244. Feel Less Stiff in the Morning With MS: 3 Quick Exercises to Wake Up Your Muscles

Summary

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Podcast Summary: The MSing Link

Episode 244: Feel Less Stiff in the Morning With MS: 3 Quick Exercises to Wake Up Your Muscles

Host: Dr. Gretchen Hawley, PT, DPT, MSCS
Date: August 6, 2025

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Episode Overview

In this empowering episode, Dr. Gretchen Hawley addresses a common struggle for people with Multiple Sclerosis (MS): morning stiffness and imbalance when getting up after sitting or lying down. She introduces three easy, discreet leg exercises designed to "wake up" your muscles and neural pathways, making it safer and easier to stand up and move—whether you’re at home, at a restaurant, or anywhere else. Dr. Hawley’s tips are practical, quick, and require no equipment, ensuring that listeners can take immediate action to improve their mobility and confidence.

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Key Discussion Points & Insights

Why Do MS Patients Feel Stiff or Unbalanced After Sitting or Sleeping?

• Muscle Tightness and Neural Pathway Inactivity:
  Dr. Hawley explains that during sleep or prolonged sitting, everyone’s muscles tighten, and neural pathways (the connections between brain and muscle) become less active.

  • For people without MS, these pathways "wake up" fast with movement.
  • With MS, these neural pathways are affected by demyelination, which can cause muscle weakness, spasticity, unsteadiness, and delays in muscle responsiveness.
  • Dr. Hawley compares this to internet "buffering"—the mind wants to move, but the body delays.
  • Quote:

    “Your mind knows, okay, gotta get up and go do X, Y, Z. But your body is just buffering. Those neural pathways are like waking up and trying to figure out what you need to do.” (07:33)

• Solution: Gentle Activation:
  Quick, deliberate movements before standing can rapidly activate these neural pathways and increase blood flow, reducing the lag and risk of imbalance or falls.

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Three Quick Exercises to Wake Up Your Muscles

Dr. Hawley prescribes three core exercises. They can be done anywhere, take as little as 30 seconds, and require no upper-body involvement or special preparation.

1. Marching (11:28)

• While sitting, lightly lift one knee towards the ceiling, then lower, then repeat with the other leg, alternating back and forth.
• It’s not about height or strength—just activating the movement is enough.
• Quote:

  “Even if it’s 1cm, any movement at all is waking up the neural pathways.” (11:55)

2. Leg Kicks (12:10)

• Straighten your knee just a little, then bend it back, alternating sides.
• Again, minimal movement is sufficient—no need to fully extend or contract the leg.

3. Toe Lifts (12:45)

• With feet flat on the floor, slightly straighten knees for ease, then lift your toes and the balls of your feet, keeping your heels on the ground.
• Can be done with one foot at a time or both together.
• Dr. Hawley notes her personal preference for alternating feet.

Why These Three?

• These target the muscles responsible for walking: hips flex, knees bend and straighten, ankles lift.
• Prepares the legs for immediate and stable movement upon standing.
• Quote:

  “By waking up the neural pathways for these three muscle groups, your legs are now prepared to help you walk, to take steps forward.” (13:39)

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How to Use These Exercises Daily

• When to Practice: Anytime before standing after sitting or lying down—first thing in the morning, after a rest, before leaving a restaurant, etc.

  • Can be as short as 10–30 seconds.
  • The exercises are discreet—no one else even needs to notice.
  • Quote:

    “If you’re at a restaurant and you know you’re about to stand up to leave, start doing these exercises under the table.” (14:35)

• Frequency & Adjustment:
  Adapt based on how you feel each day.

  • Some days, you may want or need to do them longer, others just a quick reminder movement will suffice.
  • Encourage listeners to write down the three exercises in a notes app or notepad for easy reference.

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Further Support and Resources

• Dr. Hawley mentions her online program, The Missing Link, which provides daily exercise calendars, classes, and more extensive strategies for MS management and mobility improvement.
• She emphasizes that MS symptoms and needs can change day by day and even hour by hour—these exercises are a practical first step, but personalized, holistic exercise plans may be needed for longer-term strength and stability goals.

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Notable Quotes & Memorable Moments

• On neural pathway inertia:

  “With MS, once you start moving again, those neural pathways don’t become more active as quickly… It’s like your internet or your WiFi buffering.” (07:13)

• On the exercises’ discretion and flexibility:

  “You could do these in your pajamas. You could do these once you get out of the shower. But this isn’t about breaking a sweat—it’s about waking up your muscles and your neural pathways.” (05:35)

• On adapting the strategy:

  “MS is different for every person, and… for the same individual, MS is different day to day, honestly, most times even hour by hour.” (14:52)

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Timestamps for Major Segments

• 00:00 — Introduction: Why morning or post-sitting stiffness happens in MS
• 04:00 — The science of stiffness, neural pathways, and MS
• 07:00 — Buffering analogy and how to "wake up" your nervous system
• 10:20 — Exercise strategy overview: Not about strength, but neural activation
• 11:28 — Exercise 1: Marching
• 12:10 — Exercise 2: Leg Kicks
• 12:45 — Exercise 3: Toe Lifts
• 13:39 — Why these three exercises matter for walking
• 14:35 — Practical tips: When and how to use these movements
• 14:52 — Customizing your routine and further resources

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Conclusion

Dr. Gretchen Hawley’s episode is a clear, supportive, and actionable guide for anyone with MS (or similar mobility challenges) looking to feel steadier and less stiff after periods of rest. Her three-exercise approach hinges on activating neural pathways fast, with minimal effort and no embarrassment. She encourages listeners to remember these moves, use them often, and reach out for additional resources if more comprehensive support is needed.

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If you’re looking to feel more balanced and less stiff with MS—even on tough days—these three quick exercises could be a vital new habit!

Transcript

[A]

Hello. Thank you so much for tuning in today. I have a question for you. Do you ever feel stiff or unbalanced when you go to stand up and walk after you've been sitting for a while or lying down for a while? This is something that so many of my Missing Link members and in person clients tell me. And some people would say that they just experience this after they've been in bed for many hours or after they've been sitting for many hours. But other people tell me that they feel stiff and unbalanced when they go to stand up after they've just been sitting for only five minutes or lying down for just a 20 minute nap. So the length of time that it takes you to feel stiff or unbalanced when you go to stand up and take a few steps is going to be different for everyone. But what we're going to talk about today is what you can do in five minutes or less. And to be honest, 30 seconds or less. I would say to feel more stable, more balanced, and less stiff after you've been sitting or lying down so that when you go to stand up, you're ready to move, you're ready to go move on with your day. You don't have to have those awkward moments of standing up and wondering, am I going to fall? Am I balanced enough? I need to stay here for a few seconds and then I'm going to be good. You'll just be able to get up and go.

[B]

The big question is, how does someone with Ms. Actually improve their mobility, strength, energy independence? The list goes on. My name is Dr. Gretchen Holley, physical therapist and multiple sclerosis specialist. Welcome to the Missing Link podcast. Tune in as I share the top strategies and exercises to help you gain control over your life with ms, using research driven insights and advice from top industry experts. Whether you're newly diagnosed or or have had Ms. For over 30 years, whether you have relapsing Ms. Or progressive MS, this podcast is for you. You're sure to feel empowered and inspired after each episode.

[A]

Ready?

[B]

Let's dive in.

[A]

You'll be able to implement these techniques that we're about to discuss in the mornings, right from bed. You could be sitting in in your bed or at the edge of your bed. You could do these from a chair, from a couch, anywhere that you're sitting. You can do these from heck, you could even do them at a restaurant. No one would know because you're not going to be using your upper body at all. It's just going to be your legs. So you'll have to make sure you don't kick anyone under the table because then they might have an inkling that you're doing something under there. But you can do these anywhere that you are sitting pretty before you stand up. The idea is that you do them right before you need to stand up and move. Oftentimes, my Missing link members explain this specific situation as feeling like their mind wants to do one thing, but their body is not cooperating. And that's really tough, especially if it's first thing in the morning or if you're out in public and other people are around. So. So I'm going to give you these simple movements that you can do right away. There's no gym required, no getting dressed first. You can still be in your pajamas. You could do these once you get out of the shower. But this isn't about breaking a sweat. It's about waking up your muscles and your neural pathways. Let's first talk about why this works. When we sleep, our our muscles naturally tighten and our neural pathways become less active. And if you don't know what a neural pathway is, it's the connection between your brain and your muscle. And when you have multiple sclerosis, it is imperative that you know what our neural pathways are. Because weakness due to demyelination in the neural pathways is the reason that your muscles can get weak. It's the reason that your muscles can get stiff and tight. So even when you don't have ms, our muscles naturally tighten when we're sleeping or when we're sitting for a while or lying down for a while, and our neural pathways become less active. So if you don't have ms, this doesn't really impact you in any way because once you get up and move, your neural pathways immediately turn back on and they become more active. But with Ms. And this stiffness, this feeling of being unbalanced can be even more pronounced because of the possible muscle weakness and spasticity that you might be experiencing, or tight muscles due to Ms. Due to those changes in your neural pathways. Additionally, with ms, once you start moving again, those neural pathways don't become active when right away. They don't become more active as quickly as someone who doesn't have Ms. I often like to think of it as your Internet or your wifi buffering. Like your mind knows, okay, gotta get up and go do X, Y, Z. But your body is just buffering. Those neural pathways are like waking up and trying to figure out what you need to do. But there is a way that we can speed this up these gentle movements and activate those neural pathways and increases blood flow to your muscles. And those two things can get those neural pathways woken up extremely fast, so that once you stand up, you're good to go. These are not stretches. They are activation exercises utilizing neuroplasticity. And these three exercises and strategies that we're about to discuss in a second here are are likely exercises you've heard me talk about before, especially if you are in my online program, the Missing Link. These are the three staple exercises that I give all of my clients with Ms. However, it is a very different strategy. So if you've exercised with me before in any capacity inside my membership the Missing Link, via a exercise class from one of my other programs or on YouTube, then you likely know that typically when we're working on strengthening our muscles, we go slow, we slowly lift our leg, we add a pause, and then we slowly lower. But that's not what we're talking about today. The goal of waking up our neural pathways so that we can get moving faster is not about strength. It's not about stamina or endurance. It's about waking up and activating those neural pathways. And the beautiful thing about that is that it doesn't require much movement and it doesn't require much time. So you don't necessarily need to do 10 repetitions, 15 repetitions, three sets, you don't need to do any of that. And you don't even need to be focusing on moving your leg or muscles as much as possible. You can just aim for minimal movement. That's all that's required to wake up these neural pathways. So the three exercises that you can do right in the same position as you're in before you go to stand up are number one, marching, number two, leg kicks, and number three, toe lifts. But let's go into those individually so you know exactly what I'm talking about. Let's paint a picture. I want you to picture a situation where you have felt unbalanced, stiff, unsteady, when you go to stand up and take your first few steps. So maybe you're in bed because it's the morning and you've just been sleeping. Or maybe you're in your living room or you're at a restaurant, or you're in your kitchen or at work, wherever you are, picture that. Picture that situation. So you're going to be sitting somewhere. That's where I want you to picture you doing these exercises. So the first one is marching. And. And what you're going to do is lightly lift one Leg up and then lower down, and then the other side up and down. So you're going back and forth, one leg and then the other bringing your knee up towards the ceiling and then down and the same thing on the other side. You are not aiming to lift as high as you can. You aren't necessarily putting in 100% effort. You're just aiming for some movement. Even if it's 1cm, any movement at all is waking up the neural pathways. Now, once you're done with that, maybe you just do that for 10 seconds, 20 seconds, whatever you've got time for. Then we're immediately going to move on to our second exercise of leg kicks. So what you're going to do is straighten your knee just a little and then bend your knee back to where it came from, and then straighten the other knee just a little and then back to where it came from, and keep alternating side to side. So you're not necessarily fully straightening your knee and then fully bending it. We're just trying to get a little bit of motion in straightening and bending your knee. And then the third exercise is the toe lifts. So you're going to have your feet flat on the ground. Straighten your knees just a little bit. This will make the exercise easier, but. And easy does not mean cheating. And from there, you're going to lift either one or both feet up. Your heels will stay down on the ground the whole time, but your toes, your forefoot, the balls of your feet, your midfoot come up again. For our purposes right now, it doesn't matter how high they come up. You don't have to worry about going slow or lifting as much as possible. Just any motion works. Again, you can lift both at the same time or alternating. I have a personal preference for alternating, but it's totally up to you. The reason that these three exercises are most impactful is because when we're thinking about walking, which in reality, that's what we are all right about to do, we're sitting in a position in an environment where we've been sitting for a while. We've got to wake up our muscles so that when we stand, we feel stable, secure, and we can take a step right away. Now. Now, that step requires our hip flexors to work, our knees to straighten and bend, and our ankles to lift, which is exactly what these three exercises do. So by waking up the neural pathways for these three muscle groups, your legs are now prepared to help you walk, to take steps forward. And honestly, I know I keep mentioning this, but I really want you to Understand it. You don't have to aim for big movement. This entire thing, these three exercises could take 30 seconds or less. You can do them so discreetly that no one else would know that you're doing them. You're not aiming for big movement. You're not adding a pause. The goal is to make this as easy as possible and as quick as possible. If you do have more time than you could spend up to one or two minutes preparing yourself, and then you stand up. So when you're in those situations where you've been sitting or you've been lying down, I want you to think proactively. If you are at a restaurant and you're paying your bill and you know that within the next five minutes or so, you're probably going to be getting up to leave, start doing these exercises under the table, here and there, or even if it's one minute before you have to stand up and go, or if you're somewhere, even at home, and you gotta go to the bathroom and you know, okay, I think I need to go pee right now. Pause. Do these exercises for a few seconds, 30 seconds maybe, and then stand up. It's all about two things. Knowing what to do, which you now know, and doing them at the appropriate time. If you might not remember these exercises, pull out your phone right now and just type it in your notes app, or maybe write it down. Number one is marching. Number two is leg kicks, and number three is toe lifts. So that way you now have something to look at to remind you of exactly what to do when you're in that moment where you know you're about to stand up and you want to feel steady and take that step right away. Now, as we know, Ms. Is different for every person, and not only that, for the same individual. Ms. Is different day to day, honestly, most times, even hour by hour. So there are times where you might feel like you need to do these exercises longer, or you might need more than just these three exercises, in which case we talk about this frequently inside the Missing Link, my online program. And there's tons of exercises in there to help with this, as well as other goals of improving walking, stair climbing, getting up from the ground, you name it. But then there are other days where you might feel like you don't need as much. You just need a very quick, maybe 10 seconds or less reminder to wake up those neural pathways and then you're good to go. So every day is going to be different, but these three exercises will give you the biggest impact, the biggest bang for your buck before you go to stand up and move. In fact, you're probably sitting right now as you're listening to this. So go ahead and give these three exercises a try before you stand up and do whatever it is that's next on your to do list. And if you're looking for an exact plan for strengthening, inside my Missing Link membership we have exact calendars of which exercises to do each day to help you gain strength, gain better balance, walk better, and make your daily activities feel easier. There's six exercises each day and if you're doing them in our class format, it takes about 20 minutes per day. So if you are looking for more guidance and not just these quick three exercises you can do to feel more stable right away, definitely check out the Missing Link. I will put a link in the show notes and description where you can learn more about it and see if it's a good fit for you and your goals. Thanks for tuning in.

[B]

Thank you for listening to today's show.

[A]

I am so grateful to have you as a listener.

[B]

If you'd like extra resources such as a video of one of my seated exercise classes, my favorite core exercises, and the opportunity to ask me your questions, head to missinglink.com insider. That link will be shared in the Show Notes along with links to my social media handles. If you loved this episode and think of friend or family member with Ms. Would benefit from listening, please go ahead and text or email this podcast to them right now. Sharing this podcast will help me educate and empower as many Ms. Warriors as possible. Thanks again for joining and be sure to tune in next week for another episode of the Missing Link Podcast.