Multiple sclerosis and the strategies to “remain connected”

Multiple sclerosis and the strategies to “remain connected”

First, a short review of the facts : Multiple sclerosis (MS) is a degenerative, chronic disease. It cannot be healed, and its symptoms evolve over time. It is an auto-immune condition; The body attacks itself because of an immune system’s fault. It attacks the central nervous system : the brain and the spinal cord. With the inflammation induced, the nerves’ protective sheaths (myelin) is impaired. This impairment cause a poor communication in the areas of the brain, and a poor signal sent to the body limbs(1). As physical symptoms, people with MS have mobility problems, such as walking issues. Often, the signal is not completely switch off. It is more often poor, as a bad cell phone signal. You can get the line, but it is hard to get a full and comprehensive conversation. Many words you say to your interlocutor are lost in the air. It is the same with MS. Let’s suppose you are sited, and you want to lift your knee up. You would not be able for the three first tries, and then, the fourth time, it works. The fourth time, the signal just found its way, and you bend your hip, lifting your knee up.

Why this time? Because your focused properly. Because you visualized the muscle and the signal sent to it. Or sometimes, simply because of an automatism, meaning to do something else concretely at that time.

People with MS would tell you that they have “good“ days, and “bad” days. On their « bad days », they would say that they feel disconnected. « I’m disconnected from my ankle ; I cannot lift if anymore. It would not respond to me ; It is not listening to me anymore.”

Multiple sclerosis is a degenerative disease, and people dealing with it are fully aware of that reality. It is so appealing to think about the “bad days” as an irreversible evolution of the disease. “I cannot bend my hip anymore; Efforts are worthless”. But be aware that this rationale is risky.

First, the absence of movement doesn’t mean an absence of muscular contraction. Second, it is not because you cannot do it today that you won’t be able to do it tomorrow. Third, if you stop doing it because it’s “worthless”, your muscles will quickly weaken, and atrophy. It will then be even harder to keep a good connection : a good motor control (the signal from your brain to your muscles). Plus, you may develop over time osteoporosis (a bone deterioration that increases the risk of fragility fractures), and many other health problems.

So, what are the simple tricks and tips to “remain connected to your muscles”?

 

1- Do not forget that a bad day is nothing else but a bad day. It is not an irreversible fatality. Truly, your results may be less noticeable today, but your work got is utility anyway. You stimulate your muscles, even though you don’t see any movement. It stimulates your bone density, and keep your body healthy. Don’t get discouraged to the first fails, and keep on trying to do your movements. Don’t be too hard and demanding on yourself. No matter what is your performance level, the most important is to stay as active as possible (2)(3).

2- The motor imagery : Some call it visualization. It is a mental representation of the movement. So you imagine yourself sending the command to lift your knee. You visualize the muscles contract in your groin, and visualize the movement that would be created, without actually doing it. This technique, in adjunction to more classical training (as physiotherapy exercises) has been shown to be efficient in MS treatments (4).

3 – Use different positions to do your movements and exercises. Let’s keep that example of the hip flexion. To lift the knee in a sited of standing position is demanding because you have to apply a force against gravity. You can try it in water to overpass gravity. Or you may want to try to walk on all fours. To bend the hip in that position is a little easier because you need less strength. The movement will be wider, and you’ll certainly be encouraged to see those results.

4- Do meaningful activities. The exercises you chose to do should be funny. If it is a boring or stressful duty, this may impair your performance, and then the whole thing becomes even more unpleasant. If you like to swim, combine your physical activities with pool time. If you like to cook, take advantage of that time in your kitchen to walk sideways, backward, forward…

5 – Be imaginative and creative ! Your physical activities should be adapted to your personal tastes as well as your physical abilities. If you get short on inspiration, you can always refer to your physical therapist, physiotherapist, kinesiologist, or physical trainer. He will surely has a lot of ideas for you.

 

You would like to learn more?

Bibliography

(1) More information about MS pathology : https://mssociety.ca/about-ms

(2) Canadian society of physiology and exercises : Canadian physical activity guidelines for adults with MS : https://mssociety.ca/support-services/programs-and-services/recreation-and-social-programs/physical-activity/the-guidelines

(3) Backus, D. (2016). Increasing Physical Activity and Participation in People With Multiple Sclerosis: A Review. Archives Of Physical Medicine & Rehabilitation97S210-S217. doi:10.1016/j.apmr.2015.09.027

(4) Jackson, P., Lafleur, M., Malouin, F., Richards, C., & Doyon, J. (2001). Potential role of mental practice using motor imagery in neurologic rehabilitation. Archives Of Physical Medicine & Rehabilitation82(8), 1133-1141.[/vc_column_text][/vc_column][/vc_row]