How to Perform Exercises in Bed to Reduce Spasticity

If you live with multiple sclerosis (MS), then you are probably familiar with muscle spasticity. Like a snotty teenager, spasticity can annoy you at the most inopportune of times.

One way to help manage it is upon waking up – this is because the downward pressure of gravity has not yet had a chance to challenge you in upright positioning. Like being underwater, being in the supine position can allow some assistance from gravity, versus having gravity work against you while sitting or standing.

A potential exercise to try

One activity while lying on the back that I recommend to patients is the hook-lying position. This means bending your knees while your spine remains flat on the bed. If you cannot attain this by yourself, having someone else assist you in getting a wedge under your knees may do the trick.

From this position, you can take one thigh and push it away from your opposite thigh. This may require some force, depending on the amount of hip adductor spasticity you might have. Once the thigh is splayed outwards, you can allow it to remain there in a sustained stretch.

Alternatively, you can use a vibrating massager or massage gun along the entire length of the inner thigh. I find it is ideal to start just next to the pubic area (where the seam of your underwear would be) and to use the vibrator or massage gun along the length of the adductors, with the endpoint being just inside the knee that is splayed outward.

Once this has been performed, the opposite thigh can be pushed outward and either stretched or massaged mechanically with the devices suggested above.

Why this stretch?

Performing this stretch first thing in the morning can have some real benefits:

• It stretches the muscles before gravity has had the opportunity to increase spasticity
• It opens up the pelvic floor muscles by stretching the hip adductors.

And what do most people need to do upon waking up? Pee, poop, or both. Even for those who have a neurogenic bladder and use a catheter, this exercise in bed can allow the bladder to more fully void, which can prevent retention. And if you experience constipation, performing this stretching before getting out of bed can open up the pelvic floor muscles to assist in evacuating stool with more ease.

Another exercise: spinal stretch

A spinal stretch is another exercise that I find can be beneficial to decrease spasticity. For this activity, you should be lying on your back. You can pull your knees to your chest and then rotate both legs to one side of your body. If that isn’t possible, you can bring one knee toward your chest and then pull it across your body to the opposite side.

The purpose of this stretch is to open up the spinal nerves that feed the lower extremities. It can be helpful for those who sit for much of the day in order to prevent the nerves from "tethering down." I find this stretch can also be good in general for maintaining spinal and hip mobility and preventing contracture of the joints.

Potential benefits of these exercises

As a review, performing hip adductor stretching before getting out of bed can:

• Prevent the force of gravity from making activity more difficult
• Manage inner thigh/adductor spasticity
• Potentially improve bowel and bladder voiding

Performing spinal stretches while in bed can help maintain good spinal and hip mobility. This should be an enjoyable treat when you awaken from sleep and imagine doing these activities as a gift you are giving your body before you face the challenges of the day.