According to PubMed.gov, exercise and physical activity have been associated with reduced relapse rate, mobility disability and its progression, lesion volume, and improved neuro-performance, particularly walking outcomes. This evidence provides a positive, yet preliminary, picture for exercise having possible effects on markers of disease modification and progression in MS. (NCBI: PubMed.gov)

USNews: Most MS patients don’t exercise enough, according to a survey in the June 2015 issue of Acta Neurological Scandinavia.

• It’s understandable since multiple sclerosis, an autoimmune disease that damages the myelin sheath (covering) around the neurons in the central nervous system, can cause symptoms such as fatigue, overheating, muscle weakness, tremors and other disabilities, all of which can make exercising especially challenging.
• That’s why if you have MS, you’ll want to choose an exercise routine you not only enjoy, but one that also fits your particular needs.
• “You should start by seeing a physical therapist who will help adjust exercises to fit your capabilities,” suggests Dr. Michelle Fabian, assistant professor of neurology in the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Hospital in New York.
• “An important rule in MS is to start out small and work up gradually,” (US News)

For the most part, those with MS will follow an exercise routine, just as anyone else would.

• Aerobics, strengthening, stretching and balance exercises should be a regular part of your routine.
• Water aerobics, swimming, tai chi, and yoga are also exercises that often work well for people with MS.
• You should always consult with your doctor before starting an exercise routine and physical therapy to get you started, especially if you are new to exercising.

Things to consider or precautions:

• Make sure there are no slippery floors or tripping hazards is important in keeping a safe environment.
• Start slow and warm up prior to your exercise routine.
  • Taking a walk may be a good way to start or may even be all you can do at that particular time. That is OK.
  • Don’t push yourself if you are just starting out a program.
• Grab bars or a solid surface to reach for may be needed if you have balance deficits
• If you feel sick, have exacerbations or pain, stop and do not push through the symptoms.
  • Listen to your body.
• Some people with MS are sensitive to the heat.
  • When your body temperature rises, the symptoms get worse.
  • Here are some tips:
    
    • Just like people without MS, you should not exercise outside in the hottest times of the day between 10 and 2, and not at all when the temperature and humidity are high.
    • Drink plenty of cold water/liquids. Stay hydrated.
    • Stop if symptoms worsen or cool down before continuing.
    •  Wear cooling collars, bandanas or vests or wrap a wet towel around your neck.
    • If swimming, use a pool with a temperature in the low 80s.
    • Take cool or tepid showers.

Types of Exercise to Try according to WebMD:

• Aerobics.
  • Not only does it get your heartbeat up, it lifts your mood, too.
  • Walking, running, and biking are all good.
  • If you have leg weakness or other problems moving, try something like rowing or water aerobics.
• Stretches.
  • They’re good for anyone with MS, but they’re most helpful if you have painful muscle stiffness and spasms.
  • Aside from regular stretches, yoga and tai chi are great ways to build strength and flexibility.
  • They can also help you relax and fight stress.
• Strength training.
  • If your physical therapist says it’s OK, use weights or resistance exercises to build your muscles.
  • The stronger you are, the easier it’ll be to move around. (WebMD)

Mayo Clinic: Exercise and multiple sclerosis

NIH: Multiple Sclerosis

NIH- NCBI – PubMed: Is physical exercise a multiple sclerosis disease modifying treatment?

US News: The Latest on What Exercise Works Best to Combat MS

VA: Multiple Sclerosis Centers of Excellence

WebMD: Multiple Sclerosis and Exercise

Here’s why exercise is helpful for managing lupus from the Lupus Foundation of America: Five benefits of exercise for managing lupus:

• Exercise can strengthen parts of your body that may be affected by lupus — the heart, lungs, bones and joints.
• Exercise helps reduce inflammation by regulating some of the chemicals involved in the inflammation process.
• Exercise can help control weight gain caused by use of corticosteroid medications and keep your body conditioned.
• Exercise, and even simple low-impact movement, will make muscles less stiff, increase your range of motion and help you reduce the risk of heart disease.
• Exercise may boost your mental health, making it easier to cope with life stressors and potentially improving mood and self-esteem.
  • In addition, exercise can reduce fatigue.
• You should always consult with your doctor before starting an exercise routine and physical therapy to get you started, especially if you are new to exercising.

The following are suggestions before starting an exercise program from the  article: Lupus Foundation of America: Five things to know before starting an exercise routine

• Outdoor activities can be highly beneficial to people with lupus.
  • However, it’s best not to jump right into a rigorous exercise program.
  • It’s better to ease your body into the idea of working out.
• Lupus patients can and should take part in physical activity.
  • Before doing this, you should discuss with your physician or physical therapist what the best type of exercise will be for you.
• Whether you are beginning (or renewing) an exercise routine now, or whether you have been working out throughout the year, there are a few key things that all people with lupus should know about exercise.

Before heading out the door, remember the following five points (Lupus Foundation of America):

• Walking, swimming, bicycling, low-impact aerobics, certain types of yoga, Pilates, and stretching can help tone muscles and minimize joint aggravation.
  • Exercises such as these are excellent for preventing osteoporosis, the disease in which individuals lose bone mineral density.
• Although, at times, exercise may be the last thing on our minds, it is good to stay as active as possible.
  • This prevents the muscles that are no longer being worked from becoming weak.
• It is also important to vary your exercise routine in order to promote the strengthening of different muscle groups throughout your body.
• In addition, exercise is good for relieving stress.
  • And, as you may know, stress can trigger a lupus flare.
  • However, it is vital to pace yourself!
  • When you try to do too much, that increases your feelings of stress and can also contribute to the disease flaring, which may then create even more stress.
  • Don’t push yourself too hard.
  • You have to find a nice balance that works for you.
  • It is important to allow your body to rest and recuperate.
• If you experience severe pain, or stiff and swollen joints, you should avoid or limit activities that contribute to feelings of pain.
  • Always take breaks if needed!
  • It is a good idea to limit exercises that are high-impact, such as jogging, weightlifting and high-impact aerobic exercises.
  • These can place strain and pressure on the joints.
• If you do experience pain and joint aggravation, there are several things you can do.

Ways to relieve pain and soreness after exercise:

• Joint and muscle pain can be relieved by heat and/or cold application.
  • However, moist heat has been shown to soothe painful joints much better than dry heat.
  • Try taking a warm shower, using a warm moist towel or soaking in a hot bathtub to soothe aches and pains.
• Other methods to relieve pain can include behavioral techniques, such as relaxation, meditation, focused breathing, low-impact yoga, Tai Chi and guided imagery.
  • These methods allow you to draw your mind’s attention away from the pain and to focus on relieving stress and tension that can intensify the pain experience.
  • These techniques are safe and easy to do at home and allow you to control your pain rather than suffer through it.
• Ice or cold applications are advisable only for strained or twisted muscles or injuries.
  • Follow the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing.
  • Begin right after the injury occurs and continue for at least 48 hours.
• Work with your healthcare team and develop a plan that benefits you while also limiting any discomfort.
• Finally, make sure you protect your skin against the sun’s rays.
  • Slather on the sunscreen and wear a broad brimmed hat before you walk out that door! (Lupus Foundation of America)

According to MedicineNet, Exercise will help you manage lupus but you should avoid outdoor exercise in the sun because sunlight can trigger flares.  Cover up by wearing a hat, long-sleeved shirts, and long pants, and use sunscreens with a sun protection factor of at least 15 if you walk or bike outdoors. (MedicineNet)

CDC:  Lupus

Lupus Foundation of America: Five benefits of exercise for managing lupus

Lupus Foundation of America: Five things to know before starting an exercise routine

Medicine Net: What Are Safe Exercises with Lupus?

NIH: Lupus

• Although pain and fatigue may make exercise and daily activities difficult, it is important for you to be as physically active as possible.
• Research shows that regular exercise is one of the most useful treatments for fibromyalgia.
• If you have too much pain or fatigue to do exercise, you should begin with walking or other gentle exercise.
• Over time you can build your strength. (NIH)

You should always consult with your doctor before starting an exercise routine and physical therapy to get you started, especially if you are new to exercising.

• You may be reluctant to try exercise for fear that it will make your pain worse.
• But starting low and going slow helps keep symptoms from flaring up.
• Consider starting with walking two minutes a day and gradually work your way up to 30 minutes two or three times a week.
• It’s crucial to pace yourself. If you do too much on your good days, you may have more bad days.
• If an exercise causes you increased pain for more than two hours, reduce the time or intensity of that exercise next time. (MayoClinic)

Along with low impact aerobic exercises, strengthening and stretching, other exercises such as yoga, tai chi and palates can help both physically and mentally.

• If you have access to a pool, water aerobics/therapy has shown to have a good outcome in reducing symptoms.
• According to WebMD, exercise can help maintain bone mass, improve balance, reduce stress, and increase strength.
• Getting regular exercise can also help control your weight, which is important to reducing the pain of fibromyalgia.
• “Moving your body may be the last thing you feel like doing, but you have to believe that it really does help.
• “It’s hard at first, but it does get easier.”
• Whether you’re walking or participating in an exercise class, these exercise tips can help prevent injury or pain:
  
  • Exercise at the time of day that you feel best.
    • For many people with fibromyalgia, this is between 10 a.m. and 3 p.m. But your best time may be different.
  • Stretch.
    • This can help warm up muscles and minimize pain after exercise.
    • You can stretch while lying down, standing, or sitting in a chair.
    • Some people may find it helpful to stretch in a warm bath or shower.
  • Take small steps.
    • When walking, try not to swing your arms too much or take big steps.
    • Walk on flat, even surfaces to reduce your risk of falling.
  • Ease into strength training.
    • For strengthening exercises, consider using elastic bands instead of weights and start with a single set of repetitions.
  • Pace yourself.
    • When doing stretching or strengthening exercises, alternate sides often and take a short rest between repetitions.
  • Take breaks.
    • Again, listen to your body.
    • “When first starting, rest after just a few minutes of exercise,” Matallana says.
    • “Don’t be afraid to go as slowly as you need to.”
  • Pamper yourself afterward.
    • When you’re finished exercising, take a hot shower or bath.
  • Exercising in a warm pool is another good way to start being active.
    • Warm water has a soothing effect on muscles and joints and may make exercise less painful.
    • But even if you start in a pool, it’s still a good idea to work towards a ground-based workout. (WebMD)

Mayo Clinic: Fibromyalgia

NIH: Fibromyalgia

WebMD: Fibromyalgia Exercise, One Step at a Time