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Many of you have been following my MS relapse story. The question that I am often asked is what I am doing to help regain my functionality. In my last article, I talked about working with physical therapists, occupational therapists and speech language pathologists to improve my functionality. However, once therapy ends how do I maintain the progress that I made during therapy?

All therapy disciplines will provide you with a detailed home exercise program that has pictures and instructions for continuing your personalized plan of care. They may even provide you with adaptive equipment so that you can continue to manage your condition independently at home. Once you get to a point where you are feeling better and want to continue working on strength and conditioning, here are some exercise activities that you can do without the aid of a therapist.

Aquatic Exercise – Exercising in water provides many benefits to those of us living with MS. Exercising in the water does not mean just swimming laps. You are more buoyant in water meaning that you are lighter to help support weaker limbs. This means you can achieve a greater range of motion with less effort. Water is also cooler, so your core temperature will be kept lower and have a quality workout without overheating. You can get affordable pool exercise equipment online or at big box retailers that will last a long time. If you do not have a pool, local gyms or the YMCA typically have a pool, some even offer water exercise classes. You can also find physical therapists that specialize in aquatic therapy that can help design a pool exercise routine that will help improve your strength, range of motion and functionality.

Yoga – Yoga is an ancient discipline focused on breath control, simple meditation and the adoption of certain body postures to stretch and strengthen. Inform your yoga instructor of your disability and they will adapt poses to stretch and strengthen your area of weakness. The Yoga poses can also be adapted to do in a chair, wheelchair or lying on the floor or bed. A real benefit of Yoga is controlling your breathing which increases your sense of relaxation. Yoga is also done at your own pace. There is no right way or wrong way, there is just what is comfortable for you. The more you practice, the stronger you will get. Traditional yoga is better for people with MS, as some practices, like Bikram or hot yoga, are done in a steamy room raising your core temperature. This can be dangerous for people living with MS and can exacerbate symptoms, rather than relieving them. Health benefits of Yoga include: increased flexibilities, improved muscle tone and strength, improved energy and vitality, and protection from injury. The low impact of Yoga makes it an excellent exercise alternative for a person living with MS.

Accessible Bike Riding – The thought of traditional bike exercising with MS can be overwhelming. Fatigue, balance, weakness and other MS symptoms can make the thought of traditional bike riding seem impossible. However, there are adaptive bike solutions that allow freedom for those of us living with MS that would like the freedom and exercise that biking on the open road provides. Here are a couple of examples of different bike types that are accessible for people living with MS:

• Handcycle – A handcycle is a three-wheeled bike that allows you to sit safely, buckle up and use your hands to pedal and steer. If you are unable to use your legs or have balance issues, a handcycle is the ideal, safe alternative to get on the road and build upper body strength.
• Recumbent Road Bikes – Similar to the handcycle, a recumbent road bike is a three-wheeled bike that allows you to sit and buckle safely on the seat. However, a recumbent bike is pedaled with your feet rather than your hands. This bike is also great for those with balance issues and promotes lower body strength and conditioning.
• Beach Cruisers – If you do not have balance issues and prefer a traditional bike riding experience, a beach cruiser is perfect for you. A beach cruiser is a two-wheeled bike that is designed with an extended handle bar that promotes better posture. Since the handle bar is extended further than traditional bikes, there is more clearance for your legs to get on and off. Also, the extended handle bar forces the rider to sit up straight and reach, which promotes a posture that keeps your back and neck in line. They are also one speed, so there is no need to shift and your focus can remain on the road.

Home Exercises – Your home provides a perfect place to perform physical activity without needing to get out to a gym. Here are some home exercise options to promote physical activity without leaving the house:

• TheraBand pulls – A TheraBand is a stretchy band that provides resistance when you pull it. You can wrap a TheraBand around a door knob, or other stationary home object, to perform back, shoulder and arm exercises without extra stress or strain of traditional weights. TheraBands come in different resistance levels and are available online or at health and wellness retailers.
• Wall Exercises – for upper body strength, a wall makes a handy tool. Wall exercises include wall push-ups, rolling a soccer sized ball up and down for range of motion, and upper body stretches.
• Chair Exercises – in addition to sitting, a chair is a perfect place to work on lower body strength. Sit at the edge of your chair, with your elbows and forearms flat on the arm rest and do leg raises. You can also use the back of the chair to stabilize your balance while stretching.
• There are a wealth of online resources for learning more about adaptive exercises and MS. One that I wanted to highlight here is the Stone Clinic. This link has home exercise videos and is a great free resource that will show you how to complete the above suggestions safely at home: http://www.stoneclinic.com/shoulder-rehab.

The key to living with MS is to continue physical activity in whatever capacity you can. Movement is the key. If you are unable to exercise in the traditional way try aquatic exercise, yoga, accessible bike riding or home exercises. Do your research on the internet. Don’t be afraid to ask for a discount either. If you do not have the means to take advantage of these opportunities, there are tools and resources available to help.

Organizations such as MSFocus: the Multiple Sclerosis Foundation can help you locate those resources. When you make the decision to be more physically active, you will feel empowered and have a better overall quality of life despite the challenges of living with MS.