MS Articles

How did you come to specialise in MS-specific physiotherapy?

I had the opportunity to start working with people who had Multiple Sclerosis as soon as I graduated. After treating my first clients it became clear that, because Multiple Sclerosis is so diverse, the information I learned in physiotherapy school wouldn’t be enough for me to best help my clients get stronger, walk better, and ultimately maintain their independence. That’s why I decided to further my education and specialise in MS.

You encourage people living with MS to go beyond simple management of the condition and to ‘conquer’ it instead. Why is this mindset so important?

It is important because it puts you back in the driver’s seat. Managing symptoms often makes people feel like they’re the victim, whereas conquering symptoms helps them feel like they have more control. While MS does run the show most days, there are many strategies you can implement in your routine that champion your symptoms of fatigue, weakness, poor balance or unstable walking. Putting these strategies and exercises to work often results in feeling more hopeful, stronger, and resilient.

Do you think that there is a lack of understanding around MS diagnoses and symptoms? 

When I first became an MS-specialist, about 5 years ago, many of my clients would report that their MS diagnosis date the date of their first symptom was years apart - often over 15 years! This tells me that there was a time where MS was less understood, often underreported or misdiagnosed. This is because technology and MRIs weren’t as advanced as they are now and there was a lack of understanding of the disease process. Luckily, technology and education of MS have advanced which has resulted in earlier diagnosis and earlier treatment.

With that said, I’ve found that there is a lack of understanding around MS symptoms when it comes to physiotherapy and other therapeutics because MS is not a big topic covered in school. Over 90% of my clients tell me that they doubt physiotherapy will help because they tried it before and it “didn’t work”. Most times, it’s not that physiotherapy didn’t work, but rather that the correct exercises and strategies weren’t employed. There is a specific way to exercise when you have MS and not using these strategies will leave you feeling hopeless and even more fatigued.

Why is increasing knowledge and education around MS so important?

The more we know about MS, the better able we are to help our clients. The concept of neuroplasticity (the ability of the brain to adapt to change) is one that not many people fully understand yet it’s how people with MS can improve their daily lives. There are specific strategies and techniques to increase neuroplasticity and they should be implemented for everyone that does MS exercises.

Your digital wellness programme focuses on functional exercises instead of “regular” exercise. What is the difference between the two and why is it so important?

There is a very important difference! Functional exercises are activity-based whereas “regular” exercises are weakness based. Weakness based exercises will likely increase the strength of muscle, but the renewed strength often doesn’t result in improved function. Functional exercises break down a specific activity that is challenging and strengthens the body in a specific way to make that activity easier.

For example, if someone has hip weakness that makes it difficult to walk, a “regular” exercise may be a “straight leg raise” whereas the functional exercise would require the breakdown of that movement. So, walking requires knee bending, toe lifting, knee lifting, balance, and weight shifting. It’s these five movements that should be performed.

What are some key steps patients can take to implementing a successful exercise plan into their daily life?

My best advice is to make a list of the activities or movements that are challenging. Things like: getting into the car, standing up, getting out of bed or climbing stairs. From there, pick the top one or two that you want to work on. Break down the activity into what movements are required to perform it well and work on these exercises. Remember, proper form is very important because your brain always remembers what you do. If you have proper form for most of your repetitions, your brain will be able to create a stronger neural connection to the muscle.

What role does mental wellbeing play in managing MS?

Staying on top of your mental health is a game-changer. Having MS requires resiliency and hope. It requires that you stay consistent with healthy habits, even when you aren’t noticing any improvements or even when you’re experiencing regression. Practising consistency and living in the present moment improves mental wellbeing and can make you feel more optimistic, confident, and energized.

Having a strong support system is key. With a condition like MS, it’s easy to feel alone and misunderstood. Having a supportive family and friends can help lift your spirits and remind you of the control that you have over your chronic condition. They can help you out physically when you’re having a hard day and be a constant source of energy to help you build the resilience you need to champion your symptoms.

What are the most common symptoms that occur to MS patients? 

The top two symptoms that my clients seek help with are fatigue and foot drop. Luckily, there are loads of things you can do to assist these symptoms. One exercise for managing foot drop is to sit down and practice using your ankle muscles to lift your toes. This might be hard, but keep going! Every repetition is an opportunity for your brain to find a neural pathway that will strengthen the brain to muscle connection. My best tip for fatigue is to split up your exercises throughout the day. Research shows that it is equally as effective to exercise throughout the day as it is all at once. Therefore, take frequent breaks during your exercise and spread it out!

What are your 3 top tips for living a healthy and happier life with MS?

1. Take control of your exercise, nutrition, and mindset. Make sure that you’re utilizing resources that teach you MS-specific exercises and symptom management strategies. Practice healthy eating habits. And work on your positive mindset daily.
   
   

2. Don’t isolate yourself. The more you surround yourself with other people (even via video calls, phone calls, or texts), the more connected you’ll feel. This connection goes a long way in helping to increase hope, energy, and support.
   
   

3. Reach out for support. Never feel like you’re in this alone. Don’t be afraid to reach out to friends, family, doctors, etc. when you need help.

If you or anyone you know is living with MS, check out our MS hub and talkhealth's myMS support programme for lots of expert-backed, actionable advice.

Gretchen's webinar's with talkhealth:

Motivation and exercise for MSers and other chronic warriors