Pilates can be an effective exercise method for people with MS or walking disabilities to improve their balance, leg strength and walking ability. However, before you start practicing pilates and using pilates equipment (known as a reformer), you should consider some guidelines that will help improve your pilates experience and prevent risk of injury.
Many people with MS and walking disabilities are attracted to pilates because it offers low-impact strengthening, stretching, and coordination exercises that can be performed on the floor or reformer.
The reformer is a piece of equipment with springs of various tensions to offer graded resistance; a movable carriage where you can lie, sit or stand to perform exercises; a foot-bar and foot-board as a base for closed-chain resistance exercises; and straps for use with arm or leg exercises.
By using the proper techniques that focus on leg strengthening and that address MS symptoms, you can maximize the benefits of pilates on helping improve your mobility.
Turn up the Air-Conditioning
People with MS are sensitive to heat and over-heat easily, so it's best to exercise in an air-conditioned room. An increase in your core body temperature may cause you to experience an exacerbation of your MS symptoms, such as fatigue or numbness of your legs. While your symptoms aren't really progressing, you could easily lose motivation to continue exercising. If you start to get hot, stop what you're doing and wait until your body temperature goes back to normal and your symptoms subside. Wearing accessories such as a cooling scarf and vest could help you keep cool. You can also drink cold water but if you have the MS symptom of urinary incontinence, drinking water can lead to inconvenient restroom trips or even accidents.
Be Safe and Take it Easy
The reformer's carriage makes exercising easier for people who lack balance or leg strength and can't perform exercises standing up. Before you get on the carriage, make sure that it's locked so that it's stable for you to get on. You can also use a chair, walker or any stable prop to help you get on the carriage.
If you haven't exercised in a while and over-exert yourself, you're going to be sore later in the day or even the following day. When you first begin pilates, start with 5-10 repetitions of 5-10 gentle exercises. Remember to focus on the quality of the movements rather than the quantity.
Stretch Out Spasticity
People with MS may experience spasticity, or involuntary muscle contractions. Your legs stiffen up and you have a hard time walking. One of the best things to do when you experience spasticity is to stretch your muscles and exercise in positions which inhibit this increase in muscle tone. While on a reformer, extend your leg and use the foot-board to maintain your foot in a flexed position, while doing knee or hip extension exercises. For quad strengthening exercises, you can also lie on your side on the carriage and use the foot-board for feet placement. If you use the foot-bar, avoid putting pressure on the ball of your foot.
Improve Flexibility and Motor Control
It is common for people with MS to experience a decrease in flexibility and decline in motor control. You can improve your flexibility and range of motion, while strengthening your legs, by using the foot straps on the reformer to perform leg circles. You can also flex and extend your knees or ankles by pushing against the foot-bar or foot-board in a closed-chain exercise. The movements can be small in order to strengthen isolated leg muscles and improve motor control.
You can have a positive pilates experience by following the guidelines above (the exercises can be adjusted to be performed on the floor) and working with a knowledgeable instructor. Remember to notify your instructor if you have MS so that he/she can work at your pace and focus on exercises that help with your mobility.
Mary Kay Foley, PT, GCFP, is a staff therapist at St. Luke's Elks Rehab and coordinator for the Integrative Therapies Program at St. Luke's Wood River Medical Center in Ketchum, Idaho. She is also a program staff member of The Heuga Center for Multiple Sclerosis, a nonprofit organization which provides lifestyle empowerment programs to people with MS and their support partners to transform and improve their quality of life.