Exercise and Multiple Sclerosis – Does exercise increase fatigue?

Fatigue is one of the most common symptoms of Multiple Sclerosis; occurring in about 80% of individuals. MS-related fatigue can significantly impact your ability to work and function.  It is one of the most challenging symptoms to manage over the course of a day.  The good news is – exercise can help!   

We all know that exercise is important for our health and wellbeing, and is something we should be doing regularly - but fatigue can feel like a huge barrier to exercising.  However, MS-related symptoms - such as fatigue, are actually improved through regular physical activity.     

How does exercise help?

Regular exercise helps to:

  1. Reduce current fatigue levels

  2. Prevent secondary fatigue from progressively getting worse 

Regular exercise helps to increase your muscle strength, cardiovascular fitness and energy levels.  This helps to provide you with more energy to be able to do the tasks you want to, and combat the fatigue.  Additionally, exercise helps to counteract the effects of detraining and moving less – which overtime leads to increased fatigue levels.  Partaking in low or no level of physical activity actually worsens your fatigue levels. 

What is the best type of exercise?

A combination of strength and cardiovascular, exercise are the best for combatting fatigue.

Strengthening (resistance) exercise is often better tolerated as it has a lesser effect on core body temperature.  Strength training involves contracting your muscles against an external force.  It can be completed using your body weight, free weights, machine weights, resistance bands or water resistance. Focus on using heavier weights, with lower repetitions and longer rest breaks (1-3 minutes).  This has been shown to give you the greatest benefits, as well as helping to minimise the effect of fatigue during training. 

The best way to perform cardiovascular (aerobic) exercise is by walking, however exercise bikes and elliptical trainers are also good options.  Try to avoid treadmills due to the risk of trips and falls.  It is important to start at a low intensity and exercise for a short duration.  At small and regular intervals increase these for added benefits. 

Remember for exercise to be beneficial it needs to be performed regularly – so choose an activity that you enjoy and that matches your physical capabilities. 

What should I be aware of?

Exercise is safe for individuals with MS, and does not increase your risk of relapse or other adverse events.  However there are a few things to think about before exercising:

  1. Keep cool and well hydrated during exercise.  Wear cool clothing and try to exercise inside or in the shade.  Dehydration and warmer temperatures can increase your fatigue during and post-exercise.

  2. Avoid exercise if you are feeling unwell, experiencing an infection or fever.  These raise your core temperature and often cause a worsening of symptoms.

  3. If you are not used to exercising regularly you may experience increased fatigue initially.  However, overtime with regular exercise your body systems and central nervous system will adapt.  Exercise will lead to a reduction in your fatigue levels in the long-term – stick with it!

  4. Think about what time of day you have the most energy and try to complete your exercise program then. 

Remember to build your exercise up gradually and that doing any movement is better than nothing!

How do I get started?

Seeking help and advice from a professional such as an Exercise Physiologist or Physiotherapist is very important.  They will be able to tailor an exercise program to your abilities and guide you through the process.  

Give us a call if you are ready to start exercising to combat fatigue and continue to do the things you love.