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

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.

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.

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)

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.

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.

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)

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

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.

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!