This column focuses on exercises and tips from Mariska Breland, a Pilates instructor diagnosed with relapse remitting multiple sclerosis (RRMS) in 2002. She also trains other Pilates instructors to work with MS clients.
Generally, these exercises and tips focus on balance, overhead strength and core strength. As always, make sure to check with your physician before before beginning any new exercise or routine — please!
Balance: Breland says “balance” is a combination of physical and neurological assets, including proprioception, vestibular and musculoskeletal ability and function. Unfortunately, all are subject to change because of MS progression.
1. Start by putting your “best” foot forward: Take off your shoes and socks. For those with foot drop (like me), going barefoot is the best way to actually feel the floor. So, take ’em off!
2. Keep your feet loose and mobile: The foot, Breland notes, has 33 joints, 26 bones and more than 100 muscles, ligaments and tendons. Our feet need to be very, very mobile, and using a tennis ball (or one of similar size), roll your foot over the ball in every direction, and side to side with enough pressure that you can see your toes spread out. Ideally you can curl and spread your toes with space between each toe. (It’s OK to use a toe spreader for help).
3. Proprioceptive balance: Stand barefoot and try to lift up one leg. Hold for 10 to 30 seconds. Repeat on the other side. To make it harder, hold your leg up and move it in and out, or forward and back.
4. Vestibular balance: The vestibular system responds well to head and eye turns, Breland says. Stand in a lunge and turn your head to the right, and then to the left. Look up and down. Repeat for 30 seconds. Make sure to hold onto something if you feel unsteady; your balance should improve over time.
5. Hip stability: Come to a quadruped position (hands and knees, with hands under shoulders and knees under hips). Extend a leg back, but keep both hips on the same level. The inclination will be to dip into the leg that is on the floor; this indicates weakness in the hip stabilizers on that side. Hold for up to one minute. Switch sides.
6. Quadricep eccentric strength (stand to sit squat): Anyone who has struggled to get out of a chair knows that sometimes momentum is not a friend. Breland says it’s a frequent cause of falling, and hip instability or quad weakness can cause it to happen. To practice this exercise and get stronger, keep your legs hip-distance apart and slowly bend your knees, lowering yourself to a seat on a count of three to five. To progress through the exercise, choose a high seat to start and systematically move on to lower surfaces. (Make sure the chair isn’t going to move.)
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