Why Exercise Matters for People with Multiple Sclerosis (MS)
Fzt. Kemran Hafız · 20 August 2026 · 2 min read · Last updated:
Many people newly diagnosed with multiple sclerosis (MS) conclude in the first days that they should now move less. Current physiotherapy guidance argues the opposite.
Why inactivity is the wrong instinct
In MS, slowed nerve conduction reduces muscle strength, balance and endurance over time. Staying inactive doesn't slow that loss — it speeds it up: unused muscle weakens further, reduced strength makes daily movement more tiring, and the person moves even less. Exercise is the one tool that reverses this cycle.
The fatigue paradox
Excessive fatigue, MS's most common and most draining symptom, keeps many patients away from exercise. But controlled studies show that properly dosed aerobic and strength exercise does not increase fatigue — over time it reduces it. The key phrase is "the right dose": the programme starts at low intensity and progresses gradually according to the body's response.
Heat sensitivity
In many people with MS, symptoms temporarily worsen when body temperature rises (Uhthoff's phenomenon). This is not permanent damage and resolves once the body cools; even so, a cool environment, breaks and, where needed, cooling measures are factored into the exercise plan.
What the programme focuses on
Balance and fall-risk work, lower-limb strength, gait pattern, and training in the use of assistive devices such as a cane or orthosis where needed sit at the centre of the programme. The programme is scaled back during a relapse; in recovery afterwards, exercise becomes a tool that speeds recovery.
Why coordination with the neurologist is essential
MS follows a fluctuating course; the intensity that suits today may need to change a few weeks later. For that reason the physiotherapy programme runs in ongoing communication with the neurologist following the disease's course.
Fzt. Kemran Hafız prepares graded exercise programmes for MS clients in Bursa Nilüfer that take fatigue and heat sensitivity into account. You can book an assessment.
Read on: How a fatigue-aware programme with gradually increased load is built is described on the neurological rehabilitation page.