There is a common myth amongst many of our patients with multiple sclerosis that the heated pool you find in many leisure and recreational centres around Melbourne are bad for their fatigue.
This is completely untrue.
A quick physics lesson. Air is a poor conductor of heat, which means that when people exercise on land, it is difficult for the body to lose heat directly to the atmosphere. This is less of a problem when the air is cold or cooler than the body, but when summer hits this air can often be warmer than our body temperature, and we end up absorbing heat rather than emitting it.
Which brings me to why we sweat. Water on the other hand, is a better conductor of heat. So even in a heated pool, which tends to hover around 32-34 degrees, you have a better chance of losing heat when you exercise in water than on land. And because people with MS have an impaired ability to sweat, the water can be really helpful for remaining cool.
Exercise in heated pools is also called hydrotherapy, which is a wonderfully comfortable place to exercise for people who prefer low impact exercise, but want the benefits of exercising intensively.
We all know that increasing the intensity of our workout improves our cardiovascular fitness.
How do I work out my workout intensity?
People with MS should not use their heart rates to determine their level of exercise tolerance. This is because people with MS can have autonomic changes, that is their ability to regulate their heart rate and cardiovascular output can change with their condition. So heart rate is less reliable as an indicator of how hard someone should work.
Instead, we recommend patients use the modified Borg scale, which is a simple 0-10 self rating scale used to determine oneâ€™s breathlessness or level of exertion. It is commonly used in people who have chronic heart or lung conditions.
What we suggest is to aim for a modified Borg Rating of 7 (working at 70%).
Help! My symptoms have gotten worse!
It is important to know exercise has been shown to be neuro-protective, even though following exercise you find that your symptoms and weaknesses become more apparent. In an appropriately dosed session, this normally goes away within 1-2 hours. It is important to expect this to allow time for relaxation and rest following exercise before you decide to drive home and listen to your body. If this continues for more than 2 hours, your session was probably too difficult or hard for your body at this point in time.
As always, consult your neurological physiotherapist about whether you would be suitable to exercise in the water and what exercises you should do. Being in warm water at a depth can have other effects affecting your circulation, lungs and kidney function, it is important to be aware of these and consult your health professional before embarking on such activities.
On the whole, hydrotherapy in a heated pool is a fabulous place to build up your exercise tolerance and try different intensities in a supportive and safe environment. Behavioural modification and healthy habits take time but the hardest step is always the first one.
If you would like more advice on hydrotherapy for multiple sclerosis, call us on 0434 313 897 or email us at firstname.lastname@example.org today.