The idea for this post came from a study published at the beginning of August in the Multiple Sclerosis Journal exploring whether resistance exercise can show improvements in MRI and other clinical markers of MS disease progression. The article was quickly picked up and reported by the popular press- albeit with a rather sensationalist and misleading headline - screaming:

‘Resistance training SLOWS the progression of multiple sclerosis and even REVERSES brain shrinkage, study shows for the first time’.

Not quite so accurate once you read the full study (reference below) but it got me thinking about how resistance exercise can be beneficial in the management of MS. 
 
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What do we mean by resistance exercise?
Resistance exercise (or strength/weight training) improves the strength of the muscle and its ability to resist force. 
Whilst this sounds frighteningly 'personal trainer-y' it can be as straightforward as lifting and carrying a bag of shopping (although that's not always as easy as it sounds).

Why might resistance training help with my MS?​
The premise behind study into the role of resistance training to help in MS is based on research indicating that PwMS often show loss of muscle mass over time (muscle atrophy).  This muscle atrophy is the result of decreased activity (eg walking and standing etc) and is not restricted to PwMS; muscle atrophy happens to anyone who is not active - or as active as they have been previously - for a period of time.  This loss of muscle mass further results in loss of muscular strength making functional tasks such as walking and standing, lifting and carrying even more difficult.    
In MS there is uncertainty around the origins of atrophy-based impairment; is it as a result of the disease activity per se (ie demyelination and axonal degradation in the central nervous system) and/or the consequence of reduced physical activity levels, in itself driven by effects of the disease? It’s a vicious cycle. 
A recent systematic review [consensus of results from a number of studies] revealed that despite the suggestion of muscular weakness as a result of disease activity it is evident that MS does not impede the ability of muscles  to increase in strength through training, thereby potentially improving ability to complete strength-related functional tasks (eg lifting and carrying).  It is worth emphasising that any improvements in strength are task-specific to the individual muscles trained.  
It is crucial here that you consult a physiotherapist or qualified personal trainer to pinpoint any specific weaknesses so that they can develop a bespoke programme for you; I can't reiterate enough the need to consult a professional on this, exercise can definitely do more harm than good if performed incorrectly.

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Specific ways in which resistance training can help in MS         
Since it was established in the last few decades that exercise is beneficial to PwMS (contrary to early advice to avoid exercise altogether for fear of worsening symptoms of fatigue) many studies have attempted to quantify the optimal type and amount of exercise for PwMS.
Much of this research has been focussed on resistance training to address the evidence discussed above around muscle atrophy and associated weaknesses; after earlier studies established that aerobic exercise (eg running and cycling) can raise body temperature to levels which may exacerbate symptoms (Uhthoff's phenomenon).  More recent studies have shown that resistance exercise may be better tolerated by PwMS due to the shorter bursts of activity/effort required, and frequent rest periods naturally programmed between sets
Resistance exercise has been shown to improve:
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Some ideas for resistance exercise...
Resistance exercise can come from many different sources including:body weight exercises (eg yoga and pilates poses, sit-ups, press ups or squats)

• Exercises using dumbbells, a barbell, kettlebell or resistance bands  (Before I invested in some weights for home I used filled water bottles as dumbbells!)
• Free weights (gym and with a spotter for safety)
• Water-based resistance in the swimming pool (usually as a class with floating resistance-devices)

Although on the surface resistance activity is not seen to be as 'social' or 'enjoyable' as going for a run or cycle with a friend if you are able (benefits of aerobic activity to be discussed in a later post) it has clear specific benefits for PwMS with regard to improving muscular weakness and maintaining muscle strength to complete functional tasks.  
That said, if you enjoy swimming and aren't affected by the temperature of the water, the classes which have foam 'noodles'/ 'water woggles'/ or whatever look great fun and seem to be enjoyed by people of all ages. Maybe take a friend and give it a try!      
 
What is the recommended amount of resistance activity?
The guidelines for resistance training for PwMS do not seem to differ from that of the population as a whole.  My website shows the general population guidelines for physical activity which includes two sessions per week for adults aged 18-65+.
As with any activity you should only do what feels achievable and can be completed safely.  Your ability is yours alone so only you know what is best for you.
 
Some notes on safety; it is paramount that you keep yourself safe while exercising.  Always use a 'spotter' when lifting weights, you never know when you may not be able to complete a planned exercise, so they are there to step in and help.  The same advice goes for anyone lifting weights, it is not exclusive to PwMS so always workout with a buddy when using weights; the weights really do hurt if you drop them.
See my page on tips for exercising with MS on the website; both from me and the MS trust.
    
And the final words from me...
Have a look at my website to understand more about how exercise can help us manage some of our specific MS symptoms.
Do let me know if you have enjoyed this post and found it useful.  Send me an email (address below); send me a tweet (@healthylifems) or send me a message through the contact page on the website, I'd love to know what you think.

​Hello and welcome to my first ever blog, and first website too for that matter…
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I was diagnosed with multiple sclerosis last year (2016) aged 35 which was a huge shock.  Once I’d trawled the internet - as we all do – to find out as much as possible about this disease [as up until that point – in my naivety - I hadn’t really known anybody with MS or any real idea of what diagnosis meant] I realised my 35 years of ‘life’ to date with the various qualifications and experience I had accrued actually put me in a good place to help myself and other people to deal with MS, so this website was born.
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The general advice offered by websites, books and the huge amount of research published shows that a healthy lifestyle (on a basic level, diet, exercise and managing factors like stress, smoking and alcohol) is key to helping to manage the disease.  On the surface, good advice for anyone – whether you have MS or not – but once you develop a disease such as MS this healthy lifestyle advice becomes even more important.
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​What makes me think I can advise other people on how to help manage this disease?
A long time ago now, my first degree when I left school was in Sport Science – I was always the ‘sporty one’ at school playing in all the sports teams, local club teams and to county level in some sports, then competing in University teams too.  Suffice to say I had a good grounding in how important exercise is in keeping us healthy.  Following this I spent over ten years working in the advertising industry in various locations (not so healthy by comparison!).  I had always loved learning and never really 'got it out of my system' so in 2014 I made the choice to change career into academia by studying for a Master’s degree in ‘Nutrition, Physical Activity and Public Health’ at the University of Bristol with a view to continue on to complete a PhD and eventually work as a researcher in a University.  My research pieces for both degrees were in how diet and physical activity can impact various diseases; this was long before I had any idea that I would actually need to apply this knowledge to myself!  
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Whilst applying for research jobs and PhD places I studied some practical courses in Nutrition for Weight Management and Sports Performance Nutrition (as I said, I never really got studying out of my system!).  I also studied to become a personal trainer; a nice little side-line I thought alongside the health research job or PhD I was going to get… 
As you can see, I never stood still, stopped or slowed down before this diagnosis, which – as obvious as it sounds – really, and quite literally, stopped me in my tracks.          
 
MS?  Really? Are you SURE?
I had a niggling ‘foot thing’ (twisted ankle or even cruciate ligament strain in my knee I thought confidently; typical runner/gym-goer injuries) that sent me to a doctor and swiftly to the physiotherapist.  Physio appointments are longer than your typical GP appointment so there was a bit more time to explore what might be going on.  I have historically not been a frequent visitor to my GP surgery (oh how things change!) so was super-keen to visit the physio a couple of times be ‘cured’ and get back to the gym.  Ho hum.

‘Nonsense’ I thought when it was suggested I see a Neurologist, nonsense.  I have a feeling that the words in the heading above may have actually come out of my mouth following the requisite examinations and blood tests which form part of the diagnostic process.  Oh, that and the less than sunny results of my first MRI scan.  Bother.  OK, so this is actually pretty serious now.  

‘But are you 'sure sure'?’
I imagine I am rather an infuriating patient; so many questions.
I have been very fortunate so far; this diagnosis was pretty straightforward, none of the years of uncertainty and horrid symptoms I have read about so often, and monthly visits to the hospital for treatment are relatively painless too.  So far so lucky.   
      
Why the website and blog?
Following all the research I did shortly after being diagnosed I realised that all the qualifications and experience I had gained in the role of healthy eating and exercise in disease prevention (!) and even advertising (in promoting the site) all somehow came together and it struck me, could be beneficial in helping others (alongside myself) to manage the disease. 

I will aim to update the blog weekly with articles on relevant ‘new news’ relating to exercise, diet, lifestyle and how they impact MS.  Over time I aim to add in a section on healthy recipes and maybe even exercises (although the MS Trust have this pretty well covered with their in-house Neuro-physiotherapist already); we’ll see.  I’m keen for the site and blog to evolve as time moves on.
 
How can you contact me?
If you would like to comment on what anything I’ve written, the information I have shared, ask a question or just say ‘hello’ please email me [email protected]​, tweet me (@healthylifems) or send me a message through the site.  I would love to hear from you and know what you think.  This site is purely to share information, I am not trying to sell anything or make money from it. 
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I’d love to hear from you.