Safe and effective exercise routines for SPMS

Last updated Oct. 23, 2025, by Agata Boxe
Fact-checked by Inês Martins, PhD

Secondary progressive multiple sclerosis (SPMS) can involve symptoms that may make it harder to stay active, but exercise can play an important role in managing the condition. The right activities can help preserve mobility, reduce stiffness, and support both your physical and mental health.

Because everyone’s abilities and symptoms are different, working with a physical therapist to find safe exercises for SPMS can help you stay consistent while minimizing the risk of injury or fatigue.

Safety tips before getting started

Before you begin an exercise routine for SPMS, it’s a good idea to take certain precautions so that you can exercise safely and confidently.

Advice to consider includes:

Talk to your doctor or physical therapist before starting.
Make sure to warm up and cool down to reduce the risk of injury.
Take water breaks to stay hydrated.
Exercise in an air-conditioned space to avoid overheating.

Finally, consider using assistive devices or supports when needed, to make MS-friendly physical activity more stable, flexible, and accessible. Examples include walkers and canes, as well as resistance bands that can be used instead of weights.

Exercise options that work well with SPMS

Despite the mobility challenges that SPMS can bring, you can find ways to stay active safely.

Some examples of safe exercises for SPMS that your physical therapist might recommend include:

stretching, which can help manage tight muscles and spasticity as well as increase range of motion
strength training, which can help you support muscle strength and mobility, and can be done in a standing or seated position
yoga, which can help with flexibility and balance, and can be modified as needed

You can also adapt certain exercise routines based on your SPMS symptoms and needs. For example, you can engage in aerobic exercise through low-impact activities such as walking, swimming, or stationary cycling.

Similarly, seated exercises are a good option if you’re dealing with mobility challenges or MS fatigue, and balance exercises, such as heel-to-toe walking or toe raises, may assist with your coordination and stability.

Your physical therapist may also recommend combining some of these options or suggest others. Additionally, a therapist can share specific MS workout tips to help you remain consistent and injury-free.

Making exercise fit your needs

As your SPMS needs and abilities may evolve over time, you may need to adapt your exercise routine.

Some advice for adapting your routine includes:

Start slowly and don’t overexert yourself.
Try so-called exercise snacks, or short bursts of physical activity throughout the day.
Listen to your body and adjust the intensity as needed.
Take breaks if you become fatigued.
Include rest days in your schedule to recover.
Communicate with your physical therapist if you need adjustments.

Remember that consistency matters more than intensity, so prioritize building and maintaining a routine rather than competing with yourself.

How to build a routine you can stick with

Building a routine you can stick with is critical for remaining consistent. These tips can help you stick with your plan:

Try to find a type of exercise that you like. It may be easier to continue something you enjoy.
Schedule your workouts just as you would a work-related activity.
Ask your physical therapist to help you set goals, and slowly work toward them.
Reward yourself for progress by, for example, taking yourself out to lunch or buying a new workout outfit.
Consider finding a workout buddy for camaraderie.

You may also want to find your “why” with exercising and write it down. Understanding your motivation and recording it can help you keep going.

Most importantly, be patient with yourself and practice self-forgiveness. If you are feeling too fatigued to exercise, take a break and get back to it when you feel ready.

Knowing when to slow down or adjust

A key aspect of exercising with SPMS is recognizing when you may need to take a pause or modify your exercise plan.

First, remember that resting and adapting should be embedded in a responsive exercise routine. Taking breaks and making changes are especially important as you deal with symptoms and potential mobility changes brought on by SPMS.

Signs that you may need to slow down or adapt your current workouts include:

feeling more fatigued than usual, especially for long periods
experiencing pain that does not go away with rest
dealing with more pronounced muscle weakness
overheating your body
experiencing shortness of breath

If you ever notice these or any other concerning symptoms, stop exercising right away and consult your doctor or physical therapist. They can then advise on what to do next and tell you when you may be able to resume physical activity.

Overall, knowing how to exercise with SPMS safely can help you nurture your overall well-being. With the guidance of your doctor or physical therapist, you can be empowered to feel more in control and move for the benefit of your physical and mental health.

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