What is it?
There is no doubt that multiple sclerosis (MS) is an extremely debilitating disease, and is the most disabling neurologic disease of young adults in USA (3).
It affects the central nervous system leading to a destruction of nerve machinery in a sufferer’s body. These effects result in functional impairments such as abnormal walking mechanics, poor balance and muscle weakness, leading to reducing an individual’s ability to perform daily activities. Now, I intended to write this article without too much technical wording, but in some instances I have had to cover it slightly, so bare with me, because although it maybe slightly harder to read in places, the results of the research offers MS sufferers huge benefits.
Figure 1 Motor neuron and its components.
The DENDRITES AXON & MYELIN SHEATH are destroyed by MS.
This destruction of the nerve machinery leads to a reduced ability or inability to activate muscles in the lower limbs. This is because the signals from the brain can’t get to the muscle as the motor units (signal box of our muscles) lose some, if not all function. MS sufferers can have between 30-70% lower muscle strength compared to healthy adults (2).
Maximal strength training
Whether you exercise in the gym, play sport or do another form of activity, you will be aware of when your body is working a little bit or when its working hard. In terms of strength training (ST), this involves lifting near maximum efforts for between 1-5 repetitions (working very hard). There is a vast amount of research showing that ST improves muscle strength, by stimulating neural adaptations that allow muscle to produce more force (1). The main reason for this is increased nerve signals from the brain to the muscle (1). Hence, this is why virtually all-professional athletes, regardless of sport, have a well-structured strength & conditioning plan that works alongside their sport itself. Strength gains DO NOT mean size gains, and this is evident when you watch sports such as men and women’s triple jump, high jump, 800m, tennis, synchronised swimming and diving etc.
Why does maximal strength training help MS sufferers?
Strength training in particular has been shown to increase the neuromuscular function (nerve and muscle function) in MS sufferers (2). One very recent study found an average increase of 20% in muscle strength, which was seen in just 3 weeks. This is similar to what has been reported in healthy subjects after specific strength training. These findings demonstrate a vast potential for improvements in strength and neural function following ST in MS patients.
Things to note
- · There were no adverse effects for the MS patients in this study
- · All patients dramatically improved daily living quality
- · All patients performed their specific MS rehab at the same time
- · Patients included mild and moderate conditions
- · Symptoms were alleviated
There was no mention of how long the improved state lasted, but surely a 3-week strength-training block is worth trialling, even if improvements are not permanent.
Example training plan
This study used the following intervention:
3 weeks long – 15 sessions in total (5 sessions per week)
Horizontal leg press
Seated calf raises
4 sets x 4 repetitions (85-90% 1RM – maximum effort)
Finally, if this were something that you feel is worth investigating, I would advise seeking a fully qualified coach (e.g. United Kingdom strength and conditioning association accredited coach – UKSCA). For more information please contact Coast Clinic on 01273 321133.
Written by Richard Husseiny
Richard works at Coast and is an accredited Strength and Conditioning coach and Sports Therapist. Away from elite sport, this is an area that Richard is very interested in and would love to be able to support any MS sufferers that is interested in trialling this type of intervention.
1) Behm, DG. (1995) Neuromuscular Implications and Applications of Resistance Training. J Str Cond Res, 9(4) 264-274.
2) Fimland, MS., Helgerud, J., Gruber, M., Leivseth, G & Hoff, J. (2010) Enhanced neural drive after maximal strength training in multiple sclerosis sufferers, Eur J Appl Physiol,
3) Frohman, EM. (2003) Multiple Sclerosis. Med Clin North Am, 87, 867-97, viii-ix