Being active with MS: How physiotherapy can support you

What I love about being a physiotherapist is supporting adults with taking an active role in their health. This means that my physiotherapy practice is focused more on coaching adults in finding self-management strategies, rather than more traditional rehabilitation.  

When a personal family connection brought me in touch with MS, it expanded my understanding of it from the perspective of a healthcare professional and a supporter of someone living with MS. It was then that I realized how valuable my approach could be for people living with MS. When I found Overcoming MS and saw the opportunity to train as a facilitator, it was a no-brainer for me!  

With that in mind, I hope you’ll enjoy this blog post about how physiotherapy can support you with making physical activity a sustainable part of living well with MS – with or without a physiotherapist.   

When being active with MS is easier said than done

 You may already know that regular physical activity plays a very important role in living well with MS. However, knowing something is good for our health doesn’t automatically turn it into a habit. We may not know where to start, how to problem solve when something doesn’t go as planned, or how to stick with it.  

What currently gets in the way of physical activity for you:   

• MS symptoms, such as fatigue, pain, or cognitive fog?  
• Fear of injury or a worsening of your symptoms?  
• Uncertainty about what kind of activity is right for you or how to adapt it?  
• Limited access to accessible facilities or programs?   

Finding a way forward 

While these barriers are real, they don’t necessarily mean that physical activity is out of reach. With the right strategies and support, it may be possible to find ways of being active that work for you.  

How a Physiotherapist can help

Knowledgeable guidance from healthcare professionals who understand MS is often identified by people living with MS as an important factor in becoming more active. Physiotherapists are well positioned to provide this support through their understanding of the body and ability to adapt movement to your individual needs. 

When to see a Physiotherapist for support with physical activity   

When fatigue is stopping you from being active 

Have you ever wondered:  

• How do I start exercising when I’m tired all of the time?  
• How do I know if I did too much? 
• How much rest is enough? 

These are very common questions physiotherapists hear from people living with MS. Fatigue is a complex symptom in MS and one of the main barriers to living an active life.  

A physiotherapist can help you better understand and manage fatigue in the context of your own life and body, including: 

• Helping you assess the type of fatigue you’re experiencing (e.g., physical, cognitive, emotional); 
• Outlining an energy conservation plan with you; 
• Supporting you in building confidence and trust with listening to your body; and/or 
• Helping you determine whether medications for fatigue are something to discuss with your medical team.   

Together, you can set a plan to work with fatigue so that it doesn’t become a hard-stop barrier to physical activity. This process can leave you with a sustainable and flexible approach to navigating fatigue for the long-run.   

If you’re navigating this on your own: build your ability to listen to your body 

Listening to your body can help you find a balance between rest and activity that works for you. But it’s a skill that takes practice. Doing regular mindfulness practices, such as body scans, can help to build this skill along with trust in what you notice.  

When your body doesn’t feel ready to be active  

Sometimes physical activity feels out of reach for physical reasons: weakness, unsteadiness, tightness, worries about falling.  

These challenges don’t have to mean that physical activity isn’t possible. It might mean finding an approach that bridges the gap between where you’re at and what’s possible for you right now.  

In these instances, a physiotherapist can help in a few ways:  

• To start a rehabilitation plan to address what’s getting in the way (e.g., balance, strength or pain).  
• To adapt your current activities and/or environment so that you can continue participating safely and confidently. 
• To take a combined approach that includes both rehabilitation and modification. 

With no two people experiencing MS the same way, no treatment for MS fits a one-size-fits-all strategy. This is where partnering with a physiotherapist can help you objectively determine where you’re at, and collaboratively develop a plan that makes sense for you – one that’s specific, meaningful, and with the right amount of challenge.  

If you’re navigating this on your own: focus on what you enjoy and can do 

When it’s difficult to see what’s still possible, try taking a step back and thinking about what you enjoy. How could you adapt it to what you’re able to do on a given day? For example, if dancing while standing is difficult, you might be able to move your arms to the music from a seated position. If attending a full in-person yoga class is challenging, a short yoga video might be a better fit.  

When you need support with setting realistic physical activity goals  

Taking the time to set specific and realistic physical activity goals is a step that’s often not given the time it deserves. As a result, we might set goals for ourselves that aren’t realistic without realizing it, or goals that are so broad that it’s hard to stay on track.   

The process of goal-setting can be more effective with the support of a physiotherapist who understands what you live with day to day, and is skillful with facilitating goal-setting.  

• Together, you can:  
• Identify activities that are meaningful to you; 
• Set appropriately-challenging goals; 
• Set yourself up for early success (and celebrate your wins!); 
• Identify and plan for obstacles;  
• Problem solve and adapt along the way; and 
• Build accountability to yourself. 

An intentional goal-setting process can be the difference between good intentions and something that keeps you moving. It’s also a lifelong skill you can come back to long after your physiotherapy sessions are over.   

If you’re navigating this on your own: start a physical activity diary 

Start tracking what you activity did, how long you did it for, and how you felt before and afterwards. Remember that activity can be any movement that uses your muscles and burns energy, such as stretching or doing laundry.  

Keeping a record can help you see patterns and progress more clearly, giving you valuable information to draw upon when setting goals that are achievable and meaningful to you.  

Conclusion

My hope is that this blog has helped you see physiotherapy in a broader way – not just as something you turn to when you have pain or physical challenges, but as an active process you can access at different points in your journey with being active with MS.  

And whether you work with a physiotherapist or navigate this on your own, the goal is the same: finding ways to be active that are meaningful and realistic for you.  

Explore further 

A list of exercise tips for MS https://overcomingms.org/resources/exercise/a-list-of-exercise-tips-for-ms  

Things to consider when working out with MS 

https://overcomingms.org/resources/exercise/things-to-consider-when-working-out-with-ms  

Guided exercise videos to follow along with 

https://overcomingms.org/resources/exercise