8 Exercises to Improve Your Balance When You Have MS
Balance and strengthening exercises can help people with MS regain their mobility, range of motion, and confidence as they move through the world. And the following exercises, according to Hopkins, “can be adapted to be seated, supported in standing, or be for even higher-level functioning individuals.”
FAQ
“There are a few foundational exercises that almost everyone [with MS] can benefit from,” says Leah Upton, a chartered physiotherapist at Recover Physiotherapy in Norwich, the United Kingdom. “These exercises focus on postural control, body awareness, coordination, and weight control, which are key building blocks for balance at any level of ability.”
Always check with your care team before you start a new exercise routine to ensure it’s appropriate for you and your current level of function. “A physiotherapist can show you how to modify exercises so they’re safe for your specific symptoms,” Upton adds.
Most balance and coordination exercises can be done with no equipment.
“You do not need any special equipment to start balance exercises at home,” says Hopkins. She suggests having a stable support surface nearby, like a kitchen counter, table, or heavy chair, and wearing supportive shoes.
If you want to increase the challenge as you progress, Upton suggests adding a few tools. “You can add simple items like a resistance band, a wobble cushion, or light hand weights,” she says. “These tools increase the difficulty by adding instability or extra resistance, which can help improve strength and coordination.”
“It is not a requirement, but it does help wake up the nervous system, reduce stiffness and spasticity, and improve body awareness before balance challenges,” Hopkins says.
“A short warm-up helps reduce the risk of strain and prepares your body for movement,” adds Upton.
She suggests:
- Marching in place slowly
- Gentle ankle circles
- Shoulder rolls
“When you first start balance exercises, doing them two to three times per week may feel challenging enough, and that’s completely okay,” says Upton. “With MS, fatigue and muscle weakness can make new movements feel harder at first, so give your body time to adjust.”
Hopkins recommends practicing balance exercises at least three times per week. If you fatigue quickly, she suggests doing shorter sessions more frequently.
“Include short sets with frequent rest,” says Hopkins. She recommends listening to your symptoms and fatigue levels to guide progressions. “Progress slowly, with one variable or exercise at a time, and focus on quality, control, and confidence,” Hopkins adds.
“Even just 5 to 10 minutes at a time can make a real difference,” Upton says. “Consistency matters more than intensity.”
8 Balance Exercises to Improve Your Stability With MS
The following eight-step exercise program was designed with Hopkins’s and Upton’s input in mind. It takes you from gentle core activation to standing balance postures that target specific areas affected by MS.
Although the exercises are simple, they’re a powerful way to activate the systems of the body that can help improve balance and coordination while preventing MS falls.
For any standing exercises, stand near a support, like a wall, chair, or bench. If you feel wobbly or lose your balance, hold on to your support or rest in a seat.
1. Core Activation (Lying Down)
What to do: Lie on your back with knees bent. Gently tighten your stomach muscles as if you’re bracing for a cough or zipping up snug jeans, while still breathing normally. Hold this 5-10 seconds and repeat 10 times.
Why it helps: A strong core helps keep your body steady and upright, which makes balance and walking easier. According to Upton, this exercise gently strengthens the deep stomach muscles that support balance.
“Lower-body and core strength exercises for balance and walking stability are extremely important,” Hopkins says. “These exercises provide physical support needed for postural control, weight acceptance, and safe movement.”
“When these muscles are strong, they keep the body steady, allowing the arms and legs to move without throwing off balance,” adds Upton. “A strong core also improves body awareness (knowing where your body is in space), which helps with staying steady while walking.”
Make it harder: Lift one foot at a time and bend the same knee toward your chest while keeping your stomach tight throughout the movement.
2. Pelvic Tilts
What to do: Lie on your back and gently rock your hips so your lower back presses into the floor, then relax. Think about flattening the lower back into the floor.
Why it helps: This improves control of your hips and lower back, which helps with posture and balance, says Upton.
“Weakness in the hips, legs, and trunk increases reliance on compensatory strategies, contributes to fatigue, and raises fall risk, especially during transitions and gait,” Hopkins adds.
Make it harder: Lift your hips into a bridge position and hold for a few seconds, then lower.
Bridge position “strengthens the hips and lower back, which support posture and walking,” says Upton.
3. Hip Strengthening (Side Leg Lifts)
What to do: Lie on your side and lift your top leg, about one to three feet from your midline. Hold your foot in the air one to three feet for three to five seconds before gently lowering it to the floor. Repeat these for three to five repetitions, then repeat on the other side.
Why it helps: Upton notes that strong hips help keep you steady when standing on one leg or walking.
Make it harder: Add a resistance band around your ankles.
4. Standing With Support
What to do: Stand while holding onto a wall, chair, or bench. Try to stand tall and use the chair as little as possible. You can experiment with holding firmly and then alternating to gentle support with just your fingertips.
“When introducing balance training, I like to begin with supported standing to establish confidence and safety,” says Upton. “From there, exercises are progressed gradually by reducing the base of support, increasing strength demands, and adding controlled challenges.”
Why it helps: This helps your body get used to balancing while upright in a safe way.
“Strong legs help you correct your position, walk on uneven surfaces, climb stairs, and catch yourself if you trip. Together, strong core and leg muscles improve walking confidence, reduce fall risk, and make daily movement easier,” Upton says.
Make it harder: Try standing without holding on.
5. Weight Shifting
What to do: Slowly shift your weight side to side, from the outside of one foot to the other. Then switch to shifting your weight forward and back, first into your toes, then into your heels.
Why it helps: This teaches your body how to move safely without losing balance, which is important for walking.
“Focusing on feeling the weight through both feet and legs and recognizing where the body is in space without having to rely solely on vision to do so helps reorganize the neural networks, improve balance, and decrease fall risk,” says Hopkins.
Make it harder: Reach your arms out to the sides, then directly out ahead of you, to increase the work your legs have to do to balance.
6. Standing With Feet Close Together
What to do: Stand with your feet close together while lifting tall through the crown of the head. Press all four corners of your feet down into the ground.
Why it helps: This activates all the standing muscles at once and improves control.
Make it harder: Pass an object around your waist or close your eyes.
7. Heel-to-Toe Standing (Tandem)
What to do: Stand with one foot directly in front of the other, like standing on a tightrope.
Why it helps: This improves the balance needed for walking in a straight line.
Make it harder: Pass an object around your waist or close your eyes.
8. Standing on One Leg
What to do: Stand on one leg while holding onto support if needed.
Why it helps: Walking requires standing on one leg at a time, so this builds confidence and strength.
Make it harder: Add small knee bends or close your eyes.
Safety Tips
“Safety is always a priority, especially for individuals with MS. Balance exercises should be performed in a safe environment with support nearby, such as a wall, chair, or rail,” says Upton.
- Always exercise near something sturdy, like a wall or a chair.
- Try new exercises with someone nearby.
- Go at your own pace. Don’t progress the exercises until you feel safe and confident with the previous one.
- Stop if you feel very tired, dizzy, or unsafe.
- Communicate with your healthcare team about your exercise progress, including challenges, setbacks, and wins.
The Takeaway
- Simple balance and coordination exercises can help improve the systems impacted by multiple sclerosis.
- Be sure to include your care team in your exercise plans so they can provide personalized guidance based on your current ability level.
- Exercise safely, near a sturdy wall or chair, with someone nearby in case of falls, and listen to your body, letting your symptoms and fatigue levels guide you.
- The Role of Physical Exercise in Managing Multiple Sclerosis Symptoms. Cleveland Clinic.
- Mross K et al. Sensory Integration Disorders in Patients with Multiple Sclerosis. Journal of Clinical Medicine. September 1, 2022.
- Myopathy. Cleveland Clinic. January 20, 2022.
- Inagaki HK et al. Neural Algorithms and Circuits for Motor Planning. Annual Review of Neuroscience. July 8, 2022.
Jessica Baity, MD
Medical Reviewer
Jessica Baity, MD, is a board-certified neurologist practicing in southern Louisiana. She cares for a variety of patients in all fields of neurology, including epilepsy, headache, ...
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