This article will serve to introduce you to Multiple Sclerosis, its causes and symptoms and how exercise such as Pilates can have a restorative quality on your clients who have been diagnosed with this condition.
Multiple sclerosis (MS) is thought to be an autoimmune disease. The body's own defense system attacks myelin, the fatty substance that surrounds and protects the nerve fibers of the brain, optic nerves and spinal cord (the central nervous system). The damaged myelin may form scar tissue (sclerosis). Often, the nerve fiber is also damaged. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses to and from the brain are distorted or interrupted, producing the various symptoms of MS.
While the exact cause of MS is unknown, most researchers believe that the damage to myelin results from an abnormal response by the body's immune system. Normally, the immune system defends the body against foreign invaders such as viruses or bacteria. In autoimmune diseases, the body attacks its own tissue. In the case of MS, the substance that is attacked is the myelin and sometimes the nerve fibers themselves. Scientists do not yet know what triggers the immune system to attack nervous system tissues. Most agree that several factors are involved.
No two cases of multiple sclerosis are the same. Symptoms not only vary greatly from person to person but may also vary from time to time in the same person. The symptoms of MS often begin as mild tingling or numbness in body parts. They may include slurred speech, blurred or double vision, tremors, loss of balance and poor coordination. Many people with MS experience muscle tightness or "spasticity." Problems with bladder, bowel or sexual function may occur. Severe cases of MS can result in loss of vision and partial or complete paralysis. MS may also have more subtle, "invisible" symptoms that include pain, extreme fatigue and mental changes such as mood swings, forgetfulness and confusion. Symptoms may appear in any combination, may come and go and may vary from mild to severe.
Some benefits of exercising with MS are increased physical strength, decreased fatigue and spasticity and improved balance and coordination when walking.
Pilates has the potential to help those with multiple sclerosis in many common problem areas such as balance, body awareness, stress, spactisity, bladder control, strength and proper breathing techniques. Pilates is ideal for someone with MS as many of the exercises are done lying down and they are all non impact and non weight bearing. All exercises are gentle enough to be done by someone weakened by MS. Although it does involving resistance against weights, this is never too high to cause strain or over exertion. Muscles are never worked to the point of exhaustion.
Pilates is based on a set of six core principles: concentration, control, centering, flow, precision and breath. Some benefits of Pilates include an increase or improvement in the following:
- Balance in the body
- Muscle tone
- Circulation and respiration
- Bone density
- Well being
Pilates has also been known to boost the immune system, reduce stress and strengthen the pelvic floor muscles.
Before beginning Pilates work with your client who has MS, you must know your client's limitations and endurance levels. Start with mastering the breathing and having him or her connect with finding the pelvic floor and transverse muscles. This will not only help in the session but in every day life. When creating a Pilates routine with your client, ensure movements are smooth and flowing, not "jerky." This will prevent your client from becoming dizzy. You should also allow for as many breaks as needed.
Sample Pilates Exercises
Ab prep with hands behind head for support
- Benefits: Strengthens the abdominals without the "six pack" muscle (rectus abdominis) dominating the other muscles. The abdominals are worked at their natural length.
- Breathe in; chin down but off chest – eyes look to knees or belly button.
- Breath out and connect pelvic floor and transverse
- Still on breath out, try to lift your chest off the ground. This is a subtle movement - only the spine at the lower end of your chest bends, and then only a little. Even with this small movement, your upper body has sufficient weight to really challenge those abs!
- Keep the length and width in front of the pelvis, and make sure the tail bone stays down on the ground (neutral spine).
- (Breathing in): Slowly curl back down.
- Repeat three to five times each side.
Criss Cross with hand behind head for support
- Benefits: Same as abdominal curl but strengthens the oblique muscles
- Breathe in, nod chin.
- Breathe out; connect with pelvic floor and transverse.
- Still on breath out, bring your right shoulder (not your elbow!) closer to your left knee.
- Keep the length and width in front of the pelvis, and make sure that the tail bone stays down on the ground (pelvic neutral).
- (Breathing in): slowly curl back down.
- Repeat three to five times each side.
Hundreds – knees bend – start with 50s
- Benefits: Emphasizes lateral breathing; integrates a number of movements combined with core stability; strengthens the arms; warms up the body
- Follow steps one and two from previous exercises. Head is up or down; legs are up with knees bend or on the floor.
- On next inhale, pump your arms up and down for a count of three to five. Keep your scapulas anchored and fingers lengthening away.
- (Breathing out): pump your arms up and down for another count of five.
- Repeat steps one and two for a total of five to 10 times.
Leg or Knee circles
- Benefits: Keeps the pelvis motionless in face of a moving leg challenge (requires a strong core); works the hip flexors and quads in opposition to the hamstrings
- Follow the first two steps of prior exercises.
- Breathe in and circle the leg to the inside first (easier for remain neutral starting in this directions.
- Exhale to return to start
- Perform six to eight repetitions.
- Change directions.
- If you feel/hear a grinding or popping, decrease your range of motion or stop the exercise.
- Benefits: Works core muscles including those of the shoulders, the abdomen and the buttocks; keeps entire torso including back and neck long
- Lift your head to look at the mat under your finger tips and lengthen.
- Inhale and raise your opposite arm, exhale to switch.
- Hips stay down on mat.
Living with MS doesn't have to present a challenge. With the above exercise suggestions, your MS clients will notice improved quality of life in no time. Good luck.
- National Multiple Sclerosis Society - National Capital Chapter, Washington, DC 2006
- Hamler, Brad; Exercise for Multiple Sclerosis, Hatherleigh Press, 2004