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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 MissingLink Podcast. Tune in as I share the top strategies and exercises and 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 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.

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Ready?

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Let's dive in.

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Welcome back and thank you so much for tuning in. If you have Ms. And you've ever done balance exercises and wondered how in the world does this help me in real life, you are absolutely not wrong to question it. I've been receiving a lot of questions, honestly over the last few years, but especially recently from people with Ms. Who have been to physical therapy or worked with a personal trainer or even just found balance exercises online. And they're just not understanding how it relates to real life situations, especially because they've been doing them consistently and haven't noticed improvements in real life situations and activities. And I had a recent podcast episode on exactly why that is the case and I'll link that episode down in the show notes or the description for you if you want to hear the ins and outs about that. To very briefly recap. Most balance routines isolate movements, but real life balance in real life situations and activities doesn't happen in isolation. It's so much more than that. It's often when we're moving, when we're getting out of bed, when we're getting in and out of the shower, or in and out of a car, when we're walking, climbing stairs, etc. Etc. And so I have a different episode where we talk all about the why what you are currently doing might not be working as well as the strategy behind what does work. But today we've got a different focus. So today I'm going to show you five exercises that can honestly take you 30 seconds each or however long you can tolerate them or have time for today that you can do throughout your day that directly connects to staying steady in your daily activities. Because once I educate on what the appropriate technique is and the appropriate strategy behind balance exercises when you have ms, the follow up question is always great. Well, what are balance exercises that I can do? And I do mention some in the previous episode. But again, today's focus is mostly going to be to give you Examples that you can literally do today, just throughout your day, to help you feel more confident in your routine, that it will help you improve your balance. And the biggest difference between this type of training and what you might have done before is that these exercises that we're going to discuss today train the actual movements that you want to feel steady in. But the number one thing that you can do first and foremost is ask yourself, when throughout my day am I losing my balance or feeling unstable? And I already gave you some examples, like getting out of bed, in and out of a car, the shower. It could be getting dressed. It could be while feeding your pet, whether it's a dog or a cat, something where you maybe other animals, but something where you have to bend down to the floor to feed them or to pick up their bowl. Maybe it's unloading the dishwasher, doing laundry. There's no right or wrong here. List as many things as possible that is going to help you decide which balance exercises are going to be the best for you and your goals. So we're just going to get right into this. And just a heads up, if you're listening on the podcast that I am recording this as a YouTube video as well, so you can come over to YouTube and actually see me demonstrate. However, I will verbally explain exactly what I'm doing. So if you are listening on the podcast, then you are fully supported as well. So I'm going to show you what these five exercises are and discuss exactly how to do them and perhaps most importantly, tell you why these ones in particular work. If you are watching on YouTube, then you might notice right away that I don't have any mobility aids right now. That is intentional. My reason for demonstrating without a mobility aid is so that you can see fully what my body is doing, what my legs are doing, my hips, and I don't want any mobility aid to get in the way of that. But please know that when you are doing balance exercises, you can absolutely use any mobility aid you want. A single trek trekking pole, two trekking poles, a cane, two canes, loft strand crutches or the forearm crutches, Rollator, whatever you want to use. A countertop safety is the number one thing. So the first exercise is side to side weight shifting. If you think about those goals that might have popped into your mind when I said what goals are you working towards and what specific situations do you lose your balance in? 99% of the time it requires some form of shifting our weight to one side or the other side, or alternating back and forth. Like if we're getting out of bed, you might be in a seated position, but you still have to shift your weight over to one side to move one leg forward and then the other side to move the other leg forward. Or if you are standing and reaching for something in the kitchen or in your closet, you're reaching and you have to shift your body weight side to side. So our first two exercises are weight shifting exercises. This first one is side to side. So you stand with your feet apart and you're just going to shift your weight as much as possible all the way over to one leg. And if you're watching, you'll see that my whole body shifts. I'm not just tipping my upper body in that direction or leaning my hip in that direction. My whole body shifts my weight over that leg and then I come over to the other side. Now, with ms, it's very common to not feel comfortable or confident shifting equal weights over to the right as well as left side. If you have a weaker leg or a leg that doesn't have as great of balance as the other side, which isn't always the same as the weaker leg, then you might feel like on one leg you can transfer 95% of your weight. Heck, you might even be able to lift your other leg off the ground so you're standing on one leg. But then when it comes to the other side, you can only transfer 60% of your weight before your knee locks or buckles or you feel unstable. That's fine. That's what we are working on here. The end goal would be that eventually you can transition ideally up to 100% weight on one side and then 100% weight on the other side. Even if you don't reach that goal, any improvement is going to make a big, big difference in your balance in your daily activities. A few reasons why this exercise works is because your brain learns to trust one leg or single leg support even when your other leg is still on the ground. It's allowing your brain to learn to trust that leg that you're on. And it practices the exact weight shifting that you need in order to improve walking reaching those things that we mentioned earlier. The second exercise is another weight shifting exercise where we are in a staggered stance this time. So the first time we had our feet nice and wide, they were likely a little bit wider than our shoulder stance. But whatever feels comfortable to you. And you would do that for just about 30 seconds if you can tolerate that. If not, 20 seconds is fine, 10 seconds is even great. But the second exercise, we're in a staggered stance. So you have one foot forward and one foot backward, not drastically. So it should feel like a regular step length for you. Like you're just taking a step forward as you walk. It might be very narrow. That is totally fine. We're not trying to really reach for a big stance here. So narrow stance and your feet are apart. What I mean by that is that this is not tandem stance. We do not have one foot directly in front of the other. They are separated. So your right foot is still in alignment with your right hip. Your left foot is still in alignment with your left hip. It's just that one foot is forward and one is back. And then from here, same concept as exercise number one, you're shifting as much weight as possible forward without that knee locking or hyperextending or buckling. And while you still feel safe and steady. And then shift your weight to the back leg. And similar to that first exercise, your whole body is shifting forward. You're not poking your butt out and your shoulders come forward, but your butt stays back. You're not pushing your hips forward. So your hips are forward, but your shoulders are back. Your whole body comes forward. Pause for few seconds and then your body comes onto your back leg. And of course, you would do this exercise on both sides. So you would switch legs, shift your weight forward in the staggered stance and then back. Similar to the first exercise and all the ones that we're going to review today, this is a very functional exercise, especially if you have any type of goal of improving your balance while walking, climbing stairs, stepping up on a curb, going up on a ramp, things like that. If you're walking 9.9 times out of 10, you're going to be in a position of a staggered stance. And if you can't shift your weight forward, then you won't be able to lift your back leg to move forward. So this staggered stance weight shifting is one of my staples in the Missing Link. All my Missing Link members are likely doing this at some point, if not always, if it's not obvious. Just to point out that the reason this works is that it trains this forward backward stability that we need again for walking, stair climbing, anything where we are standing. And your brain practices the exact balance challenge of stepping, because we're literally moving our weight forward so that we can then take a step. It also builds confidence in a more narrow base of support. The first exercise our feet was were wider. This one, they're staggered and a little bit more narrow. It's more of a real lifelike situation. And so you're going to build confidence in your body's ability to transfer your weight while you're in a more narrow base of support. The third exercise is cross body reaches. So for this one, I like to stand with my feet nice and wide, wider than my shoulders. It's very similar to the first exercise. My knees are slightly bent and my legs and hips are mostly just staying right where they are. But I'm going to be moving my upper body to work on dynamic balance while standing in one spot. So once you're in this position, your feet are nice and wide. You should feel pretty stable. You're going to take your left hand and turn across towards your right side of your body and reach. There's a few different variations of this exercise. The first is just what I mentioned right now, where we're just turning our body side to side. My left arm reaches towards the right side, then I come back to the center, then my right arm reaches towards my left side, then I come back to the center. But if you want to make this even more challenging for your balance, if you feel safe and steady just doing this as is, with or without turning your head. If you do turn your head, that will add a little bit of a challenge. But if you're ready for the next level, then you are going to combine this with that first exercise of side to side weight shifting. So as I shift my body weight to my right leg, my left arm turns and reaches towards my right side and then I'm going to shift my weight to my left side and my right arm turns towards the left side. So you're shifting your body weight and turning. Shift and turn, shift and turn. I love this exercise because it practices rotation while balancing, which is something so, so common in our daily. Very rarely are we just facing forward or facing sideways. We often have to turn and look if someone calls our name or turn to move. So this helps our body work on balance when we have to twist and rotate. Coordination also plays a role here. If you can't tell just from listening, this requires coordination, having to shift and turn in the right direction at the right time, at the right speed. There's more here going on than just strength and balance training. And this is essentially training the multitasking that our brains need for real world balance. The fourth exercise is one that you've likely heard of for years. Maybe you're currently doing it, maybe you're not. It's heel raises. This is a classic strengthening based exercise, but it also can be really great for balance. So I'll demonstrate standing, but please know you can sit in a chair and lift your heels, and it's essentially the same thing, just a little bit easier. But if you're standing, you're going to stand with your feet a comfortable distance apart. Likely that's going to be about the distance of your shoulders, but if you're very unbalanced, it might be a little bit wider. Once you're in that comfortable stance, you're going to slowly lift both heels up off the ground and then slowly lower them down and then slowly up and down. And I would love for your focus to be on keeping 50% of your weight through one leg and 50% through the other leg. This is really great for balance because it's strengthening the calf muscles and the calf muscles, the muscles on the back part of our leg are critical for balance recovery. And it's practicing shifting your center of gravity onto your toes and then onto your heels, which, when we lose our balance, most of the time our center of gravity is shifting. So this is essentially putting us in a position where we are purposely shifting that center of gravity with control. And allowing your heels to come down slowly trains that control. So if you ever are in a position where you're about to trip forward, you can lower those heels and safely control your way down. And the more ankle stability we have, which is built through exercises like this, the more stable we will feel on uneven surfaces as well, such as outdoors. Last but not least, my fifth exercise that I've got for you today is turning in place. So one thing I hear a lot is I lose my balance when I turn around. And FYI, if you are in my membership, the Missing link, we have a full training video on this. Just go to the search bar and type turn, and it will pop right up for you. But essentially, one version of that exercise is you're standing and you practice turning in lots of little steps backwards. So you turn around 180 degrees and then turn the same direction that you came and come back to the center. Where most people go wrong when they're practicing turning around is they just take one big step and they. Their legs might feel like cement that day. They might be more fatigued, so they're unable to safely do that, and then it results in a trip or a fall. So practicing taking small little steps all the way to one side or to wherever you're turning is a much safer approach. And if you're listening on the podcast, I just want to give you an idea of how many Steps I'm taking. So I'm facing forward right now and I'm turning. I just took one step with each leg, two steps, three steps, four steps. It took me four steps on each leg, so eight steps total to turn to face the back wall. And then I'm going to do the same thing. Turning back to the front. It takes me about the same four steps. It might take you three steps, it might take you seven or eight. But the more the merrier. Practice taking those baby steps steps similar to all of these other exercises. The reason that this is great is because we are training the exact task that might be making you feel unsteady. Your brain can learn to coordinate these movements with your legs, coordinate the rotation without getting dizzy or off balance. We're in a controlled environment, so ideally we're training that to improve so that when you do have to turn in a real life situation at a real life speed, you will handle that better, your body won't lose your balance. And of course, we can't deny that this also practices vestibular challenge. Our inner ear and our vestibular system is challenged through lots of different daily situations that include balance. For all of these exercises, again, you can just do them for 30 seconds. It took me a bit longer than that to demonstrate just because I wanted to explain what it was, how to do it, how it works and why it works. But when you're doing these on your own, again, just 30 seconds each, you can do them all at once, or you can do one while you're making your coffee, one before lunch, and just spread them out throughout the day. My goal for you and my challenge for you today is to try even just one of these. Doesn't matter which one, they're all great. Pick the one that feels most appropriate for you and the goals that you're working towards and the things that are challenging for you throughout the day, and just do it that once, maybe 30 seconds, and then tomorrow try the same thing again and just slowly but surely work on improving just that one exercise. And then eventually maybe you add a second one in. And if you are in the missing link again, just wanted to remind you, we have all of these exercises as well as tons of other ones, as well as full exercise classes that are more 20 minutes, 30 minutes, 40 minutes, that piece all of these together. And we have our exercise calendars that tell you exactly what exercises to do each day to improve your strength and your balance and your walking. So if you are someone who wants that level of guidance and structure and you are not inside the membership, then I would highly recommend you check it out to see if it's a good fit for you. I will make sure to put the link where you can learn all about it. There's even a very short 4 minute behind the scenes video on the page, so I'll put that down in the show Notes and Description thanks so much for tuning in today. I hope you found this helpful. Thank you for listening to today's show. I am so grateful to have you as a listener.