Yoga and exercise for Multiple Sclerosis
Combining Exercise and Yoga to HelpManage Symptoms of Multiple Sclerosis Multiple sclerosis (MS) is a chronic and progressive illness that affects brain and spinal cord, resulting in sensations such as numbness, loss of muscle control, vision, balance, and/or thinking ability. MS is an autoimmune disease (diseases in which the body''s immune system mistakenly attacks normal tissues). With MS, the immune system attacks the central nervous system and damages the nerves of the brain and spinal cord. The central nervous system consists of the brain, spinal cord, and nerves that act as the body''s messenger system. The nerves are covered by a fatty substance called myelin. Myelin insulates the nerves and aids in the transmission of nerve impulses, or messages, between the brain and other parts of the body. These nerve impulses control muscle movements, such as walking and talking. The term Multiple Sclerosis is derived from the buildup of scar tissue (sclerosis) and because of the fact that myelin can be lost in multiple areas. These damaged areas are also known as plaques or lesions. The scar tissue or plaques form when the myelin that covers the nerves is destroyed, (demyelination). Without the myelin covering, electrical signals transmitted throughout the brain and spinal cord are disrupted or halted. The brain then becomes unable to send and receive messages. When this breakdown of communication occurs the symptoms of MS appear. The type and severity of symptoms, and the course of MS varies widely, partly due to the location of the scar tissue and the extent of demyelination. Regular, moderate physical exercise is good for the body, mind, and spirit. For those with MS, exercise is an important tool to help maintain function, mobility, and help manage symptoms such as depression, fatigue, and anger. Regular exercise can improve a loss of fitness caused by a sedentary lifestyle and be therapeutic for such MS-related problems as spasticity and poor balance. Exercise also builds a reserve of muscle strength and cardiovascular function. Then, if an attack or exacerbation of MS calls for a time-out from physical activity, the reserve is available. When the symptoms subside and the person is able to go back to a more normal life, there is a better foundation on which to rebuild. Addressing the symptoms of MS with regular exercise may help to slow the progression of the disease as one maintains or even gains more mobility. An exercise program should consist of aerobic or cardiovascular exercise, strength training exercise, and stretching exercises. Regular aerobic exercise helps make the heart stronger and helps to increase lung capacity. Strength training exercises help to increase muscular strength. Stretching exercises help maintain joint range of motion. However, all benefits of exercise are short-term; that is, they fade away if exercise is discontinued. On the other hand, all exercise provides benefits. If you find you can’t do what you used to do, don’t give up. You can always modify or turn to something more feasible. Physical therapists and exercise physiologists can provide expert help. Exercise can help ease the symptoms of MS, but it''s important to take certain precautions if you want your exercise program to be successful. Some of the factors which can interfere with exercising when you have MS include fatigue, overheating and balance concerns. Fatigue. A common symptom for those with MS is fatigue. You may find that you have more "off" days than "on" days. Also some medications can cause fatigue as a side effect. Fatigue can also be related to respiratory problems. MS can sometimes affect breathing, and when it does, even simple activities can be tiring. Lastly, sleep problems, problems falling asleep, staying asleep, or getting the right kind of sleep prevent people from feeling refreshed when they wake up.Tips for handling fatigue- Plan ahead. Get adequate sleep the night before engaging in exercise. Take a 15-minute nap a few hours preceding any demanding exercise.- Schedule physical activity for the time of the day when energy is highest. Alternate more demanding exercise with activity requiring less.- Always talk with exercise instructors about MS before starting a new class. This will allow the instructor to support you if you need to stop and rest.- Apply the “2 minute” rule: When feeling too sluggish for working out, commit to moderate exercise for just 2 minutes. The activity may generate the energy to continue. If fatigue persists, stop and rest.- Avoid exhaustion. When it looks as if energy might start to fade, a 15-minute time-out may be all that’s required to recharge. Lie or sit with eyes closed and breathe slowly and deeply. Do nothing, except possibly listen to soothing music or repeat a comforting word, sound, or phrase such as “I am calm.” Overheating. Many people with MS experience a temporary worsening of their symptoms when they get too hot, such as getting overheated from exercise. This can occur with even a very slight elevation in core body temperature (one-quarter to one-half of a degree) because an elevated temperature further impairs the ability of a demyelinated nerve to conduct electrical impulses. It is important to remember that heat generally produces only a temporary worsening of symptoms and does not cause more actual tissue damage and the symptoms are generally rapidly reversed when the source of increased temperature is removed.Tips for keeping cool- Exercise in an air-conditioned room. - Drink lots of cold fluids during exercise. Carry cold drinks in insulated containers that attach comfortably to a belt, waist-pack, backpack, or shoulder strap.- Become aware of your body. If you notice any symptoms that you didn''t have before you began exercising, then slow down or stop exercising until you cool down.- Wear lightweight shoes. When the feet are cool, the rest of the body tends to be cool too.- Wear vests, hats, or kerchiefs that hold “blue ice” gel packs or materials that can be chilled for long-lasting coolness.- Dress in layers, in order to add or remove clothing as body temperature changes.- Lower your body temperature immediately before and/or after exercise with a cool soak in a bathtub or shower. When no showers, tubs, pools, or gel packs are handy, try running cold water over your wrists for three to five minutes or apply cold paper towels to the neck and forehead..-Refresh with “spritzes” of water from a plastic spray bottle—the type used for misting houseplants. Balance concerns. If you are experiencing a loss of balance regular exercise can help. Talk to your instructor before the class to let them know you are dealing with MS and that your balance is affected. Try holding onto a chair or rail along the wall when exercising. If there are no chairs or rails, stand within arms reach of one of the walls, so you can use it to steady yourself if needed. Combining exercise and yoga. While regular aerobic and strength training exercises are important for those with MS, yoga techniques can help to manage the symptoms that may prevent you from exercising. Yoga teaches deep diaphragmatic breathing exercises. These breathing techniques help to increase lung capacity and teach you to take in a full breath. Learning to breathe diaphragmatically is a much more efficient and relaxing way for the body to take in and process oxygen. As your respiratory system becomes stronger you will become less fatigued less often. You can start by teaching yourself to do deep diaphragmatic breathing while sitting or lying down. Then once this becomes easier try using this style of breathing when participating in aerobic exercise. Many yoga postures are excellent for improving balance. Here again start with some simple postures such a warrior one, warrior two, or tree pose. As your balance improves through the practice of stationary postures, you will find you have better balance during everyday activities including exercise. Lastly yoga helps to develop a connection between mind and body. This is where yoga is very different from traditional western-based exercise programs. Yoga teaches the student to not only become aware of how the body is feeling in relation to movement, but also encourages the participant to honor the body’s needs. As one through the practice of yoga becomes more aware of the movements and intensity of exercise that is best for their individual situation, they become less likely to overdo it. When we learn to exercise at a level that is appropriate for our individual body, then we avoid over fatiguing, muscle soreness, and other symptoms that often cause us to give our exercise program up. So listen to your body, try various classes to see which one feels best, and keep exercising!