Tag Archive | multiple sclerosis rehab

Multiple Sclerosis (MS) Common Problems, Exercise Therapy and Rehab Pilates

 acordax616Healthline website wrote a very good description about Multiple Sclerosis: “Multiple sclerosis (MS) is a progressive autoimmune disease. Autoimmune diseases mistake normal, healthy parts of the body as foreign and attack them. In the case of MS, the body attacks and destroys the protective sheath that surrounds your nerves. This sheath is called myelin. The damage to and destruction of the myelin eventually affects the nerves. Nerve damage delays and disrupts communication between your brain and parts of the body”.

Common physical problems with Multiple Sclerosis clients:

1. Foot drop

Foot drop is usually caused by a combination of weakness of the muscles of ankle dorsi flexion and tightness in the muscles of ankle plantar flexion. The weakness can be secondary to a loss of central nervous system activation, to disuse, or to some combination of the two. The tightness can be a result of plantar flexor spasticity, prolonged positioning in plantar flexion leading to decreased range of motion, or both.
Regardless of the cause, foot drop leads to higher risk of falling. An exercise program should focus on active and passive plantar flexor stretching, dorsi flexion strengthening, and exercises that retrain the ankle to function more properly during gait and balance activities.

2. Gait and balance dysfunction
For Multiple Sclerosis the gait difficulties are common and complicated. Gait may be limited by foot drop, and/or by hip and knee weakness and stiffness, lower extremity sensory loss, visual and vestibular damage, and cognitive loss. Balance loss in MS is similarly complex and is usually caused by a combination of factors that include weakness, stiffness, sensory loss, visual and vestibular loss, motor control impairments, and cognitive issues.
To prevent potential complications from gait dysfunction and balance loss is recommended to start physical therapy or Rehab Pilates (w/physical therapist) very early on.

3. Weakness and stiffness
MS clients overall weakness and stiffness are caused by CNS dysfunction but also may be a result of disuse. Stiffness can cause weakness and vice-versa.
Although stretching and strengthening exercises are clearly indicated, they must be tailored to each client’s individual needs and state of disease. Stretching and strengthening exercises should be gentle, and that is why Pilates with apparatus is a good fit for people with MS.

4. Fatigue
One of the most common findings in MS is fatigue, a lack of physical and/or mental energy. It can be primary due to CNS dysfunction, or caused by disuse atrophy from an overly sedentary lifestyle that the MS patient has adopted. Movement becomes increasingly difficult and exhausting, leading to a cycle of further immobility and worsening fatigue.
Exercise has to be gentle and with rest breaks—proper exercise program makes possible greater fitness gains without excess fatigue. Many MS clients find that Pilates exercises works well, because of breathing, engaging your deep core muscles and slow pace movements. After a class with a good teacher you feel more relaxed and less tired even though you have been working hard.

5. Mobility
MS is a disease of mobility. The big factors like loss of strength, range of motion, endurance, and balance cause many problems for MS clients daily activities and quality of life. So, that’s why exercise is the number one treatment for people with multiple sclerosis. USE IT OR LOSE IT!


Why Pilates for Multiple Sclerosis Rehab / Fitness?

Studies show that Pilates training develops balance, mobility and muscle strength of MS clients. For this reason, Pilates exercises, which are appropriate for the disability level of the clients, may be very beneficial and suggested. Pilates focuses on core muscles. Those are the muscles located around your center and spine. They are very important for your overall stability and balance. Pilates does not only build your core muscles, but also enhances your overall strength, body awareness, posture, flexibility and mobility. Muscle flexibility and Joint mobility are important to reduce stiffness and pain. Pilates training emphasizes proper breathing and smooth, flowing movements which are both natural stress relievers and causes less fatigue after session than normal exercise class. Pilates (with a good Pilates Instructor) facilitates proper movement patterns, so the muscles can learn to work more efficiently. Pilates exercises also re-educate the multiple sclerosis clients neuromuscular system. Pilates taught by Physical Therapist or very experienced Pilates Instructor is a safe workout and a good rehabilitation form for MS of any age and any other conditions because sessions can be modified for your needs and conditions.

Any Challenges?

Finding a good Pilates instructor experienced in working with people that have neurological issues and Multiple Sclerosis may be a big challenge. Our PhysioWise program for Neurological issues is available for people who live around the San Diego, North County, CA.


Clinical Pilates vs. Fitness Pilates in Oceanside, Carlsbad, Encinitas

Pilates is a wonderful exercise form for fitness as well as physical rehabilitation. Unfortunately, Pilates comprehensive certification program prepare Pilates instructors only to teach “Fitness Pilates”, which is Pilates for healthy bodies (no injuries). So, basic Pilates education does not give enough education about working with musculoskeletal and neurological problems and dysfunctions. Too confident Pilates instructors with lack of education are a dangerous combination. Don’t get me wrong, Pilates is still good for rehabilitation and post-rehabilitation – but only when taught by a skilled Physical Therapist or very experienced Pilates Instructor. Physical therapists have advanced education about anatomy, physiology, biomechanics and exercise invention and they are experienced to work with regarding different kind of diagnosis and bodily dysfunctions.

In Australia they have wisely separated clinical and fitness Pilates. Clinical Pilates is only taught by Physiotherapist (=Physical Therapist). Fitness Pilates is taught by fitness professionals or dancers. Aussies have understood also how good Pilates exercise is when practiced together with traditional physical therapy. Also in Finland they have separated clinical Pilates education which is only designed for Physical Therapists, and Mat Pilates certification program for fitness professionals. They don’t allow Pilates instructors with dancing & fitness background to work with injuries.

Clinical Pilates aims to correct biomechanical alignment and muscle imbalances which are caused by faulty compensation patterns due pain, disease or injury. Fitness Pilates concentrates only in proper Pilates exercise techniques, nice cuing and body & mind connection, which is definitely not enough for the people with post rehabilitation or rehabilitation needs.

Fitness Pilates:

  • Dance-oriented exercises, used for general conditioning and lifestyle
  • Strong bias towards flexion, stretching, end-of-range movements,
  •  No evidence to support its use for rehabilitation of low-back pain
  • Non pathology-specific exercises

Clinical Pilates:

  • Benefit Diagnostic and rehabilitation tool for injury and performance enhancement  
  • Progresses from static stabilization to dynamic; trains local then global stability systems.
  • Neutral zone stability comes before end-of-range flexibility
  • Aims to fulfill established evidence based criteria
  • Observes pathology under load and modifies accordingly

PilatesWise program in Carlsbad, Oceanside and Encinitas serves as a healing aid for anyone seeking to recover from injury, weakness from trauma, inactivity or illness, and recovery from chronic pain or disease such as MS, Fibromyalgia, Lupus, scoliosis, arthritis, Osteoporosis, sciatica, chronic back and neck pain. For more info please click HERE