Back to top

The Power of Keeping Cool

staying cool

By Adam Browne

Tips and techniques to keep cool while exercising during the warmer months

Firstly, why do you want to keep cool?

With an increase in body temperature even by as little as 0.5 degrees Celsius many people with Multiple Sclerosis (MS) experience a temporary worsening of symptoms (1). For many individuals this most predominately affects their experience of fatigue. Fatigue has been found to affect up to 75% of people with MS and is often reported as the biggest barrier to exercise and during the warmer months of the year this becomes an even larger barrier (2). This is because as the body’s core temperature increases the nerves ability to conduct and relay the appropriate messages become impaired (1,2). As each person experiences fatigue differently, different strategies may be successful in combating temperature increases, and therefore any worsening of fatigue or other MS related symptoms. For this reason it is important to trial a range of strategies in order to identify those that work for you. These strategies aim to enable you to manage heat related fatigue and other symptoms while allowing you to continue to benefit from your exercise program.

If you are sensitive to the heat, what are some of the strategies that can be used to keep your body temperature down while you are exercising? The following is a list of tips and ideas that you can try to aid in your efforts to keep cool and continue with your exercise:


Understand your body and the environment
  • Learn to recognise the early signs of heat induced fatigue (any change in visual or sensory symptoms), this way you can take a break or reduce the intensity of your activity
  • Exercise during the cooler part of the day so aim for the morning or evening
  • Wear light, loose clothing
  • Make sure the clinic or gym you are attending has air-conditioning
  • If you are planning on exercising in a pool such as hydrotherapy be conscious of the temperature of the water and if you can find a pool with a water temperature below 30 degrees Celsius


Hydrate and keep your inside cool
  • Make sure you remain well hydrated by drinking cool/cold water before, during and after exercise
  • Drinking ice drinks such as slushies or sucking on an ice-block will aid in reducing your body temperature by cooling you from the inside during and after exercise and assist in reducing heat induced fatigue symptoms


Use of cooling garments
  • Wearing a ‘cooling vest’ or ‘ice vest’ provide cooling for the body from the outside and have been found to reduce fatigue as well as decrease the effects of other symptoms induced by heat (3,4). This will allow you to exercise for longer periods while remaining cool and reducing the effects of the heat on your MS symptoms. Cooling vests come in a variety of forms and are supplied by a range of manufacturers, contact your doctor, physiotherapist, exercise physiologist or get in touch with the MS society for more information on your different options.
  • Other cooling options while exercising include the use of wet cloths/scarves, which can be worn around your neck, head or wrist, or wearable cooling products such as a cooling necktie. These options provide an alternative to the cooling vests in less costly way
  • Use a spray bottle to lightly spray yourself with water during your exercise session


  • Cool down before exercise by having a cold shower or using cooling garments has been found to reduce your body temperature and this allows you to gain extra time before your body temperature starts to increase when you exercise (3). You will need to experiment with how cool of a shower you can endure and how much it helps you, but you might be surprised at the increase in your tolerance for the heat.


Cooling after exercise
  • After exercise have a cool shower or get into a pool to assist in cooling your body and reducing your core body temperature, you can also use your cooling garments to aid in reducing body temperature after exercise and help to reduce any effects of fatigue.

Cooling and keeping core body temperature lower using different methods has been shown to be beneficial, both before and during exercise to have a positive effect on MS patients and any symptoms that may be amplified through heat sensitivity (3,4). Remember that if you do find heat sensitivity a barrier to your exercise, you can use any of these strategies to assist in keeping you cool, allowing you to continue to get the maximum benefit from your exercise therapy. Remember to discuss your heat tolerance problems with your health care providers (doctor, nurse, physiotherapist, exercise physiologist or occupational therapist) to find the best strategy for you.


  1. Mollaoglu, M., & Ustun, E. (2009). Fatigue in multiple sclerosis patients. Journal of Clinical Nursing, 18, 1231-1238.
  2. Andreasen, A. K., Stenager, E., & Dalgas, U. (2011). The effect of exercise therapy on fatigue in multiple sclerosis. Multiple Sclerosis Journal, 17(9), 1041-1054.
  3. White, A. T., Wilson, T. E., Davis, S. L., & Petajan, J.H. (2000). Effect of pre-cooling on physical performance in multiple sclerosis. Multiple Sclerosis, 6, 176-180.
  4. Meyer-Heim, A., Rothmaier, M., Weder, M., Kool, J., Schenk, P., & Kesselring, J. (2007). Advanced lightweight cooling-garment technology: functional improvements in thermo sensitive patients with multiple sclerosis. Multiple Sclerosis, 13, 232-237.