Stretching for People with MS

1 Stretching for People with MSAn Illustrated ManualFor Information: 1-800-FIGHT-MS WellBeth E. Gibson, PT, has a certificate in physical therapyfrom the Mayo School of Health Related Science inRochester, Minnesota. She has been working with peoplewith MS for 11 thanks to Susan Kushner, MS, PT, and CindaHugos, MS, PT, for their valuable by iMageWorx. Some of these drawings originallyappeared in Multiple Sclerosis: A Self-Care Guide toWellness, published in 1998 by Paralyzed Veterans ofAmerica, Inc. They are reproduced here with the kindpermission of PVA, by members of the Client Education Committee ofthe National Multiple Sclerosis Society s Medical AdvisoryBoard.

2 2004 National Multiple Sclerosis SocietyStretching for People with MSAn Illustrated Manualby Beth E. Gibson, PT2 Stretching for People with MSGENERAL PRECAUTIONS, BOTH OBVIOUS AND NOT SO AND NECK A AND FOREARM AND WRIST AND HIP AND FOOT COORDINATION AND FOR OF SPECIAL OF CONTENTS3 Everyone with MS, regardless of his or her degree of ability or disability,needs regular physical activity. Lack of exercise has serious health conse-quences, ranging from constipation to increasing the risk of heart as important, good exercise programs not only prevent problems,they promote a sense of achievement and booklet focuses on basics to move and gently stretch muscles andtendons, on your own, at your own pace.

3 For the purposes of this book,the familiar term Stretching is used, though most of these exercises are,technically, range of motion activities. Exercise can be broken down intofive categories, one of which is relaxation. All are important to peoplewith Stretching the muscle and tendon to its full length andmoving the joint through its full range. These activities decrease muscletightness and prevent loss of full range of motion which may occur withdecreased activity, weakness, or spasticity. Unaddressed, such loss canlead to joint contractures that painfully freeze joints into a increasing the force or power of the muscle.

4 Strengthcan be increased by lifting a limb up against gravity, lifting weights, or byworking against resistance such as walls, weights, or rubber exercises can help reduce improving heart and lung function. Aerobic exercisemakes the heart and lungs work harder and builds endurance, reducesthe risk of heart disease, and helps manage weight and cholesterollevels. Walking, swimming, or using a stationary bike are forms ofendurance and coordination improving quality and safety of move-ment. Rhythmic hand or foot exercises and specific standing activities,usually with directions from a physical therapist, can improve balanceand INTRODUCTION4 Stretching for People with MSRelaxation reducing physical and mental tension.

5 Relaxation can justmean stopping and taking a deep breath or sitting while listening to softmusic. Structured relaxation techniques can reduce fatigue from an exer-cise session or help manage a stressful day. The National MS Society sbooklet Taming Stress in MS contains directions for several kinds ofstructured relaxation INTRODUCTION51. Wear clothing that doesn t restrict Be sure the room temperature is comfortably cool. Consider a fan, airconditioner, or open window. If you are especially heat-sensitive, con-sider a 10-minute soak in a cool tub before exercising.

6 (Start withlukewarm water, slowly adding cooler water until the tub feels like acool swimming pool.) Or experiment with cooling headbands, vests, orneck Don t force any part of the body. If pain occurs, stop. Check with yourhealth-care professional before trying that move again. If discomfortoccurs, cut back to a motion that s Go slowly. All movements should be done evenly, allowing the musclestime to respond to the stretch by relaxing. Moving quickly canincrease spasticity or stiffness. Try to hold each stretch for 60 secondsat the comfortable far end of your range.

7 It may help to count outloud. Then gently return to the starting Feel your way to more challenge. The idea is to increase the range ofpain-free motion. Therefore, it s important to distinguish between painand the feeling of stretch. Stretch is okay; pain is If one side is weaker, use the stronger side to move the weaker side. Aphysician or physical therapist should be able to help you with Remember to breathe evenly and relax the face throughout eachmovement. There s a tendency to grimace or hold the breath duringan unusual Avoid overexertion.

8 Include rest periods, and sip cool water to preventoverheating or Experiment with times of day. Some People find early morning best;some find it helpful to break exercise sessions into two parts: one inthe morning, and the other in the afternoon or PRECAUTIONS, BOTH OBVIOUS AND NOT SO OBVIOUS6 Stretching for People with MSExercise 1 Bend head back (looking up).Do slowly; do not thrust headback quickly. Shoulders shouldbe lowered and head forward (lookingdown). See CAUTION 2 Bend head so that ear is movedtoward 3 Turn head to look AND NECK EXERCISESCAUTIONV ertigo:This is dizziness or a spinning of the room sensation.

9 If thismovement makes you dizzy, light-headed, or nauseated, stop immediatelyand check with your s sign:This is a tingling or electric shock like sensation in thespine or limbs upon bending the neck, which sometimes occurs in MS. If youfeel this sensation, discontinue this exercise and check with your 1 Starting position:Lie on yourback with arms at your sides,palms one arm up over yourhead (as if raising your hand inclass), keeping elbow and fore-arm straight. Hold for one deepin-and-out arm to starting positionand repeat 2 3 exercise with 2 Starting position:Lie on yourback with arms at your your palms one arm out to the sideand smoothly up to the side ofyour head (as if doing a one-armed jumping jack).

10 Return arm to starting positionand repeat 2 3 exercise with EXERCISES BASIC8 Stretching for People with MSExercise 3 Starting position:Lie on yourback with arm out at your sideand your elbow bent at a 90-degree angle. Turn your your forearm up and overuntil the back of your palmtouches the return forearm to start-ing position, palm down on thebed. Repeat 2 3 exercise with 4 Starting position:Stand orsit in a arm straight back, as ifreaching for something in yourrear pocket. Allow forearm arm to starting posi-tion. Repeat 2 3 exercise with EXERCISES BASIC9 Exercise 1 Step 1:Start by lying downwith arms at sides, close to theedge of the bed.