Exercise can sometimes feel hopeless on days where you’re feeling fatigued, weak, or stressed. In fact, most people think “exercise” has to be a movement in a standing or upright position, but that might be very challenging at times. Fortunately, there are many positions where people can exercise in a way that is not only attainable, but sustainable for the long haul - even on those challenging days.
I’m a firm believer that anyone with MS, no matter what level of mobility they possess, can exercise. What makes me so confident? I know all the different ways modifications are possible! Exercise doesn’t have to mean going for a walk/run, pushups, crunches, or weight training, although these examples may be the first thing we think of when we imagine exercise.
When it comes to MS there are lots of exercises that will help with strengthening our legs, arms, and core as well as improve balance and walking and they have nothing to do with the “traditional” exercises! These are most often performed in a standing, seated, or lying position.
There are 4 main ways you can modify an exercise. I’ll explain the principles here:
1 - Change your position
My favorite way to modify an exercise is to change your positioning. Let’s take a “marching” exercise as an example. This exercise is typically performed in a standing position where you lift one knee up toward the ceiling, hold for one to two seconds, then slowly lower the leg down. Repeat on the other side. It’s a great functional exercise to improve activities like walking, stair climbing, getting into and out of a car, etc. However, this standing position also requires balance and core strength which can be challenging.
We can modify this standing exercise to a seated position where you sit on a chair or couch, either upright or reclined. This may be easier because you don’t have to focus on balancing or core strength. If this is still too challenging, you can try the marching exercise while lying on your back (on your bed, couch, or floor) with your knees bent and feet on the surface you’re lying on. This position can be easier than sitting because your hip positioning is more extended than the seated position and your upper body is relaxed.
Both of these things can allow the marching movement to feel easier. Finally, if the lying down position is still too challenging, you can perform this exercise lying on your side. With this position, your knee will now be coming up toward your chest without gravity pushing your leg down. You can use also your opposite leg to help. For example, if you’re lying on your right side, you can bring both of your knees up toward your chest at the same time. The top (left) leg gets the help of the lower (right) leg. This is often best performed when the stronger leg is on the bottom.
2 - Change the speed
Once you find a position that feels easiest for you, you can modify further by changing the speed of the exercise. For some exercises, moving at a faster speed can feel easier because it doesn’t require as much control. For other exercises, moving at a slower speed can feel easier because it gives you more time to perform the movement. Try both and see what feels best for you!
3 - Less motion
Another great way to modify an exercise is to perform the movement with less motion. Let’s use our “marching” exercise as an example here. Instead of focusing on lifting your knee up as high as possible, instead focus on just marching so that your foot comes off the ground by 1 inch/25mm. Lifting your leg less should make this exercise a bit easier because it doesn’t require as much strength. Start small, then as you get stronger, work towards increasing the amount of motion.
4 - Do fewer repetitions and/or take more rest breaks
Performing less repetitions in each set exercise is a great way to modify an exercise. Instead of focusing on completing 10 repetitions in 3 sets (30 total repetitions), do 7 repetitions in each set (21 total repetitions). Feel free to add more rest breaks. If you’re set on performing 30 total repetitions, you can do 5 repetitions in 6 sets, with a rest break between each set. The goal is to do as many as you can with good quality, no matter how many rest breaks are taken.
It’s important to remember that modifying an exercise to make it easier doesn’t mean you’re cheating or that it’s a less effective exercise. It means you’ll be able to do more total repetitions with good form This translates into more opportunities for your brain to find a neural pathway/connection to make that muscle group stronger (this is neuroplasticity). So modify away! You’ve got this