I have a client with Restless Legs Syndrome. What can you tell me about this condition, and what can I do to help her?
Restless Legs Syndrome (RLS) is a neurological disorder often described by sufferers as "burning," "creeping" or "like insects crawling" deep inside the leg - typically between the knee and ankle – accompanied by an uncontrollable urge to move around in order to alleviate these uncomfortable sensations. The severity of these sensations can range from mildly uncomfortable to painful. RLS is usually a lifelong condition for which there is no cure.
The International Restless Legs Syndrome Study Group cites four criteria for diagnosing RLS:
- A desire to move the limbs, often associated with abnormal or painful sensations.
- Symptoms that are worse or present only during rest and are partially or temporarily relieved by activity.
- Motor restlessness.
- Worsening of symptoms at night.
RLS affects at least 12 million Americans. This does not include countless cases either undiagnosed or misdiagnosed by physicians or unreported by patients. Although RLS has no known cause, there may be a genetic factor involved. About half of all cases involve a family history of the condition.
Most people with RLS have trouble falling asleep and staying asleep. This can lead to constant fatigue and difficulty concentrating. Adjust your client's workout accordingly.
Although no cause-and-effect relationship has been proven, research shows a correlation between RLS and these factors:
- The health and lifestyle characteristics independently related to restless legs include body mass index, lack of exercise and cigarette smoking.
- People with diabetes are four times more likely to have RLS.
- Sedentary people (less than three hours of exercise per month) are more than three times more likely to have RLS.
- Alcohol and caffeine often intensify or elicit symptoms.
- People with low iron levels are more likely to develop RLS. Proper supplementation (prescribed by a doctor, of course) often alleviates symptoms.
- Some physicians have also found that folate and/or magnesium supplements can lessen symptoms in patients with known deficiencies.
- Some pregnant women suffer RLS in their last trimester with symptoms usually disappearing within a month of delivery.
- Certain medications including some cold and allergy medications may magnify symptoms.
Some people with RLS get relief with moderate exercise immediately before bed. However, other people find that exercise, especially vigorous exercise, within six hours of going to bed aggravates their symptoms. Experiment with various exercise modalities and intensities to discover what is best for your client. Make sure you both keep accurate logs so you can compare workout time of day and intensity to sleep quality.
After several weeks, you should be able to determine a pattern of exercise that best alleviates her symptoms.
- Allen RP, Earley CJ. Restless Legs Syndrome: A review of clinical and pathophysiologic features. Journal of Clinical Neurophysiology. 2001 Mar;18(2):128-47.
- Earley CJ. Restless Legs Syndrome. New England Journal of Medicine. Volume 348:2103-2109 May 22, 2003 Number 21
- Walters AS.Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Movement Disorders. 1995 Sep;10(5):634-42.
- Restless Legs Syndrome Foundation, Inc. www.rls.org
- National Institutes of Health National Heart, Lung, and Blood Institute www.nhlbi.nih.gov