If you have multiple sclerosis (MS), you may feel tired, weak, or low on energy, and exercise may be the last thing on your mind.

In fact, exercise has many benefits for people with MS, including improvements in strength, balance, muscle stiffness, and bowel and bladder control. It can also reduce MS spasticity and may improve or delay cognitive impairment.

The key is to start slowly and build your fitness gradually. Check with your doctor before you begin a new exercise routine to ensure you’re not overexerting yourself. You can also see a physical therapist if you want assistance in choosing the right activities for your particular condition.

Remember that exercise doesn’t have to take place in a gym. Activities such as gardening and household chores all add up to an increased activity level. Here are some other activities and exercises to help you strengthen your body and combat MS.

Many people with MS have gait disorders, or difficulty walking. Walking regularly gives you a light cardio workout and helps maintain your sense of balance. Keep up regular walking as long as you can, even if it’s only for a short distance. Bring a friend or family member for security if you have a fear of falling. Treadmill walking is another option as you can adjust the speed and intensity, and there are handrails to hold onto.

Stretching is good for everyone. Not only does it help you prepare for and recover from exercise, it also helps to maintain the flexibility that makes movement easier and reduces your chance of injury. If you have MS, stretching also helps to combat muscle stiffness. Try stretching areas such as your calves, hip flexors, and hamstrings. Some forms of exercise have an element of stretching built in, such as wall pushups performed with the heels on the ground. This stretches out both the calves and the hamstrings.

Whether it’s swimming or water aerobics, exercising in the water eliminates the risk of falling that can accompany MS. In addition to preventing falls and providing support, water also reduces the stress on your muscles and joints that activities on dry land can cause. Start with a low-intensity beginner class and progress at your own pace.

Your balance is affected when you have MS, so dedicate some of your exercise time to work on this area. Try activities such as standing on one leg to practice your balance. Make sure you have a wall or chair to hold if you need support, and try closing your eyes to increase the level of challenge. Even two-legged exercises like plie squats are more difficult when your eyes are closed, making them a worthwhile task to master in your quest to remain steady on your feet.

Muscle weakness and fatigue are a part of MS that you can prevent with strength training. Try activities such as step-ups or squats, using a chair or railing for balance. Use light weights for arm exercises such as bicep curls and shoulder presses. If you don’t have hand weights, try bodyweight strength exercises such as wall pushups or tricep dips using a chair or counter.

Your core is the foundation of your balance and stability. It’s made up of your abdominal, back, and pelvis muscles. Good exercise regimens include a core component as a way to increase performance as well as prevent injury in areas like the spine. Try exercises such as pelvis raises while lying on your back with your knees bent, and planks or pushups. If traditional planks and pushups are too difficult, try a modified version from your knees rather than your feet.

Yoga therapy is a safe and effective way to improve fatigue, balance, flexibility, and strength. Some benefits reported after a short 12-week, bi-weekly yoga program were improved fatigue, balance, step length, and walking speed. While this may not be true for everyone, it is an option to try.

Exercise can seem challenging when you’re faced with the physical changes brought on by MS. But building your fitness level can stave off the progression of the disease and help you manage your symptoms. Start slowly with simple activities you feel comfortable with. Get clearance from your doctor before starting a new exercise program, and consult a physical therapist when choosing the best exercises for you.