20250129 - How to Progress an MS Exercise Routine
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When you have multiple sclerosis, it is so important that you feel like your exercises fit you and your current ability levels, which sometimes means that your exercises are feeling a bit easier than they used to. And it's really important that you know different strategies to make your exercises a bit more challenging.
or progress your exercises to the next level.
Now that doesn't always have to mean that you add weight or do more repetitions. Of course, those are good options, but there are other things that you might not be thinking of that are really easy, simple ways to progress your routine or advance your exercises to get to that next level so that they are still benefiting you.
I see this all the time in my online program for people with MS, the missing link, where they've been doing their MS specific exercises for a while, and some of them are getting to be too easy and they often wonder, should I just stop doing this exercise and move on to something else?
And more often than not, the answer is no. You want your exercises to be challenging and the first step is to keep the same exercise, but make it harder. And you can do that in ways that we're going to discuss in just a minute or so, but make it harder first. And if that does make it harder, it's a sign that you do still need to do that exercise.
The exercises that are challenging are challenging for a reason. It's because the MS is attacking that specific muscle or muscle group. So we want to make the exercise harder and get really good at that. And then eventually, even with adding all these ways to make the exercise harder, You might feel like it's still not that bad.
It's still pretty easy. That is when you can officially remove an exercise and add on a new one to your routine.
But let's discuss the seven ways to make an exercise harder, to advance your exercises or progress your exercises. You don't need to do all of these. You could just pick one or maybe two, but it's most important that you listen to your body. All right, let's dive in.
[00:02:14] 1. Add Weight Or Resistance
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the first way to progress an exercise is so obvious that I'm just going to breeze through it, and it is to add weight or resistance. If you're someone who likes to use weights or resistance bands, you don't need to, especially with multiple sclerosis. Function and functional exercises is the number one thing to focus on.
And nine times out of ten. If not, nine and a half times out of ten, you don't need weight for those exercises. But if you are someone who likes using weights or resistance, a simple way to make an exercise harder is to use more weight or a heavier resistance. But let's move on to the ones that you might not have thought of.
[00:02:54] 2. Change Position
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Like changing the position. For this first exercise, I'm going to demonstrate bending my knee. So if I am in a standing position and I am trying to bend my knee for most of my patients that I work with and my missing link members, this is the most challenging exercise.
It can be really, really hard. to bend your knee. But, if you've been doing it for a while and you feel like you're getting better at it, we can change the position to make it even harder. Now, this is going to be different for everyone, but if standing no longer feels like a challenging version, you can try sitting down in a chair and it can have an opening underneath it, like a kitchen chair, or maybe no opening, like a loveseat or couch, something like that.
Either way, you bend your knee as far as you can. And I especially like using chairs that don't have an opening, because the goal would be to bend your knee enough so that you can push your heel into the floor. the surface into the bottom of the couch or loveseat, wherever it is that you're sitting. So you bend your knee and push, push, push, and then relax.
And that can make the exercise so much harder for your hamstrings because you're pushing into the floor. resistance. It actually uses your muscles in a different way. You're using your muscles concentrically and isometrically. So that can be a harder position. If you're looking to make that same exercise, that same muscle work more.
[00:04:35] 3. Hold longer or go slower
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For this next way to make an exercise harder, I'm going to demonstrate a squat, but please know that for all of these ways to make an exercise harder, you can apply. Every strategy to any exercise. So the next strategy to make an exercise harder and to progress the exercise is to hold longer or go slower.
For example, if I am doing a squat, so I'm standing with my feet nice wide and apart, standing up with my best posture, glutes are tight, core is tight. If I'm going really fast, if I'm hinging forward and squatting down as if I'm going to sit in a chair, if I'm going really fast, I don't need to use my muscles as much.
For example, if I'm going faster, I'm only using my muscles for about one second per repetition. But if I'm going slower, if I go really slow, if I really take my time to hinge my hips forward, slowly bend as low as I can go comfortably, slowly stand up and then rest. That whole exercise may have actually taken about three seconds or four seconds, five seconds, six seconds, depending on how slow you're going.
And what that translates to is the more amount of time, the slower I go, And the longer I'm using my muscles, the harder it's going to be because now I'm not just working on strength training, but I'm also working on stamina and endurance training. So if you're looking to make an exercise harder, go slower.
Now this kind of relates to the next exercise. strategy, which is holding longer. So with going slower, you're not necessarily holding, you're just going slow for the whole movement. But to add on top of that, you can hold it for longer. So with the example of the squat, go slow on your way down. But before you stand up again, hold.
So you're going to hold in the squat position for maybe three seconds, five seconds, 10 seconds, whatever you can do, and then slowly stand up. So you're holding the position longer and that is going to make an exercise more challenging.
[00:06:57] 4. Putting More Effort In
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Next up is putting more effort in. And another way that you can view this is to Think about moving more, see more movement. So a great way to discuss this in terms of the squat is if you're just bending and hinging and squatting, maybe only a few inches, that's not going to be as hard as if you bend or squat maybe a foot like 12 inches or lower.
The lower you squat down, the harder it's going to be. Not only that, but When you're thinking about squats or standing up and sitting down, which is kind of like a squat, think about what surfaces in your home are hard for you to stand up or sit down from like a low squishy couch or a toilet seat. Those tend to be surfaces that are either squishy, which makes standing up hard.
Or low, which makes standing up hard. So maybe instead of using your kitchen chair for a squat, every time you move over to your toilet or to your couch and you squat down there and maybe you fully sit down and then stand up. That's more movement. You're bending and hinging and sitting down lower. than you were initially, which may have just been a few inches or a foot.
So putting in more movement and more effort can make the exercise more challenging.
Of course, another way to increase the intensity and the difficulty of an exercise is to do more repetitions. So if you're normally doing, 10 squats and then you take a break. See if maybe you can do 15 squats and then take a break or 20 squats and then take a break. More repetitions. And the reason that that is more challenging and a way to progress your exercises is because by doing more repetitions, you're not just working on improving your strength.
You're also working on improving your stamina or endurance because you're not allowing as much rest time. 10 squats and then take a break. See if maybe you can do 15 squats and then take
[00:09:10] 5. Take fewer rest breaks
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Which leads me to rest. So, there's two ways that you can make an exercise more challenging, just simply by focusing on what rest time you're allowing yourself.
Option one is to take fewer rest breaks, which coincides with more repetitions. So, if you normally do 10 repetitions rest, 10 repetitions rest, 10 more and then rest. Those were three rest breaks versus if you just do 15 repetitions rest, 15 rest, that's only two rest breaks. So reduce the amount of rest breaks.
[00:09:47] 6. Rest for less time
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But the other way is to rest for less time. So if you normally rest, maybe just for, 10 seconds, just a quick break, get your muscles to relax, and then you go back to exercising. Maybe you rest for 5 seconds, lessen that time. Or if you normally rest for a minute, maybe try 30 seconds or 45. So reduce the amount of time that you're resting for.
Did
[00:10:15] Recap
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So that was a lot. That was, I believe, eight different ways to make an exercise harder. So let's quickly recap those. Number one was to change the position so that you're doing it in a position that feels more challenging for you. Number two was to go slower.
The slower you go, the harder it is. Number three, hold longer. Instead of holding an exercise for just one second or two seconds or no seconds, hold longer. Maybe pause at the most challenging part for five seconds or 10 seconds if you can.
Next is to have more movement. So if you're doing the squat exercise, squat lower. If you're bending your knee, try to bend more, look for more movement in the exercise that you're doing. Next is
reducing the amount of rest breaks that you're taking and, or shortening the amount of time that you're taking for your rest breaks. And of course, if you are someone who likes to use weights or resistance bands, you can use more weight or more resistance. But these are really simple ways that you can make any exercise that you're doing harder.
And what I recommend to my clients with MS is you make any exercise that is starting to feel too easy, feel Make it harder first before you just totally get rid of the exercise and move on to something else. If you implement one or several of these strategies and it still feels hard, that's perfect.
You want your exercises to be challenging. And if it is harder, that's a great sign that there is still weakness there that you can work on to help improve your strength, your walking, and ease of your daily activities. Eventually, you will get to a point where even with adding all these different strategies to make it harder, it's just not that hard anymore.
And that is when you can safely move on to a different exercise. I'm Dr. Gretchen, physical therapist and multiple sclerosis certified specialist at The Missing Link, where I prioritize helping my clients with MS with functional exercises based on neuroplasticity, which is just a fancy way of saying we don't just focus on strengthening the muscles, but also the brain.
And the connection between the two, which is our neural pathways. And that truly is the key to seeing lasting results when you have multiple sclerosis. If you want to learn more about the missing link to see if it's a good fit for you and your goals, check the description below.
