Multiple Sclerosis

What is Spasticity? 4 Tips for Managing this Common MS Symptom

Have your legs ever felt so tight that you could hardly walk? Or has your arm stiffened to the point where you couldn’t brush your teeth? If this has happened to you, you’re not alone. This muscle tightness, called spasticity, occurs in an estimated 80% of the MS community in one form or another. This symptom of MS can be mild muscle tightness or severe enough to cause painful muscle spasms. Addressing spasticity head-on (or early) can make all the difference, so let’s look at what spasticity is, its causes, and some common approaches to managing the symptom.

What Is Spasticity

Whenever you move a part of your body, some muscles relax while their counterparts contract. You can see this quickly by feeling your forearm as you flex and extend your wrist. MS causes a disruption in how muscles coordinate movement, which can cause too many muscles contracting at the same time.

Spasticity is the feeling of muscle stiffness or tightness and any spasms that go with it. More commonly occurring in the legs, this symptom can not only make your legs feel heavy but also make walking extremely difficult. The other side of spasticity is that it may cause uncontrollable movements as your muscles contract on their own.

There are two types of spasticity. Flexor spasticity mostly involves the muscles of the hamstrings (back of the leg) and hip flexors (top of the upper thigh). Flexor spasticity can bend the hips and knees, making them difficult to straighten. Extensor spasticity mostly involves muscles of the quadriceps (front of the leg) and adductors (inside of the leg). Extensor spasticity can straighten the hips and knees making the legs close together or crossed over at the ankles.

The breakdown of myelin causes slow or interrupted nerve pulses, causing the muscles to potentially do one of three things: tighten involuntarily, not relax as quickly as intended, or stay tight and contracted for a long duration. Several external factors can trigger spasticity, such as infections, pain, stress, heat and more.

Managing Spasticity

Allowing spasticity to go untreated can lead to serious developments like frozen or immobilized joints and pressure sores. These new symptoms also serve to trigger spasticity, so it can create an uncomfortable cycle. Learning to manage your spasticity today will pay off dividends in both the near-term and long-term health of your body.

Below are some of our favorite tips and tricks for managing MS spasticity:

  • Stretch consistently - For cases of mild spasticity, stretching consistently may be all you need to prevent bouts of tension and pain

  • Massage the areas of spasticity - In addition to relaxing the muscle, this external stimulus can send the message back up to your brain to change how it is communicating with those muscles

  • Stay active - By remaining active and using your body, you keep sending the signals to act to your muscles and slow the breakdown in muscle strength and coordination

  • Physical therapy - This may involve a more personalized regimen of exercises and stretches. If you are unable to stretch your own muscles, a physical therapist will be able to do this for you

Much like every other part of MS, the triggers of spasticity and the best sources of relief will be unique to you. Listen to your body and work in close partnership with others around you to best manage your spasticity.

While we cannot be there in person for many of you, Rekinetics has developed programs that can be delivered virtually and make an immediate impact in your quality of life in only 5 minutes a day. You can get to those options by clicking here - Start Now - or fill out a form on the Contact Us page to schedule a time to talk with our team.

Living with Cog Fog | Tips for MS

Have you ever felt you couldn’t find the right words or struggled to recall some fact? Or had trouble concentrating on a book or forgot the plot of the movie you’re watching? This brain fog, also called cognitive fog or cog fog, is a normal part of aging but can happen early and often when living with MS.

While initially thought to only impact functions of the body, in recent years research has found that around 50% of people living with MS experience some form of disruption to their cognitive abilities. The problems entailed in cog fog are rarely severe but can be especially frustrating parts of daily life. Difficulty focusing or thinking slowly can also be exacerbated by fatigue or medications.

What Causes Cog Fog?

Since MS is a disease of the central nervous system, it shouldn’t be a huge surprise that lesions in the brain can impact cognitive function. As myelin breaks down the brain’s signals travel more slowly. Did you know that the difference between thinking normally and not being able to process logical thoughts is only 100 milliseconds? Every decade after age 20 people lose up to 10 milliseconds, but whereas aging occurs at a constant rate it can be disorienting to experience that change in a more abrupt way. Keep in mind that it’s not all necessarily tied to MS; cognitive fog can also be exacerbated by fatigue, heat, lack of sleep, physical effort, stress, anxiety and medication.

Symptoms of Cog Fog

Although cognitive symptoms can vary by person and by day, below are some of the most common ways in which cognitive fog appears.

  • Memory - Difficulty learning new information and retrieving stored information on demand or carrying out plans

  • Concentration - It may be easier for the mind to wander, which can make it harder to follow a conversation or the plot of a book or movie, for example

  • Information Processing - Struggling to shift attention from one topic to another or understand information being given quickly

  • Executive Function - Planning and problem solving skills can be impaired, as well as understanding how your decisions will impact the future

  • Speech and Language - This can be the feeling of a word on the tip of your tongue or feeling tongue tied and needing to really focus on conveying what you want to say

  • Visuospatial - This refers to how well you process and judge objects in space, like their distance or speed

Managing Cog Fog

Below are some of our favorite strategies and tactics to reduce cog fog and better manage the symptoms. We’d recommend you pick 1 or 2 to start with and apply to your life.

  • Get more sleep - Getting enough quality sleep has a massive impact on clarity of thought and ability to process information. If you’re interested in this topic I highly recommend the book Why We Sleep

  • Physical exercise - The positive impact of physical activity on cognitive function has been well documented throughout a person’s lifetime

  • Train your brain - Challenge yourself with crosswords, puzzles or a new hobby

  • Learn things in multiple ways - Strengthen a new concept or person’s name with associations. That could mean seeing something and writing it down as well, or tying each person you meet to the city they’re from

  • Reduce distractions - Put yourself in places and situations to avoid distractions. If you are in a crowded area, find a quieter location to better control the situation

  • Pick 1 task to focus on - In a world of growing distractions and smartphone notifications, deliberately deciding to work on 1 objective or task can be a scary idea but will ensure you spend your cognitive energy on what matters most to you

  • Conserve your cognitive energy - You have different mental strength at different times of day. Learn when your cognitive reserves are highest and you can focus on more difficult tasks

  • Use checklists - I personally rely on my iPhone calendar for all of my work and personal events and tasks. Leverage technology or paper like post-it notes to be a kind of external brain to pick up the slack for you

  • Take a break - When you’re feeling slow or foggy, recognize it and allow yourself to check out and recover your mental strength

  • Meditation - If you give yourself some time to regroup, meditation can be a great way to recover even faster. Try some deep breathing or use an easy meditation app like Headspace



Whether you have the occasional feeling of fog or it seems like more of a constant in your life, picking 1 or 2 techniques can be a great comfort.

While we cannot be there in person for many of you, Rekinetics has developed programs that can be delivered virtually and make an immediate impact in your quality of life in only 5 minutes a day. You can get to those options by clicking here - Start Now - or fill out a form on the Contact Us page to schedule a time to talk with our team.

Understanding the 4 Types of MS

Although MS is classified as one disease, the way that people experience MS can be drastically different. It’s almost like no two people have the same MS! While the symptoms and development can vary widely, it’s important to understand the 4 types of MS to know the likely course and potential treatments for your MS. Most people diagnosed with MS never become severely disabled, so understanding your course can help ensure a higher quality of life with MS.

Initial Signs: Clinically Isolated Syndrome (CIS)

CIS is the first time that neurologic symptoms rear their head and cannot be tied to fever or infection. The episode has to last for at least 24 hours and can be characterized by one symptom or several. If brain lesions similar to that for others with MS are found in an MRI there is a 60-80% chance of another episode.


Type 1: Relapsing-Remitting MS (RRMS)

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The most common form of MS, about 85% of people with MS are initially diagnosed with RRMS. This type is characterized by alternating periods of relapses (also called attacks, bouts and exacerbations) and periods of partial or complete recovery. There is no real rhyme or reason to how symptoms come and go, or the frequency of that process, or which symptoms become permanent. You might not even notice an attack as not every brain lesion comes with symptoms.



Type 2: Secondary-Progressive MS (SPMS)

MS_Progression_SPMS_Rekinetics

Most people diagnosed with RRMS will eventually progress to SPMS, characterized by a progressive worsening of neurologic function as sustained symptoms and more disability accumulate. On average the transition from RRMS to SPMS occurs 10 to 20 years after initial diagnosis, but for some it occurs quite quickly while for others never at all.





Type 3: Primary-Progressive MS (PPMS)

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Whereas most people move from RRMS to SPMS, PPMS only occurs for about 15% of those diagnosed with MS. In PPMS neurologic function worsens and symptoms accumulate without periods of relapse and remission. Typically appearing in those age 40-60, the first symptom often is difficulty walking which may include their feet dragging (or foot drop). The underlying science and causes of PPMS may also differ from RRMS. Whereas in RRMS the immune system attacks the nerves’ myelin, in PPMS the nerve fibers gradually deteriorate.


Type 4: Progressive-Relapsing MS (PRMS)

Occuring in only 5% of MS cases, the disease steadily worsens from the outset with acute relapses but no remissions. People with PRMS more often become disabled because they have periodic attacks that dot the building progression of symptoms.



While it is important to understand the different forms of MS, a big takeaway is that everyone’s MS is different. Even for the same type of MS the symptoms that one person experiences can vary dramatically throughout the course of the disease. That’s why you need to listen to yourself and your body by doing the things that make you feel better in the course of your MS.

While we cannot be there in person for many of you, Rekinetics has developed programs that can be delivered virtually and make an immediate impact in your quality of life in only 5 minutes a day. You can get to those options by clicking here - Start Now - or fill out a form on the Contact Us page to schedule a time to talk with our team.