Newly Diagnosed With Multiple Sclerosis: A Physiotherapist’s Guide to Exercise and Rehabilitation
- Tom Morgan, Chartered Physiotherapist
- 5 days ago
- 2 min read
Updated: 2 hours ago
A useful MS exercise programme needs options across different ability levels and should address the person's main limitations rather than prescribing the same routine forever. Strength, aerobic fitness, balance, mobility and functional practice can all be included depending on goals.
For this stage of Multiple Sclerosis physiotherapy and exercise, the most useful priorities are usually:
choosing an exercise dose that is challenging but repeatable
working on the specific limiting problem such as fatigue, balance, walking, strength or foot clearance
using pacing and recovery rather than avoiding activity completely
adapting the programme as symptoms, relapses, temperature and daily capacity change
MS rehabilitation should be individualised because symptoms can fluctuate. Progress does not always mean doing more repetitions: it may mean better movement quality, less support, improved endurance, a harder balance task, greater resistance or completing the same task with less fatigue. Build from a level that can be repeated consistently rather than using one very good day as the new baseline.
Use a repeatable weekly structure and change one training variable at a time. On lower-energy days, reduce the dose or use seated and supported versions; on better days, progress resistance or task challenge without turning every session into a maximal effort.
using a one-size-fits-all exercise sheet regardless of symptoms
stopping all exercise because fatigue is present
pushing through marked heat-related symptom worsening without adapting the environment or dose
focusing only on walking and ignoring strength, balance, transfers, upper limb function or participation goals
When should you get extra help?
New or clearly worsening neurological symptoms that are unusual for you should be discussed with your MS team, particularly when they last rather than settling with rest or cooling. Sudden severe symptoms, chest pain, collapse or another medical emergency should be assessed urgently rather than treated as an exercise problem.
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