Exercise and multiple sclerosis

By Amelia York, MBS 2020, Geisinger Commonwealth School of Medicine
Mentor: Michael Sulzinski, PhD

My sister, Hannah, and her best friend, Ashley, were in the bathroom doing their hair and makeup for a girl’s night out. Listening to music and laughing so hard they would tear up. They were going to the mall and then to have dinner at their favorite Thai restaurant. Everything seemed to be at peace and make sense in the world of these two 18-year olds. They had both just graduated from high school. Hannah received a basketball scholarship at a college in Maryland and would be starting in the fall. She felt so sure and grateful that her future was turning into exactly what she had wanted. As Ashley finished the final touches of her makeup, Hannah carefully used her CHI straightening iron to smooth out the last few pieces of her long, blonde hair. CHI straightening irons were, and still are, very popular tools for straightening hair because of how hot their temperature can get. They go up to 392°F and that day, Hannah had hers adjusted to the maximum heat setting. She had noticed something interesting a few days earlier while doing her hair. When she accidently hit her left arm with the burning hot straightener, she did not feel any pain. She was not sure why this occurred and simply shrugged it off as luck or her toughness. But for some reason that day, she wanted to see if her left arm would feel the pain. She told Ashley to watch and placed her left wrist in between the two prongs of the straightener. When she pressed down, she felt nothing. No pain, burning, searing, or need to pull her arm away. Flustered, Ashley quickly grabbed the straightener and pulled it away from Hannah’s arm. There were clear burn marks on her wrist, but Hannah just stood looking at her best friend. Neither of the young girls knew what to say. Ashley stood in uncomfortable silence for a few minutes before she finally decided what to do. She looked at Hannah and said calmly, “We have to tell your parents, right now.” A week of visits with a neurologist, internal medicine physician, and radiologist ensued after the girls told her parents. She was diagnosed with Relapsing-Remitting Multiple Sclerosis (MS), at the age of 18.

A diagnosis of a disease that is incurable and life altering is devastating, but manageable with a dedication to physical health. One of the main teaching points to patients with MS is physical activity. Yoga is a highly studied and recommended exercise as even patients with deficits to MS, such as weakness or chronic pain, can take part without a heavy toll on the body. Yoga is not only a practice to strengthen and relax the muscles, but also the mind. As stress can be a trigger for MS relapses, body-mind connection is important for these individual’s collective health. Pilates has been shown to increase the posture and gait of MS patients by encouraging the strengthen of core stabilizing muscles through low impact training. Issues with gait and posture were proven to increase in recent studies. Finally, a common affliction experienced by patients with MS is muscle fatigue and weakness which narrows the amount and type of exercise that will be tolerated. An alternative method that is being used to target these groups is aquatic therapy. Clinical trials showed decrease fatigue, improved muscular strength and overall endurance increase after a few weeks of aquatic exercise. It is important to note that aquatic is uniquely beneficial in that it provides a cooler environment therefor protecting the patients with heat sensitivity due to fatigue. All of these therapies impart the opportunity to a unique group of individuals to be able to work out and improve their physical and mental well-being.

While my sister has had sad and difficult days dealing with MS, she is an absolute warrior. She has never let this diagnosis define her and has remained steadfast in her dedication to her own physical and emotional well-being. Hannah is a shining example of someone who has chosen to live life on her own terms, despite her obstacles. I hope that whoever reads this, and is dealing with a similar diagnosis, finds the same light and joy that she has found.