Managing fatigue, spasticity and balance with physiotherapy exercises for MS

At MSWA, our experienced Physiotherapists and Accredited Exercise Physiologists will work alongside you to help you move well and feel stronger. Whether you’re newly diagnosed or have been living with MS for years, we’ll design a program that suits your abilities, goals and changing needs so you can stay independent and keep doing the things you love.

MS can affect the brain and spinal cord in ways that interrupt signals to your muscles. This can lead to muscle stiffness (spasticity), poor balance and coordination, and overwhelming fatigue that doesn’t always improve with rest. 

• Fatigue: MS fatigue is different from ordinary tiredness. It can feel overwhelming and unpredictable, often unrelated to how much you’ve done that day.
• Spasticity: Spasticity is muscle stiffness caused by nerve damage. This stiffness resists opposing muscle movements, making them slower and more energy-demanding. Over time, it can also reduce range of motion and flexibility, further limiting functional movement.
• Balance problems: Damage to the nerves that control muscle coordination can make you feel unsteady or increase your risk of falls. 

With the right exercise plan and ongoing support, you can tackle these challenges one step at a time.  

Physiotherapy helps to improve mobility and independence by focusing on movement, strength, and balance. Working with a MSWA Physiotherapist can help you: 

• Maintain or improve mobility
• Reduce the severity of spasticity and muscle tightness
• Boost balance and coordination
• Build endurance to better manage fatigue
• Prevent falls and injuries 

Through individual sessions, group sessions, educational workshops, hydrotherapy and home visits, our physiotherapists can help you find the right physiotherapy exercises for your MS symptoms that match your abilities and goals. 

1. Stretching for spasticity relief 

Stretching helps reduce muscle tightness and spasms. Focus on areas commonly affected by MS, like the calves, hamstrings and hip flexors. 

Example: calf stretch 

• Option one: Lean toes against the wall, one leg at a time. 
• Option two: stand on top of a step and drop heels down. 
• Hold for at least 60 seconds per leg. 

Daily stretching can help maintain flexibility and reduce stiffness. 

2. Strength training to combat fatigue 

Strengthening exercises help maintain muscle power, making everyday activities easier and less tiring. Start with light resistance and build up gradually. 

Example: Sit-to-stand 

• Sit forward on a chair 
• Toes under knees
• Practice leaning forward, standing up and then sitting down.  

The frequency of this exercise will be dependent on the individual. Discuss with your physiotherapist to determine the best approach for you.  

3. Balance exercises for stability 

Balance exercises help retrain your body’s ability to adjust and prevent falls. 

Example: Heel-to-Toe Stand 

• Stand near a wall or chair for support.
• Place one foot directly in front of the other, heel to toe.
• Try to hold your balance for 10 – 30 seconds.
• Switch feet and repeat. 

Aim to do these two to three times per side. Over time, these small challenges help improve steadiness. 

When you’re living with MS, pacing yourself is essential especially when you’re managing fatigue. It’s also normal for motivation to dip, especially when fatigue or spasms make movement feel harder.  

Try these simple tips to help you stay active, motivated and safe: 

• Break it up: Do shorter sessions spread throughout the day and rest between movements.
• Plan for your best time: Many people have the most energy in the morning, so exercise when you feel strongest.
• Stay cool: Overheating can make fatigue worse. Keep water nearby and choose a cool, comfortable space to exercise.
• Set small, realistic goals: Little goals help you stay motivated and build confidence.
• Track your progress: An exercise journal can help you see how far you’ve come.
• Find support: Involve a friend, family member or carer, or join a group class designed for people with MS.
• Celebrate every win: Every stretch and every step counts.
• Put safety first: Ensure your space is clear of tripping hazards and use sturdy chairs or supports to prevent falls. 
• Listen to your body: Stop and rest if you feel overly tired, dizzy or in pain and remember it’s always okay to skip a session if your body needs a break. 

Progress isn’t about perfection but about moving safely, staying strong and feeling confident. 

At MSWA, our Physiotherapists will work with you to develop a program that matches your unique needs, goals and changing abilities. For some, water-based physiotherapy exercises are ideal as they’re gentle on joints and muscles while still building strength. Others may benefit from using equipment like resistance bands or balance balls for extra support and challenge. 

There’s no one-size-fits-all approach to multiple sclerosis physiotherapy. That’s why your MSWA Physiotherapist will design a plan that fits your lifestyle and priorities whether you prefer home-based exercises, hydrotherapy, gym sessions or group classes with others who truly understand your journey.  

Physiotherapy works best as part of a team approach. When needed, our physiotherapists can work alongside other MSWA services like Occupational Therapy, Nursing and Counselling so you get truly holistic care. They can help you manage different aspects of your condition, including when to adjust your exercise plan. 

Fatigue, spasticity, and balance problems are common challenges for people living with MS but they don’t have to hold you back. With the right physiotherapy exercises for MS, you can build strength, move more freely and regain confidence in your daily activities. 

Every step, stretch and balance hold is a step towards feeling more capable and empowered. Even small amounts of regular movement can make a big difference over time. Start where you are, go at your own pace and know you’re not alone. 

Ready to get moving? Get in touch today to find out how MSWA Physiotherapists can design an exercise plan to help you feel your best.