Exercise can be a challenge for some people with multiple sclerosis (MS), a neurological disease that affects around 2.8 million people worldwide. Common symptoms such as muscle weakness, numbness, and balance issues can make physical activity difficult.

Still, exercise is important for people with MS. While the condition does not have a cure, a good exercise routine may help ease symptoms, including:

  • reducing fatigue
  • increasing balance
  • improving quality of life

Many people with MS find that water therapy is the easiest and most rewarding way to stay physically active. The buoyancy of water, which offsets body weight, helps support your limbs, making them feel lighter,

Water also provides resistance, which helps to strengthen muscles. People with MS may find it easier to stand in the water than on dry land and comforting that there’s a lower risk of injury due to a fall.

Hydrotherapy, which is also called aquatic therapy and pool therapy, involves using water to treat various conditions and promote health. It features water in different forms and temperatures, and can include:

  • immersion at various temperatures
  • inhaling steam
  • water and ice massage
  • walking or exercising in water
  • hot or cold compresses
  • whirlpool baths
  • mineral water baths

Research provides support for the claim that hydrotherapy may help with pain management and with conditions including multiple sclerosis and fibromyalgia, among others.

People with MS may find that movement is easier in the water. As previously noted, water’s buoyancy offsets body weight. As a result, there’s a lot less weight on your joints when your body is submerged. Swimming can also improve your coordination, flexibility, strength, and balance.

A 2020 review of research suggested that aquatic therapy may delay the progression of MS and improve depression, balance, and walking ability.

Swimming can additionally reduce fatigue, which affects around 80 percent of people with MS. In another research review published in 2020, 8 weeks of aquatic exercise was shown to reduce fatigue and improve quality of life in people with MS.

Another 8-week aquatic exercise training program documented in a small 2018 study also found that the training lowered fatigue while also improving balance and functional capacity.

Water activities can help people with MS avoid overheating, which can sometimes worsen symptoms. This can happen in a hot tub, sauna, in high temperatures, or even in a hot bath.

Swimming is a good way to exercise while staying cooler because excessive heat can aggravate MS symptoms. According to the National Multiple Sclerosis Society, the water temperature should be below 85 degrees.

Swimming is a primary form of water exercise that’s beneficial for people with MS. Still, it’s not the only way to work out in the pool.

If you’re not confident in your swimming abilities or you just don’t like dunking your head underwater, other water-based activities have also been found to help with MS. They include:

Ai Chi is a type of mind-body water therapy created in Japan. It’s a sequence of movements in the water that combine deep breathing and slow, broad motions. Performed in a group setting, Ai Chi blends a sense of community with healthy physical activity.

Many communities offer aquatic classes that focus on stretching, balancing, and muscle strengthening. Your doctor or physical therapist may be able to recommend a specific water therapy program that may include leg lifts, marching, and use of resistance equipment.

Hydrotherapy classes are often led by licensed physical therapists who specialize in helping people with MS or other disabilities.

Depending on your physical abilities, you may not need a class to get your pool exercise. Playing in the pool with the kids or grandkids can be great exercise — and a lot of fun.

Research indicates that for people with MS, exercise in general can lead to improvements in:

  • balance
  • walking
  • fatigue
  • quality of life
  • depression

There are many types of exercises that can be beneficial if you have MS. If you’re thinking about starting a new exercise program, talk with your healthcare team about the types that may work best for you.


Research suggests that Pilates may have benefits for movement and strength. A small 2014 study found that practicing Pilates for 8 weeks improved balance, mobility, and muscle strength.

Another study published in 2016 indicated that 12 weeks of Pilates or standard physical therapy were similarly effective at improving walking and balance in people with MS.


Aerobic exercises like cycling, both outdoors on a bicycle and inside on a stationary bike, can also be good if you have MS. Another small 2020 study involving 10 adults with MS found that compared with 15 minutes of resting, 15 minutes of recumbent cycling led to improved function, including in posture and gait.

In a 2019 study, with a total sample size of 20, 12 weeks of combined resistance training and stationary cycling showed effectiveness in reducing MS patients’ disease severity, depression, and fatigue while improving their quality of life and walking ability.

Strength training

Resistance training on its own may improve strength and coordinated movement in people with MS, too.

In a 2015 study, 14 women participated in an 8-week resistance training program, with 13 others in a control group. The study found that disease severity scores decreased in the training group.

In addition, the training group showed a 27.5 percent increase in levels of brain-derived neurotrophic factor, which may help with repairing neurons.

Another study from 2015 found that 8 weeks of an individualized progressive resistance training program improved muscle strength and functional ability while reducing disease severity.

Everyday activities

Many daily tasks that incorporate physical activity are also beneficial for people with MS. These can include:

  • gardening
  • cooking
  • walking up stairs
  • shopping
  • doing chores around the house

Whether you participate in an exercise program or daily activities, moving regularly is important to help with MS.

Exercise benefits your body and your sense of well-being. If MS symptoms interfere with your ability to exercise, water therapy may help you get the physical activity you need.

Talk with your doctor before starting if you’re not sure you’re physically able to handle swimming or exercising in the pool. They may be able to refer you to a physical therapist or a class with qualified instructors.