Tips for Swimming With Multiple Sclerosis

You can work your muscles and raise your heart rate with swimming or water-based exercises without pounding your joints, risking a fall, or getting a flare up due to overheating.

Ready to dive in? Here’s what to look for in a pool, what gear you need, and how to adapt your time in the water if you have weakness in your legs or arms.

MS can make land-based exercise difficult. Weakness, stiffness, muscle spasticity, balance problems, and fatigue may turn a simple walk into a major effort — but moving through the water is a different story.

“When the water comes up to your breastbone, you’re roughly three-quarters unloaded in the pool, which means movements that need a lot of help on land can sometimes be done with little or no assistance in the water,” says physical therapist Laura Kate Covey, DPT, of Corewell Health in North Muskegon, Michigan.

Water also provides gentle resistance in every direction. That “thickness” of the water makes your muscles work a bit harder with each step, kick, or arm pull, which can help build strength over time. At the same time, water slows you down; if you do lose your balance, you have more time to react and correct, says Covey.

Before you commit to a membership or class, ask for a tour of the facility so you can see how the space will work for you on a good day and a not-so-good day.

Safety and Accessibility

Look at the entire route from the parking lot to the water.

Questions to consider:

• Is there accessible parking and an entrance without lots of steps?
• How far is it from the front door to the locker room and from the locker room to the pool?

“For some people with MS, just walking to the back of the building can be tiring, so knowing where you might need rest breaks is important,” says Covey.

In the locker room, check for wide stalls, grab bars, and shower chairs if you or a care partner might need them, she says.

Near the pool, Covey suggests checking for the following:

• A lift or hoist to help you in and out of the water if you have limited mobility
• Ramps with nonslip surfaces and sturdy railings
• Grab bars along the pool walls to help you stabilize and perform exercises with hand support

If you use a cane or other mobility equipment, ask if you can use it in the pool area, says Covey. “Make sure the area is safe for moving, and wear water shoes to assist with traction and reduce fall risk,” she says.

A pool lift or ramp can make the difference between needing two people to help you in and out of the pool versus being able to get in on your own or with just one person assisting you.

A place to sit near the pool is also helpful if you are waiting for an appointment or class, or if you have a caregiver that is attending with you and will not be getting into the pool, says Covey.

And consider finding a pool with a lifeguard on duty for added safety in case you get tired while swimming.

Water Temperature

Ask about the usual pool temperature. For most people with MS, a slightly cooler pool — between 80 and 84 degrees F — is more comfortable and less likely to trigger heat-related symptoms, says Covey. Very warm pools may feel good at first but may cause issues if you’re heat-sensitive.

Equipment and Instruction

Look around to see what equipment is available and how people are using it. Many therapeutic or community pools have:

• Foam pool noodles
• Kickboards or core boards
• Float belts or dumbbells
• Buoys or fins

“These tools can help with balance, make it easier to walk in the pool, or add resistance to build strength,” says Covey.

If you have weakness, stiffness, or poor coordination in your legs, you may still be able to enjoy swimming or water walking with a few adjustments.

Covey recommends:

• Try gentle stretching for your hips, knees, and ankles before you get into the pool. A caregiver, friend, or therapist can help if spasticity makes it hard to move a leg through its full range on your own.
• In the water, floating positions may feel easier than upright ones at first. Use a noodle or float under your arms or around your waist so your legs can relax and trail behind you.
• Add a small float or light ankle cuff to help lift a leg that wants to sink, or a light weight if a very spastic leg pops up toward the surface.
• Use a special walker that’s designed to help you move around in water.

If you’re unsure what will work best for your body, consider starting with a few sessions of aquatic physical therapy.

“A therapist can show you safe ways to get in and out of the pool and help you experiment with floats, weights, and positions so you feel confident when you swim on your own,” says Covey.

Arm or shoulder weakness, stiffness, or coordination problems can make some strokes tough, but you still have options.

• Begin with gentle, pain-free range-of-motion exercises at the side of the pool. Let the water support your arms as you move them forward and back, out to the sides, and in circles. Warmed-up shoulder muscles are less likely to spasm or tighten when you start swimming, says Covey.
• Use a float belt around your waist so you can focus on moving your arms without worrying about staying up.
• Hold on to the pool wall or a sturdy bar while you practice kicking or leg movements, so your arms do less work.
• Stick to strokes that feel comfortable — sometimes a modified backstroke or sidestroke is easier than traditional freestyle.

If arm strength is a major issue, water walking, gentle jogging in place, or using equipment like noodles for support may be more realistic than lap swimming on some days.

You don’t need a bag full of gear to start swimming, but a few tools can make the experience safer and more comfortable:

• Goggles to protect your eyes and reduce irritation if you’re sensitive to pool chemicals
• A swim cap if you plan to do regular laps
• Aquatic shoes for traction on slippery pool decks and ramps, which can lower your fall risk
• A robe or towel to keep you warm and dry when you’re not swimming

Optional equipment if your facility doesn’t provide them includes:

• Floats, noodles, hand paddles, or kickboards for extra support or balance
• Fins to add resistance once you’re steady and want more of a workout

If traditional lap swimming doesn’t appeal to you, you still have plenty of ways to move in the water.

When checking out the facility, ask about what types of classes and aquatic physical therapy are available.

Classes that may be appropriate for you include:

• Water walking or gentle jogging in the shallow end
• Group water fitness classes, including MS-specific or “gentle joints” classes
• Aquatic physical therapy sessions focused on strength, balance, and gait
• Simple exercises like leg lifts, marching, mini-squats, or arm movements at the pool wall

Next to safety, enjoyment is key — finding a water activity you enjoy will help you stick with and get the most benefits.

• Swimming and other water-based activities and classes can make exercise safer and more comfortable for people with MS by reducing strain, easing balance challenges, and helping prevent overheating.
• Choosing the right facility — one with good accessibility, appropriate water temperature, and available equipment — can make your time in the pool easier and help you feel more confident and independent.
• Modifying strokes, using flotation tools, or starting with aquatic physical therapy can help you stay active even if you have weakness in your legs, arms, or shoulders.
• If lap swimming isn’t the right fit, options like water walking, gentle fitness classes, or pool-based strength exercises can still help you build endurance, support mobility, and enjoy the benefits of movement.