Strength Training May Protect Against Brain Shrinkage in MS

Woman sitting in a chair lifting hand weights

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We know that exercise improves many symptoms of multiple sclerosis (MS), such as fatigue, muscle strength, bladder and bowel function, and walking abilities.

What may surprise you, though, is that there is also scientific evidence suggesting that exercise, especially strength training, may have a positive impact on the brains of people living with MS.


Myelin Sheath and the Role It Plays in MS

Research Behind Exercise and the MS Brain

In a small study in Multiple Sclerosis Journal, 35 patients with relapsing-remitting MS were randomly assigned to undergo either six months of twice-weekly supervised progressive resistance training (PRT) or six months of normal day-to-day unsupervised activities.

Progressive resistance training is a strength training method where people exercise their muscles against a type of resistance—this resistance is then gradually increased over time. Typical equipment used for PRT includes free weights, elastic bands, and exercise machines. 


Prior to the study and after the six-month exercise or activity period, the patients underwent a brain magnetic resonance imaging (MRI). The investigators found that there was a tendency for the brain to shrink (atrophy) less in those who underwent the resistance training compared to those who did not. 

In fact, the brain volumes of the participants who participated in resistance training remained stable or unchanged. Since the brains of people with MS shrink (called atrophy) at a faster rate than healthy individuals, this finding of "no change" is positive.

Even more, in those who underwent the exercise program, some small areas of the brain appeared to thicken or regrow on the MRI.

This suggests that exercise may help with brain tissue regeneration, although we do not know the direct effect of this "regrowth" on a person's MS symptoms.


It's important to keep in mind that this study was small and only lasted for a short time. Larger and longer-term studies would give us a better idea of precisely how exercise impacts the brain.

In addition, the study only included patients with relapsing-remitting MS (the most common type) and not patients with primary progressive MS or secondary progressive MS

Bottom Line

The idea that strength training or other forms of exercise could slow down the progression of brain shrinkage and thus, potentially, the progression of a person's MS is an exciting finding.

Nevertheless, these study results do not imply that exercise should replace an MS disease-modifying medication. Rather, the findings suggest that exercise could be a complementary therapy that augments or optimizes your MS care.

Other Benefits of Exercise in Multiple Sclerosis

Besides the possible positive effect of exercise on MS symptoms and the structure of the brain, there are also studies that have found that exercise may improve cognitive function in MS, like a person's thinking and memory abilities.

Of course, exercise improves bone and heart health as well—two additional bonuses to becoming more physically active. 

A Word From Verywell

If you (or a loved one) has MS, be sure to speak with your healthcare provider before engaging in a new exercise regimen to ensure it is safe and right for you. 

Moreover, if you are interested in a strength training program, like progressive resistance training, it's probably best to see a physical therapist, especially one who has experience working with people with MS. This way you can be sure to maximize the benefits of your workouts, while also considering your unique MS symptoms.

1 Source
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  1. Kjolhede T, Siemonsen S, Wenzel D,  et al. Can resistance training impact MRI outcomes in relapsing-remitting multiple sclerosis? Mult Scler. 2018 Sep;24(10):1356-65. doi:10.1177/1352458517722645

Additional Reading

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.