MS has many different faces, and you may find them all in one client at different points in time.
I try to treat all my clients as ‘normal’ as possible, and people with MS are not different in that respect. I do an assessment and decide on a program and its progression based on it.
One general precaution with MS is to be concerned about overheating; however, people with MS are usually well aware of it. Even when people have a ‘mild case’ of MS, balance is a concern, and I would recommend to keep that in mind when doing standing exercises. Have something nearby for support, and avoid exercises that require sudden changes in direction.
Also: be mindful that a program for a month may need to be altered as conditions change. Flare-ups can occur without warning, and falls are often the result.
As a MELT instructor, I have been invited to give a demo at an education event for the local chapter of the MS Society in October. I have observed that the MELT Foot Treatment can greatly improve the sense of grounding. In conjunction with the improved alignment using the other MELT techniques with the roller, people suffering from MS can greatly improve their body sense and thereby gain greater confidence in their body.
The complete MELT techniques may be unknown to you but I would urge you to check out the MELT Foot Treatment.
I highly recommend all my MS clients to become active MELTers for many reasons, including the need for ongoing work in proprioception. If you do not know about The MELT Method, you can go to www.meltmethod.com and get some basic information and names of instructors in your area.
I am presently a Hand and Foot MELT Instructor and will soon be taking additional classes in the MELT Method. I am amazed at the differences in my clients who MELT regularly and those who do not. I think you will find this a very helpful addition to your fitness routine. Good luck to you.
The ACSM states:
Exercise prescription for individuals with Ms should focus on maintenance, and when possible, on improvement of joint flexibility, muscular strength, balance, cardiopulmonary endurance. Exercise professionals should be aware of the following when prescribing exercise programs for people with MS:
1. Fatigue can reduce exercise tolerance.
2. Impaired balance may affect the choice of exercise mode.
3. Heat intolerance may affect intensity, duration, mode and environmental demands.
4. Spasticity may require special foot strapping.
5. Sensory loss may preclude upright activities, such as walking or running.
6. Muscle paresis can reduce exercise intensity and duration.
Taken from ACSM’s Exercise Management for Persons with Chronic Diseases ad Disabilities – Third Edition.
Depends on how aggressive the MS is with that client. I recently had a client with progressive MS. She was an ex professional dancer/choreographer for Disney and an ex-professional cheerleader for the Rams, so she did not want to be treated like she was disabled. She knew she had limitations on what she wanted to do and what her body/brain/nervous system was going to decide on what it wanted to do, but it was all about the Intention of trying. I modified all of her exercises so she could activate those muscles that were always in a fixed position due to being in a wheel chair most of the day. For some individuals, it may be challenging to exercise someone with MS because there are sometimes when you need to muscle their bodies in the position you want to get them in. Most of the time you can use their momentum to adjust a position, etc. When it came time to pass my client on to the next trainer that I trusted, I had to make sure they not only had the knowledge, but they also needed to have the strength.
I’ve only trained two clients who have disclosed to me that they have MS (one prior, one current) and have a relative who fought it for 30 years before it took her life. Both were pretty early on in the progression of their condition, still walking and actively exercising. Balance was / is a challenge for both, so the previous recommendations about MELT for proprioception are spot-on. Both clients feel increased proprioception from the foot treatment and one loves the rebalance sequence.
Heat is really hard. One client liked to work out outside, so we had to meet soon after sunrise for her to be comfortable.
Stress also has a big effect on the condition. Seeing its effect on the progression of my family member’s condition, I try to make working with me as low-stress as possible.