By Dana Bubenko, Physiotherapist, BMR-PT

Let’s talk about fatigue, the most common problem for people living with Multiple Sclerosis (MS).

There are two kinds of fatigue:

1. Objective fatigue – Your muscles get weaker with repeated contraction, no matter how hard you try. This is due to the demyelination of nerves, the actual disease
2. Subjective fatigue – This is how you feel, just tired, depressed, overwhelmed.

You can have one or the other kind of fatigue, or both.

We can also categorize fatigue into primary and secondary:

1. Primary fatigue is due to actual lesions in the nervous system, and
2. Secondary fatigue is from adaptations your body makes to become more and more sedentary, like disuse atrophy.

This essentially means if you are not moving, then you will get worse simply from not moving. It has nothing to do with the disease process! Your body has actually learned to be disabled simply from not moving.

How We Can Help

How does Physiotherapy help with all of this? When dealing with objective or primary fatigue, we help you design an exercise program based on High Intensity Interval Training ("HITT").  This includes exercise with rest periods to help you exercise more efficiently, and get more benefit from exercise. Studies have proven custom HITT training works to improve exercise tolerance, as well as balance and mobility in general.

The secondary issue, disuse atrophy, sedentarism, or “unlearning,” is more of an issue in later or more severe MS cases. In this instance, Physiotherapists are uniquely trained to help you re-learn functional movement and make you more independent. Exercise on its own will not accomplish this, you need task-specific training. I’m not saying that if you are in a wheelchair that you will walk again, but perhaps you can sit up in bed by yourself without assist, or sit and balance by yourself without falling over. Tasks can be re-learned.

As an additional note, there are other factors that play into MS, such as vestibular problems, abnormal breathing patterns, and balance. At River East Physiotherapy, I evaluate and treat "holistically."  A holistical approach means I know addressing one part of the equation will often benefit all parts.

If you are living with MS and would like to live better, please give me a call, I would love to help you on your journey!

~Dana 

Click here to learn more about physiotherapist Dana Bubenko, BMR-PT