Primary progressive multiple sclerosis (PPMS), like other forms of MS, can make it seem like staying active is impossible. On the contrary, the more active you are, the less likely you are to develop an early onset of disabilities related to your condition.

Additionally, regular exercise can help with:

  • bladder and bowel function
  • bone density
  • cognitive function
  • depression
  • fatigue
  • overall cardiovascular health
  • strength

With PPMS, there are numerous options for activities you can partake in, even if you’re starting to have mobility issues. The key is to select activities that you feel most comfortable doing, while still being able to challenge yourself. Talk to your doctor about the following activities.

Yoga is a low-impact exercise that combines physical poses, called asanas, and breathing techniques. Yoga not only improves cardio, strength, and flexibility, but also carries the added benefit of stress and depression relief.

There are numerous misconceptions about yoga. Some people think that yoga is only for the most fit, and that you have to already be super flexible. There’s also the misconception that all asanas are performed standing or seated without any support.

Despite some of the trendiness surrounding Western practices, yoga is inherently designed individually to meet your needs. The word “practice” here is also important in understanding the purpose of yoga — it’s meant to be done regularly to help you build your body, mind, and spirit over time. It isn’tan activity designed for seeing who can do the best headstand.

If you’re new to yoga, consider finding a beginner’s or gentle yoga class to attend. Talk to the instructor ahead of time about your condition so that they can offer modifications. Remember that you can modify the poses as much as you need to — there are even chair yoga classes you can try out.

Tai chi is another low-impact option. While some of the principles — like deep breathing — are similar to yoga, tai chi is actually gentler overall. The practice is based on Chinese martial arts movements that are performed slowly along with breathing techniques.

Over time, tai chi could benefit PPMS in the following ways:

  • increased strength and flexibility
  • reduced stress
  • improved mood
  • lower blood pressure
  • overall better cardiovascular health

Despite the benefits, it’s important to discuss your condition along with your concerns with a certified instructor. They can help determine if there are any movements you ought to avoid. Like yoga, many tai chi movements may be performed sitting down if you have mobility concerns.

Tai chi classes are available privately, as well as through recreation and fitness clubs.

Swimming offers support for MS in numerous aspects. Water not only creates an environment for low-impact activity, but also offers support in cases where mobility may prevent you from doing other types of workouts. Resistance against the water helps you build muscle without risking injury. Furthermore, swimming offers the benefit of hydrostatic pressure. This may be helpful for PPMS by creating compression-like sensations around your body.

When it comes to swimming, your ideal water temperature is another consideration. Cooler water can keep you comfortable and reduce the risk of overheating from exercise. Try adjusting the pool temperature to around 80°F to 84°F (26.6°C to 28.8°C), if you can.

Aside from swimming, you can work the water of a pool to your advantage for performing a number of activities. These include:

  • walking
  • aerobics
  • water-based dance classes, such as Zumba
  • water weights
  • leg lifts
  • water tai chi (ai chi)

If you have a community swimming pool, chances are group classes are available that offer one or more of these types of water exercises. You may also consider private lessons if you want more one-on-one instruction.

Walking is one of the best exercises in general, but mobility and balance are real concerns when you have PPMS. Ask your doctor if any gait issues may prevent you from walking.

Here are some other walking tips:

  • Wear supportive shoes.
  • Wear splints or braces for added support and balance.
  • Use a walker or cane if you need one.
  • Wear cotton clothing to keep you cool.
  • Avoid walking outdoors in the heat (especially during the middle of the day).
  • Allow time for rest during your walk, if you need it.
  • Stay close to home (especially when you’re by yourself).

The good news about walking is that it’s accessible and affordable. You don’t necessarily have to pay money to walk in a gym. It’s a good idea, however, to enlist a walking buddy for more motivation and safety reasons.

While staying active is important with PPMS, it’s equally important to take things slow. You may need to start exercising gradually, especially if you haven’t been active in a while. The Cleveland Clinic recommends starting out in 10-minute increments and eventually building up to 30 minutes at a time. Exercise shouldn’tbe painful.

You may also consider:

  • talking to your doctor about potential safety issues
  • asking for initial supervision from a physical therapist
  • avoiding activities you’re not comfortable with at first until you build your strength
  • limiting outdoor activities during hot temperatures, which may exacerbate PPMS symptoms