Primary progressive multiple sclerosis (PPMS), like other forms of multiple sclerosis (MS), can make it seem impossible to stay active. 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 with a doctor about the following activities.

Yoga is a low impact exercise that combines physical poses, called asanas, and breathing techniques. Yoga improves cardio, strength, and flexibility and carries the added benefit of stress and depression relief.

There are numerous misconceptions about yoga. Some people think that yoga is only for the fittest 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 designed to meet your own individual 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 to see who can do the best headstand.

If you’re new to yoga, consider finding a beginner’s or gentle yoga class to attend. Talk with the instructor about your condition ahead of time so 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 principles — like deep breathing — are similar to yoga, tai chi is gentler overall.

The practice is based on Chinese martial arts movements that are performed slowly, along with breathing techniques.

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

  • increasing strength and flexibility
  • reducing stress
  • improving mood
  • lowering blood pressure
  • improving overall cardiovascular health
  • improving balance

Despite the benefits, discussing your condition and concerns with a certified instructor is important. 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 and through recreation and fitness clubs.

Swimming offers numerous benefits for MS. 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. If possible, adjust the pool temperature to around 80–84°F (26.6–28.8°C).

Aside from swimming, you can work the water of a pool to your advantage for performing several 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, group classes 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 can be real concerns when you have PPMS. Ask a 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.
  • Use walking sticks to aid balance

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. Enlisting a walking buddy for more motivation and safety reasons is a good idea.

Stretching is an important component of any exercise routine for PPMS. It can increase flexibility, decrease spasticity, promote balance, and ease stiffness.

A physical therapist can recommend specific stretching positions that may be beneficial for you. A helper or caregiver can also provide assistance with stretching as needed.

A few other tips to keep in mind:

  • Choose clothing that doesn’t restrict movement.
  • Take plenty of rest periods and avoid overexertion.
  • Listen to your body and progress as tolerated.
  • Breathe evenly as you stretch.

You should stop if you experience any pain, numbness, or tingling during a movement or stretch. Check with a doctor before attempting any movements that cause discomfort again.

Exercise doesn’t necessarily have to involve a rigorous training routine. In fact, many other simple activities can help you stay active in the comfort of your home.

Some examples of physical activities you can do at home include:

  • cooking
  • gardening
  • walking the dog
  • taking the stairs instead of the elevator
  • household chores, such as cleaning or doing the laundry

According to the National MS Society, you should aim for around 150 minutes of physical activity per week, as tolerated.

However, 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. Exercise shouldn’tbe painful.

You may also consider:

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

What activities can you do with multiple sclerosis?

You can do several MS activities, including yoga, tai chi, stretching, swimming, and walking. Many sports and recreational hobbies can also be modified for people with MS, such as basketball, cycling, skiing, and horseback riding.

You should talk with a doctor before adding new activities to your routine.

What is the best exercise for multiple sclerosis?

All types of physical activity can benefit the general health and well-being of people with MS. According to the National MS Society, it’s best to find an exercise program that fits your needs and abilities.

A healthcare professional, such as a physical therapist, can also offer guidance on the best types of exercises for you.

What should you not do with multiple sclerosis?

If you have MS, it’s important not to push yourself too hard in any exercise program to avoid injury. Instead, be sure to start slowly and build up over time, stay hydrated, and exercise in cool environments to avoid overheating.

Staying active can offer many benefits for people with PPMS and may help improve strength, flexibility, and cardiovascular fitness.

Many activities can be incorporated into an exercise routine for PPMS, including yoga, tai chi, stretching, and water exercises like swimming.

Be sure to talk with a doctor before starting a new exercise program. You should also listen to your body, progress slowly, and follow safety precautions as a healthcare professional recommends.