Working Out Multiple Sclerosis-Related Fatigue

Medically Reviewed by Carmelita Swiner, MD on March 02, 2023
3 min read

Fatigue is the most common symptom of multiple sclerosis (MS), so it makes sense if exercise isn’t your thing. But exercise is a great remedy for MS fatigue and one of the most important parts of your treatment.

Exercise improves your balance, muscle strength, and heart health. As you get stronger, daily tasks that used to be a struggle will start to seem easier, and they won't tire you as much.

Physical activity also releases hormones called endorphins that boost mood and energy. Exercise helps you sleep better, too, so you’re fresher in the morning. Staying active also teaches your body to use oxygen more efficiently, which gives you more energy and endurance.

Don’t worry if you’re out of shape, stiff, or struggle with balance.  A physical therapist can design a routine that suits your needs and your fitness level.  It’s also important to find exercises you enjoy and will stick with. Maybe you like to work out by yourself. Exercise is a form of meditation for some people. Or you might do better with group workouts or team sports.  Once you figure out what you love, you can make exercise part of your everyday life.

A mix of progressive strength training, aerobics, and stretching will work best. Ask your doctor or physical therapist about:

Progressive strength training. You use free weights, machines, bands, or your own body weight to build muscle in your arms and legs. As you get stronger, raise the resistance you work with. The more strength you build, the easier it’ll be to get around without getting tired. Strength training can also prevent falls and may even slow the progression of your MS.  Try to fit progressive strength training into your routine at least twice a week.

Aerobics. This is anything that gets your heart rate and oxygen rate up. You can dance, jog, walk, cycle, swim, or climb stairs. You should be sweaty and breathing hard, but you should still be able to talk if you need to. Your physical therapist can help you figure out a good plan. Aim for at least 30 minutes of activity, 5 days a week. If that’s more than you can handle, you can divide your workouts into 10-minute sessions.   

Stretching. This is the best way to keep your range of motion and build muscle control. Shoot for 10 minutes each day. Choose active stretches that keep your body moving. Tai chi and yoga are great options.

If your workout seems too hard, don’t give up. You and your team can always modify it, or you can switch to another type of exercise.

Keep cool. When you exercise, your temperature goes up.  This can cause tingling, numbness, or blurred vision when you work out. These symptoms usually go away as you cool down. Exercise during the coolest part of the day or crank up the AC, drink lots of water, and wear a cooling collar or other device that can help keep your temperature down.

Don’t overdo it. When you first start to exercise, it’s easy to want to do too much.   A physical therapist or trainer who knows MS can help you safely up your game when you're ready to.

Don't be too hard on yourself. If you need to cut down on exercise for a while, it can take a few weeks to get your strength back. Don’t be discouraged. This happens to everyone, even elite athletes.

Use the "2-minute rule." On days you don’t want to crawl out of bed, tell yourself you only have to exercise for 2 minutes. Once you get started, you usually feel better and can go as long as you normally do.