8 Exercises for Managing Multiple Sclerosis (MS) Symptoms

Living with Multiple Sclerosis (MS) is a journey of constant adaptation and discovery. Some days feel clear and full of energy, while others are dominated by fatigue, stiffness, or uncertainty. If you’ve ever wondered if exercise could be a part of your management plan, the answer is a resounding, evidence-based yes.

For a long time, people with MS were advised to avoid physical exertion for fear of worsening symptoms or causing excessive fatigue. We now know that the opposite is true. Regular, tailored physical activity is one of the most powerful tools you have to take control of your well-being. It’s not about running marathons or lifting the heaviest weights. It’s about moving your body in ways that build resilience, combat common symptoms, and boost your overall quality of life.

This guide is designed to be your friendly, supportive introduction to the world of MS exercises. We’ll walk through eight foundational types of movement, explaining the “why” and “how” behind each one. Our goal is to empower you with practical, safe, and effective strategies for multiple sclerosis symptom management. Remember, you are the expert on your own body. This guide is here to help you listen to it, work with it, and discover a stronger, more capable you.

A Crucial First Step: Talking to Your Healthcare Team

Before you begin any new exercise regimen, it is absolutely essential to consult with your neurologist and a physical therapist (PT) who has experience with MS. They can:

• Provide personalized advice based on your specific symptoms and limitations.
• Help you identify and avoid movements that might be counterproductive.
• Recommend adaptations to ensure you exercise safely.
  They are your partners in this process. This MS fitness guide is a general resource, but your healthcare team’s guidance is irreplaceable.

The Golden Rules of Exercising with MS

1. Listen to Your Body (The #1 Rule): MS is unpredictable. What feels good one day might not the next. Pay close attention to your energy levels, pain, and other symptoms. “No pain, no gain” is a dangerous myth. Instead, think “steady effort, consistent gain.”
2. Pace Yourself: Start with shorter sessions (10-15 minutes) and lower intensity. It’s far better to do a little and feel good than to overdo it and be sidelined for days.
3. Stay Cool: Many people with MS are heat-sensitive. Exercise in a cool room, use fans, wear cooling gear (like vests or bandanas), and drink cold water. Swimming or water aerobics in a cool pool is an excellent option.
4. Focus on Consistency, Not Intensity: The greatest benefits come from moving regularly, not pushing yourself to exhaustion twice a month. Finding a routine you can stick with is the real victory.
5. Rest is Part of the Workout: Schedule rest days. Your body needs time to recover and rebuild strength.

Now, let’s explore the eight best exercises for MS that can form a balanced and effective routine.

1. Stretching & Flexibility: Easing Stiffness and Spasticity

Why it helps: Muscle stiffness (spasticity) is a common and challenging MS symptom. Regular, gentle stretching helps maintain range of motion in your joints, reduces feelings of tightness, and can decrease muscle spasms. It’s a wonderful way to connect with your body and start or end your day feeling more limber.

How to get started:

• Focus on Major Muscle Groups: Pay special attention to areas that often feel tight: calves, hamstrings (back of thighs), hip flexors (front of hips), chest, and shoulders.
• Hold, Don’t Bounce: Move slowly into a stretch until you feel a gentle pull. Hold the position for 30-60 seconds. Avoid bouncing, which can trigger spasms.
• Breathe Deeply: Never hold your breath. Inhale deeply, and exhale slowly as you ease into the stretch. This helps relax the muscle.
• Make it a Ritual: Try incorporating 5-10 minutes of stretching into your morning routine or after a warm shower when your muscles are more pliable.

A Simple Starter Stretch Routine:

• Calf Stretch: Stand facing a wall. Place your hands on the wall for support. Step one foot back, keeping the leg straight and heel on the floor. Gently bend your front knee until you feel a stretch in the calf of your back leg. Hold. Switch sides.
• Seated Hamstring Stretch: Sit on the edge of a chair. Extend one leg straight out in front of you, heel on the floor. Keep your other foot flat on the floor. Gently lean forward from your hips until you feel a stretch down the back of your extended leg. Hold. Switch sides.
• Doorway Chest Stretch: Stand in a doorway. Place your forearms on the door frame, elbows slightly below your shoulders. Step one foot forward and gently lean into the doorway until you feel a stretch across your chest.

2. Strength Training: Building a Foundation of Support

Why it helps: Weakness in the limbs is a frequent symptom of MS. Strength training, or resistance exercise, counteracts this by building muscle. Stronger muscles do more than just make you physically stronger. They:

• Improve stability and balance, reducing your risk of falls.
• Make everyday tasks (like carrying groceries or getting up from a chair) easier.
• Help combat fatigue by making your body more efficient at performing movements.

How to get started:

• Start Light: Use light weights, resistance bands, or even your own body weight. The goal is to perform movements with control, not to lift the maximum weight possible.
• Focus on Form: Proper technique is more important than the number of repetitions. A physical therapist can show you the correct form to avoid injury.
• Major Movements: Concentrate on exercises that work large muscle groups: squats (to sit and stand), modified push-ups (against a wall), and rows (with a band).
• Reps and Sets: Aim for 1-2 sets of 10-15 repetitions for each exercise. You should feel fatigued by the last rep, but not in pain or unable to maintain form.

Simple Strength Exercises:

• Chair Squats: Stand in front of a sturdy chair with your feet shoulder-width apart. Slowly lower your body as if you are going to sit down, just tapping the chair before standing back up. Use the chair as a safety guide.
• Wall Push-ups: Stand facing a wall, arm’s length away. Place your palms on the wall at shoulder height. Slowly bend your elbows and lower your body toward the wall, keeping your back straight. Push back to the start.
• Resistance Band Rows: Sit on the floor with your legs extended. Loop a resistance band around the soles of your feet. Hold the ends of the band. Pull the band towards your chest, squeezing your shoulder blades together. Slowly release.

3. Balance Exercises: Cultivating Confidence and Stability

Why it helps: Problems with balance and coordination are core symptoms of MS, often leading to a fear of falling. This fear can cause you to become less active, which in turn leads to further decline. Balance exercises directly challenge and improve your proprioception (your body’s awareness of where it is in space) and strengthen the stabilizing muscles around your ankles, knees, and core.

How to get started:

• Safety First: Always perform balance exercises near a sturdy counter, wall, or chair that you can hold onto for support. Have someone nearby if possible.
• Start Simple: Begin with exercises where you have plenty of support and gradually reduce your reliance on it as your confidence grows.
• Focus Your Gaze: Keep your eyes fixed on a point straight ahead of you. This visual anchor significantly improves stability.

Beginner Balance Drills:

• Heel-to-Toe Stand: Stand facing a counter, holding on for support. Place the heel of one foot directly in front of the toes of the other, so they are touching. Hold for 15-30 seconds. Switch foot positions.
• Single-Leg Stand: Holding onto your support, shift your weight to one leg and slowly lift the other foot off the floor. Try to hold for 10-15 seconds. Switch sides. As you improve, try touching the counter with just your fingertips, then one finger, then no hands at all.
• Weight Shifts: Stand with your feet hip-width apart, holding onto a counter. Slowly shift your weight entirely onto your right foot, lifting your left foot slightly off the ground. Return to center. Shift to your left side. Repeat 10 times.

4. Aerobic Exercise: Boosting Energy and Fighting Fatigue

Why it helps: It might seem counterintuitive, but using energy through aerobic exercise is one of the best ways to fight MS-related fatigue. Cardiovascular exercise improves the health of your heart and lungs, increases blood flow, and releases endorphins (your body’s natural mood elevators). This leads to:

• Improved stamina and reduced feelings of fatigue.
• Better mood and decreased symptoms of depression.
• Enhanced cardiovascular health.
• Improved cognitive function.

How to get started:

• Find What You Enjoy: The best aerobic exercise is one you will actually do. Options include walking, swimming, stationary cycling, water aerobics, or using an elliptical machine.
• Monitor Intensity: Use the “Talk Test.” You should be exercising at a pace where you can still hold a conversation, but you couldn’t sing a song. This ensures you’re working at a safe, effective level.
• Start Short: Begin with 5-10 minutes of continuous activity. Gradually add 1-2 minutes to your session each week as your endurance improves. The general goal is to work up to 20-30 minutes on most days of the week.

Excellent Aerobic Choices for MS:

• Walking: Simple, accessible, and highly effective. Use supportive shoes and choose smooth, level surfaces.
• Swimming and Water Aerobics: The water provides natural resistance for strength building while its buoyancy supports your joints and eliminates the risk of falling. The cool water is also perfect for managing heat sensitivity.
• Stationary Cycling: A safe way to get your heart rate up without worrying about balance or falling. You can cycle at your own pace, indoors in a cool environment.

5. Tai Chi: The Flowing Meditation in Movement

Why it helps: Tai Chi is often described as “meditation in motion.” This ancient Chinese martial art involves performing a series of slow, graceful, and precise movements while practicing deep breathing. For MS, it’s a powerhouse because it combines balance, strength, flexibility, and mindfulness all into one low-impact practice. Research has shown it can significantly improve balance and reduce the fear of falling.

How to get started:

• Find a Class or Video: Look for a “Tai Chi for Beginners” or “Tai Chi for Arthritis” class (these are often very suitable for MS). Many community centers or online platforms like YouTube offer excellent beginner tutorials.
• Focus on Flow, Not Perfection: Don’t worry about getting every movement exactly right. The goal is to move slowly and consciously, connecting your breath to your motion.
• Use a Chair for Support: Many Tai Chi movements can be adapted and performed while holding onto the back of a chair for added stability.

6. Yoga: Uniting Mind, Body, and Breath

Why it helps: Much like Tai Chi, yoga offers a holistic approach to wellness. It emphasizes physical postures (asanas), breathing techniques (pranayama), and meditation. For managing multiple sclerosis symptoms, yoga can:

• Improve flexibility and reduce spasticity.
• Build core and functional strength.
• Enhance balance and coordination.
• Teach techniques for managing stress and anxiety.
• Promote better sleep.

How to get started:

• Choose the Right Style: Look for gentle, restorative, or chair-based yoga. Avoid hot yoga (Bikram) or very vigorous styles (like Ashtanga) due to heat sensitivity and intensity.
• Work with an Informed Instructor: If taking a class, let the instructor know about your MS beforehand. A good teacher will offer modifications for poses.
• Listen Intently: Use props like blocks, straps, and bolsters to support your body and make poses accessible. Your practice is about how it feels, not how it looks.

Gentle Yoga Poses to Try:

• Cat-Cow Stretch: On your hands and knees, alternate between arching your back toward the ceiling (Cat) and dipping your belly toward the floor (Cow). This is excellent for spinal flexibility.
• Legs-Up-The-Wall (Viparita Karani): Lie on your back and rest your legs vertically up a wall. This is a deeply restorative pose that can help reduce swelling in the feet and ankles and calm the nervous system.
• Child’s Pose: Kneel on the floor, sit back on your heels, and fold forward, resting your forehead on the mat. This is a resting pose that gently stretches the back.

7. Pilates: Building a Powerful Core

Why it helps: Pilates is a system of exercises that focuses on developing core strength, stability, flexibility, and overall body awareness. A strong core is the foundation for all movement. It stabilizes your torso, improves posture, and is absolutely critical for good balance. For those with MS, Pilates can help create a strong, supportive “girdle” of muscles that makes every movement more efficient and secure.

How to get started:

• Mat vs. Machine: You can do Pilates on a mat (Mat Pilates) or on specialized equipment like the Reformer. Mat Pilates with simple props is a great and accessible place to start.
• Emphasis on Precision: Pilates is about quality of movement, not quantity. The exercises are performed with controlled, precise movements and coordinated breathing.
• Find a Qualified Instructor: Seek out an instructor who has experience working with clients with neurological conditions or who is willing to learn and adapt exercises for you.

Basic Pilates Principles:

• Breathing: Learning to breathe fully and deeply is central to the practice.
• Centering: Every movement originates from your core, or “powerhouse” (abdominals, lower back, hips, and buttocks).
• Control: Every movement is done with complete muscular control.

8. Aquatic Exercise: Freedom of Movement

Why it helps: We’ve mentioned it before, but water-based exercise deserves its own spotlight. The properties of water make it an ideal environment for MS exercises. The buoyancy supports your body weight, reducing stress on joints and making movements feel easier. The water’s resistance provides a natural and uniform strength training effect. And the cooling effect of the water is a major benefit for those with heat sensitivity. It offers a sense of freedom and ability that can be hard to find on land.

How to get started:

• Water Walking or Jogging: Simply walking back and forth in chest-deep water is a fantastic workout. The resistance challenges your legs and core.
• Water Aerobics Classes: Many pools offer classes specifically designed for people with arthritis or mobility issues—these are often perfect for MS. The instructor can guide you through a safe and effective routine.
• Use Water Weights or Noodles: Foam dumbbells or “noodles” can add fun and extra resistance to your workout.

Putting It All Together: Creating Your Personal MS Fitness Plan

You don’t need to do all of these exercises every day. The key is to create a balanced, sustainable weekly routine that addresses your main symptom concerns.

Sample Weekly Routine (Example Only):

• Monday: 15 minutes of gentle stretching + 20 minutes of stationary cycling.
• Tuesday: 20-minute strength session (focus on legs and core).
• Wednesday: Rest day or a gentle 15-minute walk in a cool environment.
• Thursday: 30-minute aquatic therapy class or water walking.
• Friday: 20-minute balance drills + 15 minutes of yoga.
• Saturday: Fun activity! Gardening, a slow dance in the kitchen, a walk with a friend.
• Sunday: Rest and recovery.

Celebrate Every Victory

Your journey with MS exercises is uniquely yours. Some days, your victory will be a full 30-minute workout. Other days, it will be remembering to do your calf stretches while the coffee brews. Both are equally important.

Be patient and kind to yourself. Progress is rarely a straight line. By incorporating movement into your life in a way that feels supportive and sustainable, you are taking a powerful, proactive step in your multiple sclerosis symptom management. You are not just managing symptoms—you are building a stronger, more resilient you.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Please consult with your healthcare provider before starting any new exercise program.