What Is MS?
MS is a progressive autoimmune disease, where the immune system attacks the myelin sheath which surrounds and protects the nerve cells. This leads to ‘lesions’ and inflammation along the nerves; which interrupts its messaging system. As such, it can affect any part or function of the body, depending on where the damage is. There are different types of MS, and numerous possible symptoms which can vary from mild to severe.
I have been working with people with MS for many years, mainly through classes I run at the
MS Centre Dorset. In that time, I have learnt much about the condition and how yoga therapy
can help.
1. Make the sessions fun and joyful
Living with a chronic condition can be challenging, so encouraging moments of lightness and joy can be helpful. It is common for someone who is newly diagnosed to experience feelings of grief for the life they had before, or fear of how their life may be affected in the future. If a client is disabled and relies on others for daily tasks, they may experience frustration, anger, or sadness.
2. Check the temperature of your room
People with MS often have difficulty regulating their body temperature, so may feel the cold more in the winter or easily overheat in the summer. If a client overheats, it may worsen their symptoms.
3. Do your research
Make sure you are familiar with the different types and possible symptoms of MS. Ask your client about their symptoms and how it impacts their day to day living. Whilst some have minimal symptoms, others may have limited or complete loss of movement in particular parts of the body.
4. Move slowly and pace practices
People with MS often experience fatigue, or it may take them a moment to process a movement, so be mindful to alternate movement and more challenging practices, with more restful practices such as breath awareness. Observe your client and check in with them regularly to see if they are tired or sleepy. Finishing with a guided relaxation is often helpful.
5. Keep it simple
Working on the principle of less is more, simple practices can make a
big difference. Take time to work with simple warm-ups and joint mobility movements
for example.
6. If speech is affected
Take time to make eye contact and communicate with your client
simply and clearly. Be patient whilst they respond to a question. Working with sound
can help clients access their voice.
7. Muscle spasms
If there is a spasm, encourage your client to take a moment to pause and breath. Be aware that muscles and joints can also be stiff or floppy.
8. Take particular care with neck flexion
Bringing the chin towards the chest can trigger ‘Lhermittes sign’ which is an ‘electric shock’ type sensation through the nervous system. This nerve pain is not life threatening, and usually only lasts for a few seconds, but can be quite uncomfortable. That said, if done slowly and mindfully, neck movements can also be very helpful.
9. Agree a focus for the practice
Practices to improve posture, balance, co-ordination and strength can be really helpful, but so can relaxation and meditation. If a client has lost some of their mobility, visualising movement can be beneficial. Decide what you want to achieve and be creative in adapting practices and using props.
10. Honour their Independence
Whilst it is great to aid clients when they need, be aware of the things they would like to do themselves. Most clients appreciate a helping hand with a movement or stretch they are unable to do themselves, but sometimes it is enough to guide them initially. Encourage their achievements with positive feedback.