To help us understand how exercise can make a difference, we would like to introduce Adam Browne. Adam is an Accredited Exercise Physiologist, specialising in Multiple Sclerosis rehabilitation and in strength conditioning. He has offered to share his knowledge and some practical tips via a series of articles to be shared here. For more information on Adam and to join him online, please visit:
Too tired to get to the gym? No need to!
By Adam Browne
Simple exercises that can be done at home or at home to help strengthen legs
If you haven’t previously started an exercise program please see my previous article ‘A Balancing Act – How to get your exercise routine started’
Have you started an exercise program recently or been regularly exercising for a period of time but feeling too tired or fatigued to do your exercise when you have planned to? Today we are going to look quickly at why we want to exercise, some different options to complete strength training and also provide you with a simple (recommended) home program you can complete within your own capabilities.
There are a few things that can be implemented to help you deal with fatigue, but firstly you need to identify why you might feel tired.
Fatigue can be caused by a number of different processes, but most commonly referred to as either primary or secondary. Primary fatigue is associated with the MS disease process and can be worsened by heat. Secondary fatigue can be caused by other factors such as MS related symptoms or daily occurrences, including: disturbed sleep, pain, spasms, stress, muscle weakness, illness etc. This secondary fatigue can also be attributed to decreased physical fitness levels, in which MS populations have been found to be less physically active as a result of their symptoms. The combination of this decrease in physical activity and MS related fatigue causes a progressive cycle which decreases physical fitness, increasing the amount of energy required to complete the activity, in turn increasing fatigue levels and then leading to further reduction in daily physical activity levels. And so the cycle continues. This cycle can be broken though, through regular exercise using appropriate prescription, the aim of this is to increase muscular strength and physical fitness to therefore reduce the energy needed to complete daily tasks and therefore, reduce secondary fatigue.
How much exercise should you do?
Firstly you need to understand that while these are recommendations - everyone will need an individualised approach to their exercise program based on capabilities, limitations and the need to be flexible and adapt due to fatigue or other symptoms. For this article I am going to focus on strength or resistance type training. Resistance training should always be supervised by a qualified person until the individual has acquired the appropriate level of competence. All strength programs should be progressive and flexible, and can include: machines, free weights (if appropriate), bands and or body weight exercises. Rest periods between sets and exercises in the range of 1- 3 minutes depending on how heavy the weight is and the level of fatigue on the day. Below is a table which highlights the current recommendations for strength training for people with MS.
Number of Exercises
4-8 (mixture of upper and lower body)
Times per Week
2-3 (always with day rest between)
What can you do to still complete your exercise when fatigued or tired?
If you are feeling particularly fatigued or too tired to think about completing your exercise program, that is ok. Listening to your body and having an understanding of what you are able to do is important. It is also important to remember ‘something is better than nothing’. Are you able to still complete part of your exercise program at home or are you even able to complete your whole exercise program through out the day by splitting it up into smaller more manageable bouts of effort? Always remember to exercise with in your limitations, if you are feeling more tired than usual it is ok to reduce your normal exercise routine or increase your recoveries to suit how you are feeling on the day. Attached is a general home exercise program that can be completed using only body weight as resistance. The attached program is a guide, for more specific exercises always see your allied health team (exercise physiologist or physiotherapist). This program can be completed at home or in the work place and can be spread out through the day to better manage your fatigue if doing it all at once is too much.
Blozis, A., Harrison, C., Stuifbergen, K., et al. (2006). Exercise, functional limitations, and quality of life: A longitudinal study of persons with multiple sclerosis. Arch Phys Med Rehabil, 87(7), 935–943.
Dalgas, U., Stenager, E., et al. (2008). Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance and combined training. Multiple Sclerosis, 14(1): 35-53. 3.