Fatigue is a common symptom with Multiple Sclerosis (MS) effecting approximately 75% of people with MS at some stage with significant implications on quality of life and daily function. However it is important to know that fatigue is experienced very differently between individuals and can be attributed to several different causes. The Fatigue Management Panel of the Multiple Sclerosis Council for Clinical Practice Guidelines defines fatigue as “a subjective lack of
physical or mental energy that is perceived by the individual or caregiver to interfere with usual and desired activities”. Fatigue can be increased by exposure to heat which is a primary factor and fatigue can also be a secondary symptom to experiencing other symptoms like pain, spasms, disturbed sleep and medications.
Despite this, one of the main reasons for feeling fatigue is as result of reduced activity or inactivity.
Exercise and Fatigue
People with MS are often concerned or reluctant to exercise due to their fatigue and often feel that it will increase the fatigue symptoms. As a consequence, disuse results in a reduction of physical fitness and strength and a downward spiral of decreasing activity and further secondary complications, for example increased risk of heart disease.
There has been significant evidence published that shows that exercise does not increase fatigue in MS but actually improves it. As the body becomes stronger and fitter it is able to perform activities with less exertion.
Top Tips to Managing your Fatigue
1. Don’t avoid exercise – it needs to be become a regular activity most days of the week.
2. Resting means pure rest – No mental or physical stimulation, most people make the mistake of thinking they are resting while watching the TV, reading a book or on the computer. Your brain is still processing all that stimulation and not able to switch off. A rest means no visual or auditory stimulation.
3. Perform your exercises either early in the day or split them up throughout the day – for example instead of doing a 45mins continuous exercise you can do 15mins three times throughout the day
4. Work at your own pace when exercising and take regular rests.
5. Start with only one short exercise session with at least one rest day and slowly increase the exercise time and number of active days. Avoid BOOM and BUST – when you go from doing nothing or very little to a hard exercise session, your body will be exhausted as it is not able to cope with the sudden demand.
6. Start with only a low number of repetitions of exercise at a low impact level and slowly increase as they become easier.
7. Alternate which part of the body you exercise – perform one exercise on your upper body and then one on your lower body. This allows one set of muscles to rest while one works.
8. Take regular fluids when exercising to avoid dehydration.
9. Energy conservation – balance your time between rest and activity by planning in advance what tasks are a priority.
10. Pacing – rather than trying to complete a task as quick as you can to get it over with, slow down and take regular breaks – for example vacuuming the house, do one room at a time throughout the week.
11. If fatigue symptoms last for longer than 24 hours post exercise the exercise was too strenuous and needs to be reduced until you have built up stamina.
12. Try to take 20min rests at the same time each day – the human body likes routine, if you can take a short 20min rest at the same time each day your body will be more prepared to work knowing it has a rest coming up.
If you would like to know more about managing your fatigue around regular exercise than please call the centre to make an appointment.