Water therapy may be what you need to help improve your MS. Other exercises you can do include Pilates, weight training, or cycling.

Exercise can be a challenge for some people with multiple sclerosis (MS). Muscle weakness, numbness, and balance issues can make physical activity difficult.

Still, exercise is important for people with MS.

Many people with MS find water therapy a rewarding way to stay physically active. They may find it easier to stand in the water than on land and reassuring that there’s a lower risk of a fall injury.

Hydrotherapy, also called aquatic therapy and pool therapy, involves using water to treat various conditions and promote health. It can include:

  • immersion at various temperatures
  • walking or exercising in water
  • whirlpool baths
  • mineral water baths

Research supports the claim that hydrotherapy may help with pain management for MS.

People with MS may find that movement is easier in water. Water’s buoyancy offsets body weight, resulting in less weight on joints when the body is submerged.

A 2020 review of research suggests that aquatic therapy may delay the progression of MS and improve:

Swimming can reduce fatigue, which affects around 80% of people with MS.

In another 2020 research review, 8 weeks of aquatic exercise was associated with reduced fatigue and improved quality of life in people with MS.

Water activities can help people with MS avoid overheating, which can sometimes worsen symptoms. This can happen during physical activity on land.

Swimming is a good way to exercise while staying cooler because excessive heat can aggravate MS symptoms. According to the National Multiple Sclerosis Society, the water temperature should stay below 85°F (29°C).

Swimming is a primary form of water exercise that’s beneficial for people with MS, but it’s not the only way to work out in the pool.

Other water-based activities that may help with MS include:

  • aquatic aerobics
  • water walking
  • ai chi, which combines tai chi and qigong in water

Ai chi is a type of mind-body water therapy created in Japan. It’s a sequence of movements in the water that combine deep breathing and slow, broad motions.

Many communities offer aquatic classes that focus on:

  • stretching
  • balancing
  • muscle strengthening

Your doctor or physical therapist may recommend a specific water therapy program that may include:

  • leg lifts
  • marching
  • use of resistance equipment

Licensed physical therapists who specialize in helping people with MS or other disabilities often lead hydrotherapy classes.

Research indicates that for people with fatigue and MS, exercise can lead to improvements in:

Many types of exercises can be beneficial if you have MS. If you’re thinking about starting a new exercise program, talk with your healthcare team about what will work best for you.

Pilates

Research suggests that Pilates may have benefits for people with MS. A 2024 study found that practicing Pilates-based telerehabilitation for 6 weeks improved:

  • muscle strength
  • core endurance and power
  • balance
  • walking speed, cadence, and distance
  • functional exercise capacity
  • quality of life
  • fatigue

Aerobics

Aerobic exercises like cycling, both outdoors on a bicycle and indoors on a stationary bike, can be good for people with MS.

A small 2020 study involving 10 adults with MS found that compared with 15 minutes of resting, 15 minutes of recumbent cycling led to improved balance and gait (walking) quality.

In a 2019 study of 20 people with MS, 12 weeks of combined resistance training and stationary cycling was associated with reduced disease severity, depression, and fatigue and improved quality of life and walking ability.

Strength training

Resistance (strength) training may improve strength and coordinated movement in people with MS.

A 2023 review looked at 13 studies relating to high intensity training in people with MS. It found that high intensity aerobic training, resistance training, and functional training may benefit walking speed and walking endurance.

Another study from 2022 found that 10 weeks of a fast-velocity resistance training program improved:

  • force development
  • mobility
  • perception of quality of life

Everyday activities

Daily tasks that incorporate physical activity are beneficial for people with MS. These can include:

Whether you participate in an exercise program or daily activities, moving regularly is important to help with MS.

Exercise benefits your body and your sense of well-being.

If your MS symptoms interfere with your ability to exercise, water therapy may help you get the physical activity you need.

Talk with your doctor before starting if you’re not sure you can physically handle swimming or exercising in a pool. They can refer you to a physical therapist or a class with qualified instructors.