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Multiple sclerosis (MS) is an often-debilitating autoimmune disease caused by the body’s immune system attacking the protective coating of nerve cells, called myelin. Symptoms can range from numbness to paralysis, making exercise a difficult task. “For many with MS, fatigue is going to be a big issue. Often, people do too much and are then completely exhausted. To that end, start with a very small amount [of exercise] every day and gradually increase,” says Terry Wahls, MD, author of Minding My Mitochondria: Second Edition and professor of medicine at the University of Iowa in Iowa City. “Another factor is core body temperature. Higher temps decrease neurological function and tolerance for exercise.”

The struggle is worth it. Regular exercise produces more mitochondria, Wahls explains, which means muscle cells will function more efficiently and improve biological processes.

Wahls, a former tae kwon do champion who’s had remarkable success treating her own MS with nutrition and exercise, offers the following suggestions. For more about her methods, see her TED Talk and visit

  1. Work out in a cool environment. Try swimming in a cool pool. If you’re lifting weights, take longer breaks between sets or keep the intensity down.
  2. Focus on stretchingDue to a misfire of electrical impulses from the brain and spinal cord, MS causes muscles to spasm, resulting in stiffness and shortness over time. Stretching increases the length of the muscle cells themselves and combats the tightening effect.
  3. Get stronger using resistance bands, free weights or body-weight exercises. MS causes a slow deterioration in strength and muscle mass, so the sooner you can get on a strength program, the better off you’ll be long-term. This type of strength work improves balance and coordination more effectively than machines. It may also be easier to transition between exercises.
  4. Lower your stress levels. Exercise programs with an aspect of mindfulness as part of the training, such as tai chi, yoga or qigong, can help lower inflammatory stress hormones such as cortisol.
  5. Eat to quell inflammation. People with an autoimmune problem are prone to food allergies, and their bodies are more likely to contain toxic compounds such as heavy metals. If you’re working out but still eating a diet high in white flour, sugar and high-fructose corn syrup, or low in vegetables, wild fish or grass-fed meat, you’re pouring gas on your autoimmune fire. If, on the other hand, you adopt an anti-inflammatory diet, as Wahls suggests, with plenty of greens, sulfur-rich vegetables, brightly colored vegetables, grass-fed meat, organ meats and seaweed, you douse dietary triggers.
Jen Sinkler

Jen Sinkler, PCC, RKC-II, is a fitness writer and personal trainer based in Minneapolis. Her website is

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