Prospective client with MS

[Karl Schudt]

Woman, 36 or so, with MS that causes her to lose control of her hands at times. She is nervous about the press and bench press. I'm certain squat and deadlift will help her, but really want to get her some overhead work. Two questions:

What adaptations do you have to make in general for MS trainees?

What would you do about the press if her hands can stop working?

Those of you with experience, could you help me?

[Nick Delgadillo]

This is a good question, but I have zero experience with this. I know if it was my client, I'd have her press a broomstick and proceed very slowly and cautiously. Maybe someone else can help?

[Paul Horn]

I don't have experience with this, but perhaps others do. Let's start the discussion.

What happens when she loses control of her hands? Is it complete and instant failure or does she feel it coming? I'm wondering if you set the pins high enough and she had to drop a press, could she get out of the way or does she risk dropping the bar on her head?

[Karl Schudt]

I haven't trained with her yet, so I suppose we'll find out. I do have a 15lb bar, so damage would be minimized. Perhaps we could work on stepping forward if she misses. That will depend on her courage. At light weights, I can probably just shadow her with my hands and grab the bar when it fails, but that's not a long-term solution.

[Kyle Schuant]

I've had a couple of personal training clients with MS. Both were quite small mature women (50yo and 50kg or so), and we didn't have barbells under 20kg, so I had them begin with dumbbells for all exercises, with some leg press to help it along, progressing to barbells for squat and deadlift; they never used barbells for bench and press.

Most will know what triggers their symptoms and will be able to tell you about this. In general, elevated body temperature and stress will do it, obviously not candidates for Tabata intervals and 20 rep squats, but you probably weren't going to do that anyway. Focus on form even more than for a healthy client, they tend to get the greatest benefit from focus on quality rather than quantity, any nervous system issue is about a lack of control, after all.

Start easy and progress more slowly than for normal. Andy Baker's comments on training older people will be relevant to the MS population; the same goes for all people with nervous system issues such as spinal cord injuries, after all part of ageing is degeneration of the nervous system. Note that there is both experimental and anecdotal evidence that weight training helps control the symptoms of MS.

Any person with chronic illness or pain, their biggest issue in the weightroom is confidence. Typically they'll have had some horrible episode or two where they were helpless, nobody wants to go back to that, so they'll need lots of reassurance about things, trust will be important. "This won't hurt me, will it?"

[melody]

I am not a coach, but I have helped a friend with MS train. When we started she could not do an air squat or press 2.5 lb dbs. I had her sit to a chair and stand, deadlift 10 # DBs off of chairs, overhead press 1 lb weights, and do modified planks/pushups. 3 months later she is goblet squatting 10 lbs DBs, deadlifting 25# DBs, and pressing #5. Heat is an issue for her, as is adequate protein and getting regular B vitamin shots.

[BigDave]

According to the information presented in my PT cert course, raised body temperature should be avoided with MS clients as it promotes demyelination of the axons (speeding up MS). Why this would result in immediate effects, I don't know. Food for thought.