional status, balance levels, strength, and possible limitations.

Some useful strategies include:

• Starting with brief exercises and gradually increasing duration and frequency.
• Using support devices when necessary.
• Choosing times of day when energy levels are higher to exercise.
• Applying cooling techniques to avoid exacerbating symptoms due to heat.

Why exercises for multiple sclerosis are more important than one might think?

For Mexico, where MS has a relatively low prevalence, the impact of this disease can be silent but very significant: most cases manifest during productive adulthood and with the possibility of long-term disability. Therefore, incorporating adapted exercises for people with multiple sclerosis into the daily routine can be a way to maintain mobility, reduce relapses, and improve quality of life.

These physical activities are not just an option: they can become a pillar within the comprehensive treatment of this disease. Although they do not replace conventional medical treatments, their systematic use, guided by specialists, has the potential to significantly transform the daily lives of people with MS.