You can’t talk about MS without talking about the gym. It’s really hard to overestimate the effects of working on yourself. Most people are lazy by nature, they count on someone to solve their problems for them. This problem, of course, does not apply only to multiple sclerosis patients, it is known that regular sports reduce the risk of heart attack, cancer, improves well-being. So honestly, how many of your adult friends run, bike, swim, walk in the mountains? But in the case of multiple sclerosis, training is much more important. It is sometimes – literally – a matter of life and death.
Some of my blog posts on the subject:
https://healthytreatment.org/2022/01/27/the-gym/
https://healthytreatment.org/2022/01/31/gym-basic-rules-and-dispelling-myths/
The mechanism for improving health through exercise in the gym is very simple. Each muscle is controlled by a certain number of nerve cells. Disease makes these cells less and less useful, making it harder and harder for them to do their job. But if we exercise in the gym, do it the right way, then the body will allocate additional cells to control the muscle in question. The effects in the case of MS are truly astonishing. Within a few months, patients are able to regress by up to several points on the EDSS scale. I know this is hard to believe, but it has been confirmed by studies. So as not to be lip service, the study:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592758/
After just 8 weeks in the gym, where exercise took 30 minutes 3 times a week, EDSS changed from 3 to 1.5 on average!

People don’t believe that how their disease progresses depends mainly on themselves. They fall into fatalism and accept whatever happens, or they put all the responsibility for the course of treatment on doctors. Meanwhile, how much the disease takes from us depends mainly on ourselves, how much we let it. Once I heard the story of a woman suffering from progressive paralysis, I no longer remember if it was amyotrophic lateral sclerosis or something else. At one point she had only two fingers of her right hand, the index and middle finger, working out of both hands. She was unable to move any of her other fingers, but these two were completely functional. The woman simply smoked cigarettes and had to use them, so only these two got some exercise.
Regular exercise also has many other benefits. They provoke the body to increase bone density, that is, they undo the processes of osteoporosis, one of the causes of serious problems for people with MS. In a year of training, one can easily “rejuvenate” bones by 10 years, by that much postponing the moment when we will be at risk of fractures. They have an amazing effect on mood, in one study they were found to be more effective in treating depression than modern antidepressants. They can give a sense of realization, of changing oneself, of progress. The importance of such changes in human life cannot be overstated. They increase testosterone levels, which is extremely important in developing MS, since low testosterone is a risk factor. I also wanted to reassure women right away. No, you will not start looking like bodybuilders. You will not grow muscles. No woman will grow big muscles unless she takes anabolic steroids. If any bodybuilder woman looks like a guy and convinces that she did it naturally, she is simply lying.
A lot of people have probably already tried various forms of training and programs for MS and they didn’t have such good results. That’s because most trainers and therapists who put together such programs have no clue how to do it. I’ve seen a few of them and was overwhelmed with horror. These goddamn “experts” are paid to lay out exercises, not to make someone feel better afterwards. As a rule, instructors either know a lot about sports, but have no idea about MS, or, conversely, they know everything about MS, but not much about sports. And, in most cases, they know nothing about anything, but got paid to write a “training program” because they have connections.
The secret is to train with maximum load. Only then does the so-called “neuroadaptation” take place, only then does the body increase the number of neurons allocated to the muscle. Then, too, there is an increase in bone mass. Unfortunately, almost no form of training at home, with instruments or with your own body, such as “push-ups” or “sit-ups” – will do much. You need to go to a gym, or invest in your own heavy equipment.
If possible, train with free weights, i.e. barbells and dumbbells. They are much more effective than machines, and are also – contrary to appearances – safer. It is essential to ask the instructor to demonstrate proper execution. Of course, people who are seriously ill will not be able to use free weights, but in principle anyone who is still able to walk, even on crutches, will easily be able to exercise on the devices. You can ask an instructor or someone to help you, at gyms people are really very nice (contrary to popular opinion), even pin a limb to a machine. I won’t elaborate here on all possible forms of training, there are thousands of sites on the Internet where it is described better.
Of course, before each workout you should warm up properly. If you are an absolute novice, you can – before moving on to the actual training – spend a month or even two on preliminary training with light loads and more repetitions to strengthen the joints and muscles. It won’t change very much in the disease itself, but it will protect against injury when applying very heavy loads.
We start the actual training. You can first do a series of repetitions of an exercise with a low load, for example, 20 times. But proper training must come down to training with a load so heavy that we can’t do more than 5, top 10 repetitions. The ideal exercises are those in which the whole body is involved, or at least several adjacent muscle groups, i.e. it will be much more effective to perform a squat with a barbell, during which a dozen muscles work, than to “push” a weight on a machine with your legs, or other exercises in which only the leg muscles work.
You can exercise the whole body in one day, or divide the exercises into 2 or even 3 sessions. It doesn’t really matter which program you choose, as long as you follow the principle of heavy-load exercise. You can divide into leg training in one day, arm training in one, you can divide into exercises in which you push off and exercises in which you pull (the popular “push-pull”), you can do ABx strength training.
It is important to give each muscle a longer rest. For example, you must not exercise your biceps every day, even every other day is inadvisable. The body should be allowed to recuperate. It is also not very advisable to strain the same joint two days in a row, but this is not so important. You should also pay special attention to the muscles responsible for maintaining balance and for the basic functions of life, namely the muscles of the back, abdomen, gluteus maximus, gluteus medius, thigh adductors, keeping the foot in balance (tibialis posterior), as well as the muscles of the forearms. There’s probably no point for me to write out a detailed workout for these muscles, especially since the tibialis posterior, for example, is very hard to isolate, and each patient has completely different training options and access to different equipment, but if you have trouble finding an instructor or information on the Internet, let me know on my forum, I’ll write out some basic program for the most important muscle groups.
As a point of reference, I’ll summarize the training program used in the study I linked to above.
In the first week, 1 series, 6-10 repetitions were performed with 50% of the maximum load (or if someone was able to lift 100 kg once, he performed the exercise with a load of 50 kg). Second week: 1 series, 10-15 repetitions, 60% of the maximum load. Third and fourth: 1 series, 10-15 repetitions, 70% of the load. Finally, from the fifth to the eighth: 1 series, 10-15 repetitions, 80% load. Before each session there was a 5-10 minute warm-up, such as riding a stationary bike.
Among the exercises performed were the bench press (note, this exercise is NOT performed alone at home, if there is no one to assist, use dumbbell presses), sitting rowing, leg extensions and leg presses.
It is worth changing the set of exercises performed every few months, then you provide the brain with new stimuli and force it to “learn” to deal with other muscles, in a different configuration.