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Multiple Sclerosis Exercise Program

An image of people taking part in a multiple sclerosis exercise program.

This multiple sclerosis exercise program has been carefully crafted to help keep you fit and physically active. The program is fully customisable and can be modified to meet your personal training needs.

In addition, the program can be adapted to accommodate those with a limited range of mobility or MS sufferers who are wheelchair-bound. In conjunction with the program, a range of best exercises have been outlined and an example of a workout plan.

Concluding this article, you will be able to:

Create a personalised workout
Modify exercises to suit your level of ability
Develop a safe training session
Tailor the exercise program
Implement and begin an exercise program

About the multiple sclerosis exercise program

The multiple sclerosis exercise program has been created in collaboration with the Rosewood Counselling and Coaching Services Multiple Sclerosis course, a free learning resource designed to support people living with MS.

Part of the course covers healthy lifestyle factors that have been shown to exert a positive impact on reducing and attenuating MS flare-ups and relapses. These lifestyle factors include the implementation of a plant-based diet, reducing and managing stress, improving sleep, avoiding harmful substances (alcohol, cigarettes, vapes, and other noxious chemical substances), and participating in regular exercise.

We were asked to produce an intervention that could be used by people with MS to implement an exercise regime.

How to start the multiple sclerosis exercise program

Of course, your current conditions and exercise experience will largely determine how much of the program you can commit to. For example, if you are physically able but haven’t before participated in regular exercise, two days will be more than enough for the first two weeks of the program.

Once you have become accustomed to training consistently and developed a base level of fitness, you can gradually begin increasing the number of weekly workouts.

Incrementally increase exercise frequency until you have established a routine that is suitable for your personal need and lifestyle commitments. Ideally, you want to aim for a minimum of four exercise sessions per week.

What is the best exercise for ms?

There is no best exercise for people with multiple sclerosis. And, echoing the point above, your mobility and training experience will largely determine which exercises you can do. It’s for this reason that the program includes exercise options. This ensures that a broad range of requirements and abilities are catered for.

However, it is true that some exercises are better at promoting positive health outcomes than others. For example, in the brilliant book Exercised: The Science of Physical Activity, Rest & Health, professor of biology Daniel Liberman outlines a study showing the comparative effectiveness of cardio and resistance training at reducing body fat.

The outcome of the study was unequivocal: ‘individuals prescribed just weights barely lost any body fat but those prescribed twelve miles a week of running lost substantial amounts of fat, especially harmful organ fat,’ (Exercised – p304).

aerobic exercise for multiple sclerosis

Though twelve miles of running a week may sound a lot to some, the takeaway here is that cardio exercise is a far more efficient method of maintaining a healthy body weight. Cardio exercise also confers a score of other health and fitness benefits. (Try this low-impact cardio workout.)

According to the World Health Organisation, regular physical activity, specifically aerobic exercise, is ‘proven to help prevent and manage noncommunicable diseases (NCDs) such as heart disease, stroke, diabetes, and several cancers.’

The good news is that to enjoy these benefits you don’t have to run twelve miles every week. Breathe a sigh of relief.

Recent research has shown that relatively low doses of cardio exercise help to fight fat, improve fitness and provide a measure of protection against certain diseases. For example, cycling at a light- to moderate intensity for just 20 minutes per day has been shown to improve cardio capacity and increase muscle endurance in the legs (Exercise Physiology | Second Edition). Similar findings have demonstrated the remarkable rapidity at which the body positively responds to even modest amounts of cardio exercise.

So, while there’s no best exercise for those with MS, there are more effective exercises for promoting health and improved general fitness. Such exercises are aerobic, and they include:

Airdyne cycling

weight training with ms

But though the importance of aerobic exercise cannot be overstated, it is beneficial to participate in other forms of training as well. While weight training is an inferior form of exercise for fighting fat, it is beneficial in other ways.

For instance, weight training with MS is essential as it can help maintain muscle strength, improve proprioception, coordination, and dexterity. In addition, preserving or augmenting one’s physical strength is positive for other reasons besides those outlined.

In the Overcoming Multiple Sclerosis Handbook (OMSH), the authors talk about the phycological empowering effects of exercise for MS sufferers. ‘Studies have found a number of key associations between better physical and mental health,’ (my italics). What these studies discovered was that people with MS who participated in regular exercise and kept up their physical strength had ‘better mood and concentration’ while generally enjoying an ‘improved quality of life.’

balance exercises for multiple sclerosis

Balance exercises should also be integrated into a multiple sclerosis exercise program. The importance of balance is emphasised in the OMSH. In answer to the question What’s the best exercise? Dr Stuart White tells us that, while there is no ‘best’ exercise, there are types of exercises that people with MS should do ‘to offset some of the effects’ of the condition.

He goes on to explain that practicing basic stretching and balancing ‘can help overcome spasticity and muscle tightness.’ Moreover, MS sufferers have also reported that improving balance helps with walking and avoiding falls (Overcoming Multiple Sclerosis Handbook).

Related: Reduce muscle tightness with this Daily Stretching Routine

The most effective way to develop your flexibility and balance is by taking up yoga (Pilates or tai chi). There are scores of teach-yourself yoga tutorials on YouTube. Lesley Fightmaster (my personal favourite teacher) has produced an excellent range of videos that cater to the complete beginner and the budding Patañjalies in the crowd. Make time tonight and have a go at Fightmaster's Hatha Yoga For Flexibility and Balance 45-minute Flow.

Essential reading: Anatomy of Hatha Yoga

How to adapt the program and best exercises for ms sufferers in wheelchair

One of my most humbling experiences was training an MS sufferer. Though Richard was wheelchair bound he never let that prevent him from attending the gym twice a week. I remember, during my first week working as an instructor, watching him struggle to get on and off the exercise equipment.

I went over and asked if he’d like some assistance. Richard took me up on the offer and we instantly formed a lasting friendship. Every time he came to the gym, I dropped what I was doing to support him through his training routine.

What struck me most was not so much the fact that Richard overcame so many barriers to attend the gym; for him getting on and off the equipment was equally, if not more challenging than performing the exercise itself. What most impressed me was his attitude towards focusing on exercises that he could do rather than ruminating over what he couldn’t do.

ms chair exercises

For example, because Richard had very limited mobility in his legs, he couldn’t participate in conventional aerobic exercise – running, cycling, or the cross-trainer. But he compromised by using the grappler (or SkieErg) and modifying the rower.

The grappler is a cardio machine that involves repeatedly pulling a rope in a hand-over-hand fashion. Because the resistance is low, you can sustain a continuous output for protracted periods which stimulates the cardiovascular system. And, most importantly, the exercise is performed in the seated position.

Richard modified the rower by fixing the seat in position. He would then pull the paddle to his chest continuously for 5- to 10-minutes. This exercise modification was very effective and at the end of the session, Richard would be sweating profusely. (I was so impressed with this modification that I started to incorporate it into my own workouts.)

ms strength training chair exercises

Richard didn’t stop at adapting cardio exercises, he also tailored resistance movements so that he could train strength without having to get out of his wheelchair. One simple way he achieved this is by switching from machines to free weights – such as dumbbells and kettlebells.

In addition, he regularly used resistance bands as he found them to be versatile and easy to manage. Sometimes Richard struggled to manoeuvre a pair of dumbbells into position to perform certain movements. He overcame this limitation by substituting dumbbells for resistance bands. Because bands are much lighter than dumbbells they are easier to handle, yet they still offer the same range of resistance.

Example ms strength training workout in wheelchair

What follows is an example strength training workout that has been modified for MS sufferers in a wheelchair. The workout is loosely based on Richard’s standard resistance training routine.

A strength routine for MS sufferers in a wheelchair. This is part of the Hungry4Fitness multiple sclerosis exercise program.

Multiple sclerosis exercise program benefits

The primary aim of this exercise program is to act as an impetus to promote positive lifestyle change. Irrespective of a person’s health status, exercise is good for our physical and biological well-being and thus we should maintain a consistent regime.

However, exercise is arguably more important for people with MS. Research cited in the Overcoming Multiple Sclerosis Handbook found that maintaining your physicality can mitigate a plethora of diseases and conditions. Furthermore, and of primary interest to the present audience, ‘scientists are realising that regular exercise prevents physical illness from getting worse,’ (OMSH – p89).

‘Importantly for diseases like MS, exercise has specific, helpful effects on the nervous system.’

But the exercise program goes one step further than sparking the impetus. It also provides a comprehensive framework around which you can construct a more active lifestyle.

Those two outcomes – motivation and methodology – can potentially exert a dramatic impact on your future health. Recalling the WHO’s assessment of the benefits of exercise: ‘Regular physical activity is proven to help prevent and manage noncommunicable diseases (NCDs) such as heart disease, stroke, diabetes and several cancers.’

multiple sclerosis exercise program outcomes

The multiple sclerosis exercise program has been designed to confer a number of positive health and fitness outcomes (see list below). Of course, the program will only do so if part (a minimum of two days per week) or all of it is implemented.

Arguably the single most important change that can be made is to maintain exercise consistency.

For those starting out on their exercise journey, the concern at this early stage is not what type of training you do, the intensity, or even how frequently you workout. What matters most is that you commit to a routine and stick to it.

Over time, when you become accustomed to exercise and your fitness and confidence improve, then you can begin expanding your exercise repertoire and mixing different training modalities.

But until then, if you can consistently sustain a minimum of two training days per week, these are just some of the positive outcomes that you could enjoy:

Improved fitness conditioning
Increased aerobic capacity
Developed whole-body strength
Reduction in fat mass and improved body composition
Stronger heart (cardiac muscle) and improved vascular efficiency
Enhanced self-confidence and self-efficacy
Reduction of stress and improved mood
A strong sense of empowerment

multiple sclerosis exercise program workout plan

As outlined in the introduction, one of the aims of this article is to teach you how to create safe and effective workouts. By learning the principles of creating an effective workout, you will become empowered and with it able to confidently direct your own training journey.

Below, in the multiple sclerosis exercise program pdf, you will discover a generic workout plan. The plan features a brief explanation and example of the four principles that all workouts should be comprised of.

Multiple sclerosis exercise program

Multiple Sclerosis Exercise Program
Download PDF • 853KB


Multiple sclerosis exercise program FAQ

To conclude the multiple sclerosis exercise program, I thought it would be helpful to answer three frequently asked questions concerning MS and exercise. For brevity and the reader’s diminishing patience, I’ve limited the FAQ to three questions.

If I’ve neglected to answer a question you have, first, please accept my apology, and second, pop it in the comments box below or email me at

Does exercise help MS?

As I’ve endeavoured to outline throughout the article, exercise is beneficial for a multitude of reasons. Just a brief recap. Exercise improves general physical health while significantly reducing disease risk factor.

In the hugely important book How Not to Die, which is arguably responsible for single-handedly reinvigorating the plant-based diet movement, author and medical clinician Dr Michael Greger reminds us that ‘in addition to helping you enjoy a healthy body weight, exercise can also ward off and possibly reverse mild cognitive decline, boost your immune system, prevent and treat high blood pressure, and improve your mood and quality of sleep, among other benefits,’ (How Not to Die – p393).

But for MS sufferers there are even more reasons to get active and engage in regular exercise. Dr Philip Startin, a key contributor to the Overcoming Multiple Sclerosis Handbook, drives home this message. ‘Exercising preserves and develops muscular strength and endurance. It is well documented that exercise improves the immune response, protecting against viruses and infections, and can actually reduce neurodegeneration,’ (OMSH – p164).

Is exercise good or bad for MS?

Research studies, underpinned by a plethora of personal testimonies, support the statement that ‘exercise has very few downsides and does not seem to make people’s MS worse,’ (OMSH – p 88).

On the contrary, because exercise promotes immune function and increases the chemical secretion of brain-derived neurotrophic factor (BDNF) and nerve-growth factor (NGF), both instrumental in rebuilding brain tissue, it can help hasten the healing process after an attack.

However, a common reported negative side effect of exercise is peripheral numbness and over-sensitivity in the extremities. This is a consequence of the rise in core body temperature which can trigger relapse-like symptoms.

The good news is that, while exercise for some may induce mild discomfort, it typically subsides when core body temperature normalises. Many MS sufferers who experience these side effects find that a cold shower after exercising helps attenuate the symptoms.

Can exercise help MS symptoms?

Exercise certainly plays an integral part in the process of mitigating and reversing the physiological damage caused by multiple sclerosis. As we’ve seen, exercise can facilitate the regrowth of nerve cells and encourage myelination – the fabulous biological mechanism by which oligodendrocytes repair and rejuvenate the wear and tear in the myelin sheath that insulates neuronal axons.

But, contrary to popular misunderstanding, exercise is not a panacea.

Dr Gregor drives this point home when he cites research showing that ‘physical inactivity ranks down at number five in terms of risk factors for death […] and number six in terms of risk factors for disability.’

So, what’s the single most important lifestyle intervention for MS sufferers? According to emerging research, transitioning to a whole-foods, plant-based diet is of paramount importance. In addition, supplementing high doses of vitamin D (10000 IU daily), as it helps to boost the immune system and repair damaged tissue.

(However, ensure to purchase vitamin D in the liquid form – not nasty pills – preserved in olive oil as opposed to coconut oil. Coconut oil is high in saturated fat which has been shown to exacerbate inflammation. Moreover, ‘saturated fats tend to be ‘sticky’, encouraging clotting and other abnormal processes,’ (OMSG – pp.48-49). Olive oil, by contrast, is a source of polyunsaturated fat which actively reduces inflammation.)

Related: Healthmarque vitamin D ticks all the above boxes


In this text box it says: As we are very interested in user experience here at Hungry4Fitness, we would be very grateful if you could take a few seconds out of your day to leave a comment. Thanks in advance! Blog Author: Adam Priest, former Royal Marines Commando, is a personal trainer, lecturer, boxing and Thai boxing enthusiast.



Greger, M., Stone, G. (2017) How Not to Die. USA. Macmillan.

Jelinek, G., Neate, S., O’Donoghue. (2022) Overcoming Multiple Sclerosis Handbook. Allen & Unwin. Great Britain.

WHO statement on the benefits of physical activity. The full quote reads as follows: Regular physical activity is proven to help prevent and manage noncommunicable diseases (NCDs) such as heart disease, stroke, diabetes and several cancers. It also helps prevent hypertension, maintain healthy body weight and can improve mental health, quality of life and well-being.’ (Accessed 2022).

For a comprehensive outline on the potentially health-degrading effects of vitamin pills, see the excellent BBC article: Why vitamin pills don’t work, and maybe bad for you.

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