Three important questions to ask yourself:
“Have I stretched every day?”
Stretching is like brushing your teeth. It should be done every day and multiple times. Stretching is the most basic exercise that needs to be done by everybody, especially by people with MS who have any mobility limitations. Stretching complements all other exercises in areas such as strength training and balance. Insufficient stretching commonly leads to poor movement patterns, pain, posture dysfunction, and in some cases, worsening spasticity and decreased independence in transfers.
“Did I see a Physical Therapist at least once in the past six months?”
Whether it is with Dr. Kanter or Dr. Sathe at the IMSMP or a trusted local physical therapist, the best way to prevent a pattern of physical deterioration is to schedule a physical therapy evaluation or plan of care review to update every 6 months. This session can be essential in keeping you on track by adjusting exercises that may not be beneficial or just need to be changed. Seeing a PT on a more regular basis will provide an opportunity to catch a new impairment such as weakness, tightness, or poor balance before it becomes a big problem. For people who use wheelchairs, this session can be useful in considering how the age and breakdown of the chair may be leading to new problems not directly related to MS.
“Is there anything I cannot do this year that I was able to do much better last year?”
This is possibly the most important question to reflect on. It is common to get frustrated with not being able to do an activity that you were able to do when you were “younger,” but it is the decreased abilities that occur in the short term that need to be addressed head-on since those are usually the most controllable.
Withdrawing from an activity that is considered harder commonly leads to additional limitations. For example, if you were not physically able to safely rake leaves during the fall this year and in 2018 you were able to, this should be addressed with your physical therapist. Returning to activities, even with modifications and/or supportive devices, as soon as possible, can decrease or halt the rate of disability.
Take a moment to review your responses to these questions. The expectation of performing exercises every day can be daunting for people who feel overwhelmed by their schedule and other obstacles. In short, the answer can be “Do the best you can.” As the physical therapists at the IMSMP tell their patients, performing ZERO exercises on a given day is not an option. Any number of repetitions, even if fewer than prescribed, must be done every day with very few exceptions.