Welcome to Season 5 of Living Well with MS, the Overcoming MS podcast where we explore all topics relating to living well with multiple sclerosis. In this episode, we are sharing the highlights from our ‘Exercising at (or close to) home’ webinar with Overcoming MS Facilitator and qualified yoga teacher, Dr Véronique Gauthier-Simmons. Véronique speaks about the importance of exercise when you’re living with MS and how to make exercise a healthy habit that you’ll enjoy.
Find out more and listen to the episode here
Welcome to Living Well with MS. This podcast comes to you from Overcoming MS. The world's leading multiple sclerosis healthy lifestyle charity, which helps people live a full and healthy life through the Overcoming MS program. We interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own. Don't forget to subscribe to living well with MS on your favorite podcast platform so you never miss an episode. And now let's meet our guest. Today's episode features highlights from the Exercising At (or Close to) Home webinar presented by Overcoming MS facilitator Véronique Gauthier-Simmons recorded live in front of our global audience as part of the Refresh with OMS webinar series. To join us live for the next webinar, or to watch the original presentation head to our website overcomingms.org.
Véronique Gauthier-Simmons 00:57
So my name is Véronique Gauthier-Simmons, and I'm French just in case you haven't noticed it. I live in the south of Portugal with my amazing husband who is English. And we are surrounded by beautiful hills not far from the sea. It's a paradise. I was diagnosed with relapsing remitting MS on the fourth of February 2000. I know the date. So that's over 20 years ago, and the first seven or 10 years were really really, really bad. But I'm now fantastic. I feel fantastic. I've been on the OMS program for eight years because I really feel better and stronger all the time. And I've been a facilitator for OMS for three years, and I was very lucky to lead many exercise sessions. In previous retreats, I'd like to talk about what you can do and how you can practice safely, while staying motivated. Let me start with a quick recap on the benefits of exercise for the general population. When you exercise you sleep better, it helps to maintain a healthy weight, it helps to manage stress.
Véronique Gauthier-Simmons 02:19
Overall, the quality of life is better. There are also many studies now showing that exercise helps to prevent some conditions the risk of developing some conditions such as type two diabetes, cardiovascular disease, it helps to prevent to prevent falls, or depression and dementia, joint and back pain and also helps to prevent from cancers such as colon and breast cancer, that's for the general population. We know that exercise is good, but there is no shift from saying that exercise is good to stay fit to saying that exercise is important for your health. And you now have for instance, doctors prescribing exercise to their patients. So that's really important. But what about us living with MS? So when I was diagnosed 20 years ago, at the time I was into step aerobics and squash. And my neurologist advised me that this was bad for us. But since then there are loads of studies and research showing that this is not the case, it's actually good for us, even if the symptoms come up when you exercise. So these are some of the benefits for people with MS. Obviously, exercise is good to maintain and develop muscle strength. And this has an impact on your mobility, your posture on daily activities. So you can do more things. If you you have strong muscles, you might know the saying that either you lose, you use it or you lose it. And that's the case for us for muscles. It also helps to maintain walking speed, it has been proven that exercise increases your energy level, talking about fatigue, just being tired at the end of the week after a busy week. So when I'm tired, now my husband tells me go and walk go and do yoga go and run because he knows that I will get more energy. I suspect he also says that because when I'm tired, maybe grumpy. So I think he wants me out of the way. But even if it is the case is right because exercise also improves the mood thanks to the endorphin and the all the good hormones that are released when you exercise. So that's really really important. Another really important impact of exercise is on sexual function. So we know that, for instance, doing cardiovascular exercise is good for blood circulation, so it improves sexual function, you can also do some strengthening exercises that allow for better muscle control. And it's also good for the libido. If I'm really tired, and then my mood is a little bit down, then between having sex and a good cup of tea, I'd probably go for the cup of tea. But when you exercise, everything gets better, you've got more energy, you're in a better mood, and that improves the libido as well.
Véronique Gauthier-Simmons 05:45
The next topic is bladder and bowel function. And I know this is a delicate subject. And it's we're not very at ease talking about it. But there is an impact. For instance, in yoga, there are loads of poses that are really good when you've got for instance, constipation, but you shouldn't do them when you've got diarrhea or loose bowels. Or you also have poses that are really good for mild bladder issues. So ideally, you want to be able to talk about it with your instructor or your teacher, or at least try and find information about what you should do and what you shouldn't do. But there's definitely as well an impact in this area. But all together altogether. exercise improves the our quality of life. Now, as well, studies showing that exercise improves the MS progression. So exercise stimulates the formation of neurons, and also the connections between neurons in a way, that's really, really good to know people with MS who exercise show an increased level of neurotrophic factors. They are like your molecules that helped you repair the neurons. And I think that's really, really important.
Véronique Gauthier-Simmons 07:17
There's also now more research showing that those who exercise the most, show the least amount of brain shrinkage, after six months, people with MS who did resistance training showed a reduction in brain atrophy. And also that small areas in the brain started to grow again. And I think that's really, really amazing. Maybe that's another saying you might have heard before that exercise makes you smarter, okay, it doesn't mean that people who exercise are smarter than people who don't exercise. What it means is that when you exercise, you are smarter than you would be if you didn't. Personally I think it's true, not that I'm particularly smart. But I think when I when I exercise, I feel I feel a bit sharper, I feel my brain is quicker, I feel my memory is better. When I'm struggling at the gym, I've got a personal trainer that was really pushing me very, very, very hard and or when I train on my on my own. Sometimes I like to visualize my neurons getting, you know, repairing themselves or communicating between themselves just as a motivation to keep exercising exercise may modify the course of MS.
Véronique Gauthier-Simmons 08:43
I'd like to quote, the exercise and sports science Australia, saying that we all understand that exercise supports our physical health. However, during times of crisis such as this, it is the first activity we tend to ignore. Being active cannot only keep us healthy, it can also help us fight off infection. I think that it is probably the first activity we tend to ignore, not necessarily intentionally. For instance, before the lockdown. I had a personal trainer and I was going twice a week to the gym. I also took swimming lessons and I was going twice to the pool as well to the gym besides yoga and so on. So I had to stop. So these were four hours less you just don't have access to the gym and to the pool or to the yoga class that you attended before. But it is really important to try and keep exercise because moderate exercise reduces inflammation and improves the immune function. So more than ever, it's important to exercise as vigorous as your level of physical activity allows. So don't try and go and run a marathon. Suddenly, it just as as much as you can do. But regularly, ideally, you want to do 30 minutes, minimum three to five times a week. And it's important to include resistance training, it can also be your own bodyweight. So when you press against a wall, or when you squat, you only need your body resistance. Or you can have resistance bands as well. So you don't need to go to the gym. And it's also nice to include endurance exercise, that gets your heart rate up. Because with endurance exercise, then you get fitter and fitter, so you can do more and more. And there is also some research indicating that endurance exercise or aerobic exercise are really, really good, especially for memory loss in MS. So there's every reason for us to do regular exercise to the extent that we can, but what are the things that you should take into consideration now when we want to establish an exercise routine, I just want to say that I'm not the exercise police and I'm not here to, to make you feel guilty.
Véronique Gauthier-Simmons 11:19
If you don't exercise or if you exercise less than usual, I think fatigue is definitely always the the main issue. When it comes to exercise, it can be really, really, really difficult to, to exercise when we suffer from fatigue. But it's also something that exercise can improve as a way to find something that you like. And for those of you who say I really, really hate exercise, sorry, but I can't do it, I will recommend a book by Dr. Kelly McGonigal called The Joy of Movement. And it's really nice, it's all about enjoying moving. And there's one idea that I really like, if you have a song that you like, I'm sure most of us will have one song that they like a lot when you make a cup of tea, played a song and just start moving, just dancing. And then do it again the next time you make a cup of tea. And maybe the next day or the next week, play two songs and start feeling how good it is just to move because it does feel good just to move it doesn't have to be exercising first. But the other thing that is really important, especially now is what fits with your lifestyle. And I'm aware that some of you might have to look after young children. And there are loads of situations where it's difficult to fit in some exercise. But again, I think that maybe with some, some help, you can find ways to to find solutions. Maybe if you have to look after children, maybe it will be to play with them in a way that is more like a physical activity, and things like that.
Véronique Gauthier-Simmons 13:05
Next, I'd like to share a couple of ideas they're not, they're very simple ideas. But first things like online classes, there are more and more teachers actually offering online classes. So you can have a look at some of for free on YouTube. You can also look at some some classes specific for MS. So you've got for instance, the MS Gym, or the MS Workouts with completely different styles. And there's some stuff for everybody. You also have some apps, if you are used to going to the gym, maybe you can also create create your own program can also ask your teacher or your instructor and I'm sure they would be ready to help you as well create your own program at home. Again, I think that you can do a lot without weights or dumbbells or without any specific material, just with your own bodyweight, and maybe with elastic band or something that you've got at home.
Véronique Gauthier-Simmons 14:08
During the OMS retreats, I always encourage people to find an accountability partner or a buddy and it's it's just a way to keep motivating yourself. When it's 6am. And you've got a text from a friend saying, "I'm meditating," then you're like, "Okay, I'd be a good girl, I'd get up and meditate with you" know, even if we're miles away. It's nice to know that someone else is meditating at the same time. And with exercise, it can be the same or you could even exercise together and have a little video conference and do your exercises together. It's important to be safe for safety. I just would like to remember to remind you of a couple of things like stay hydrated.
Véronique Gauthier-Simmons 14:53
And also make sure that when you exercise there's nothing lying around, in particular cables. You know, like, if you watch class on your laptop on your phone, make sure that there is no cable that you can trip on, we've seen that quite a few of you have issues with balance. So if you do something that is challenging for the balance, ideally, maybe try to practice in a corridor so that you've got two walls, or at least near one wall on your chair, just in case, it's better to be safe than sorry. Now to stay motivated. Personally, I find it very useful to set goals, and maybe to join challenges. But that's probably my personality, type. Setting goals is really important, it's really important to make sure that you don't over overdo it, especially if you're like me, I mean, I'm always setting goals like really, really high.
Véronique Gauthier-Simmons 15:50
But now I've learned to be a bit more mindful, a bit more careful with my body setting goals could be just small, achievable. But it is motivating. There are also loads of challenges around on the on social media, and you can join one entails as well to, to being motivated. Keeping track is useful to personally I use my digital watch to keep track, for instance, when I'm running, but you can also just have a normal diary and see your progress. And because that thing that's as well, important, when you see you're getting better than you want to keep going.
Véronique Gauthier-Simmons 16:29
And the last one is to schedule it. For me, exercise is it's like taking, it's like my medication. So I scheduled it, I have to do it. That's it. That's part of managing MS. I'd like now to talk briefly about high intensive interval training, because it's something that is really good for people with MS because the aim is to work very hard. For a short period, studies have shown that people with MS actually can cope with high intensity interval training better because you don't get as tired you rest regularly. So that's something that I think we should all try to incorporate in our exercise routine. Don't be scared by the high intensity interval training the high intensive, you don't have to jump or squat or do planks, it can also be just walking, but you walk as fast as you can, and then you rest and then you walk again. And then you rest. So the idea is really more than these intervals, do you work really hard. And when I say working hard, if you do some squats, and if it's available to you do as many squats as you can. And then the next one is "I can't do the next one." And then the rest. And again. So when you are starting, you can rest for twice the time. So if you work for 30, you would rest for 60. And then you get better and better. You can reduce. For instance, I've got one app for high interval training. And I can just select whether I want to do arms or legs or what or mix if I wanted to five minutes, or eight or 10. And if I want to do like a mixture of all the body parts, I can select 10, 20 or 30 minutes. And I've got the beeps all the time and all the exercise showing up on my phone. And I think that's quite quite nice. But you can also do it with any type of exercise. As I said, you can also do it when you walk next fatigue.
Véronique Gauthier-Simmons 18:45
So I kind of knew that this would be the biggest issue for the majority. This is an example of a daily routine that I would suggest if you if you suffer from fatigue, you break it down. So you can for instance in the morning, you could do two minutes warmup and the warm up. There's one very simple warm up that you can do which is basically moving all your joints, one after the other from the hands to the elbows, the shoulders, the knees, the feet, the toes, just moving them around slowly. And then you do five minutes, maybe stretches in the morning. Then later during the day, maybe you're on coffee break, you can do another two minutes on warm up and five minutes leg strengthening and later, core strengthening. Maybe in the afternoon some upper body strengthening. This can simply be placing your hands on the wall and pressing resisting or it could be pushing, resisting with your own body. This is strengthening and you can just do five minutes like this. And then in the evening, I would suggest doing some relaxation. So you select one or two Exercise, do 10 or 15 repetitions, and little by little, you work up to doing two sets of repetitions. And that's one way to exercise despite fatigue, which I know is really difficult. But we have to remember that exercise can significantly reduce fatigue levels. So it's important to exercise, I think it's important to remember that even 10 minutes makes a difference.
Véronique Gauthier-Simmons 20:30
So you don't have to run a marathon. Moderate exercise regularly is great. And if you can't do 30 minutes, because you are too tired, or because you're in pain, or you've got balance issues, then do 10 minutes, it's better than nothing. And maybe later, you can do another five or 10 minutes to try to break it down. If it's too much in one, go. And remember to adapt to your condition and be flexible. Don't blame yourself, if you wanted to do a class and you can't do it, but try to work around it and adapt. There are some videos on the Overcoming MS website. So it's a good resource and the MS Trust as well as some some exercise section, the two subscription, a website MS Workouts and the MS Gym, check them out. They also have some free videos on YouTube so you can have a look. I also like the Johns Hopkins Cooley Center, they've got a YouTube channel. They offer high interval intensive training, yoga, bodyweight, they've got loads of things.
Véronique Gauthier-Simmons 21:39
There are basically three types of fatigue. Yeah, there's the first fatigue which is the primary fatigue, which is the MS symptom, there is secondary fatigue, which is due to too much. For instance, if you didn't sleep enough, or if another reason, and it's a side effect, so you should deal with that. And then there's the neuromuscular fatigue. And the foot drop is what happens when you've got this neuromuscular fatigue, which is basically when you move your body then you get tired. But the good thing is that it doesn't last when you rest. It's it's gone. And that is so that doesn't impact on the progression of your MS. It's really good. The more you keep doing it, the less it will happen.
Thank you for listening to this episode of Living Well with MS. Please check out this episode's show notes at overcomingms.org/podcast you'll find useful links and bonus information there. Have questions or ideas to share? Email us at firstname.lastname@example.org or you can reach out to Geoff on Twitter @GeoffAllix. We'd love to hear from you. Thanks again for tuning in and see you next time for tips on living a full and happy life with MS.