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Living with MS mobility issues is not just about the physical symptoms—it’s about the way our environment either supports or hinders us. A simple accessibility bench in the park may seem trivial to some, but for someone with difficulty walking, it becomes a lifeline.

Understanding MS mobility issues is rarely a sudden transformation. More often, it begins with small betrayals of the body—an uneven step, a stumble, a hesitation where once there was certainty. I remember my first mobility symptom with uncomfortable clarity. One evening, in the fading light, I caught my toe and pitched forward, landing flat on my face. I wasn’t hurt, not physically at least, but my pride bore the bruise. That unceremonious fall was my first real encounter with foot drop, sometimes called drop foot—an invisible symptom of MS that quietly alters the mechanics of walking long before others notice.

In the years since, I’ve learned that such moments are common among those living with MS. What starts as an occasional misstep can evolve into persistent difficulty walking, or subtle gait changes that demand new strategies. Mobility is never just about muscles—it’s about fatigue, balance, confidence, and the environment around us.

This is where the importance of accessible design becomes clear. A thoughtfully placed accessibility bench can mean the difference between turning back in defeat or pausing, regrouping, and continuing the journey. Public features, like benches and ramps, are not luxuries but lifelines for those managing mobility challenges.

In today’s Fable in the Fog, we meet a friendly dog and a quietly dignified bench. Together, they help us reflect on mobility challenges, how assistive devices can empower us, and why compassion in public spaces matters.

The Fable: The Dog and the Accessibility Bench

One misty morning, a weary traveller with gait changes stopped midway across the park. His legs felt heavy, each step like a stubborn stone. He looked around for a resting place.

There stood the Accessibility Bench, strong, low to the ground, with supportive arms to ease the act of sitting and rising. Yet the traveller hesitated—self-conscious, unsure if pausing meant defeat.

At that moment, a golden dog trotted up, tail wagging. Without hesitation, the dog hopped onto the bench, stretched out, and looked at the traveller with eyes that said: “Resting is natural. Why should you feel ashamed?”

The bench spoke too, in its silent sturdiness: “I was made for you. For anyone who needs me. That is no weakness—it is wisdom.”

The traveller sat, the dog curled beside him, and together they watched the fog lift. Sometimes resilience means moving forward; sometimes it means knowing when to rest.

Moral of the story: Accepting support—whether from a bench, a cane, or a friend—turns a challenge into an act of quiet strength.

MS What Are Common Mobility Symptoms?

Mobility in multiple sclerosis is shaped by many overlapping factors. Some are obvious, while others remain invisible until they interfere with daily life. Below are some of the most common symptoms that affect movement—and why they matter.

• Muscle weakness in the legs or trunk
  When the nerves that carry signals to the muscles are disrupted by MS lesions, strength declines. This doesn’t always mean dramatic paralysis; often it begins subtly, with legs that tire faster or feel heavy after a short walk. Muscle weakness contributes to uneven steps and the need for more frequent rest, especially on longer outings.
• Spasticity, making movements stiff
  Spasticity refers to involuntary muscle tightness or spasms. It can feel as though your legs are resisting your own instructions, pulling in directions you never intended. For some, this means jerky, awkward movements; for others, it makes straightening or bending the legs a real effort. Spasticity is a frequent cause of difficulty walking, especially on uneven ground or stairs.
• Fatigue, which compounds difficulty walking
  MS fatigue is not just feeling tired—it’s a deep, draining exhaustion that seeps into every movement. Walking just a few minutes can feel like a marathon. The body may still have the strength, but the energy to use it effectively is gone. Fatigue magnifies other mobility challenges, making balance less reliable and steps more uncertain.
• Balance and walking issues, leading to unsteady steps
  Balance is an intricate dance between the inner ear, eyes, muscles, and nerves. MS disrupts these connections, often causing dizziness, swaying, or veering off course. The result is a walking pattern that may appear unusual to others—sometimes described as a “drunken gait.” For many, these gait changes are as emotionally challenging as they are physical, because they draw unwanted attention in public.

These symptoms often come and go, reminding us that MS is unpredictable. One day, walking may feel manageable; the next, it can feel like scaling a mountain. But unpredictability does not erase dignity—it simply invites us to adapt, pace ourselves, and seek support when we need it.

Symptoms of Multiple Sclerosis That Affect Movement

Not all mobility symptoms of MS are visible, and many are misunderstood. A stumble might look like simple clumsiness, but beneath it lies a much more complex story of disrupted nerve signals and altered body awareness. Here are a few of the ways MS changes the way we move:

• Foot drop (drop foot)
  This was, for me, the very first sign of MS mobility issues. One evening I tripped over my own feet and landed flat on my face. To an onlooker it might have seemed careless, but in truth it was foot drop—the inability to properly lift the front of the foot when walking. This causes the toes to drag or catch on the ground, dramatically increasing the risk of falls. While it may resemble a coordination problem, it is not. Foot drop is a neurological symptom, often stemming from weakness in the ankle muscles or misfiring signals between the brain and leg. It is one of the earliest and most stubborn gait changes many people with MS experience.
• Coordination problems
  True coordination issues in MS often involve the cerebellum—the part of the brain responsible for fine-tuning movement. When it’s affected by lesions, actions that once felt smooth become jerky, unsteady, or overshot. Carrying a cup of tea without spilling it, or trying to thread a key into a lock, can suddenly feel like threading a needle in a windstorm. These problems overlap with walking difficulties, making steps unpredictable and contributing to mobility challenges.
• Numbness or paraesthesia
  Paraesthesia refers to unusual sensations—tingling, buzzing, or numbness—that distort the body’s natural feedback. When you cannot feel your feet properly, walking straight becomes harder, as if the ground itself is uncertain. Even simple actions, like fastening buttons or holding cutlery, can feel strangely uncoordinated. This is not clumsiness, but the absence of reliable sensory signals that most people take for granted.

Each of these symptoms—foot drop, coordination problems, and paraesthesia—may come and go, shift in intensity, or combine in surprising ways. Together, they create a walking pattern that is unique to each person living with MS, reminding us why patience, pacing, and acceptance of assistive devices are not signs of weakness but of resilience.

Physical Therapy Occupational Support in MS

Physical therapy and occupational therapy are often suggested as frontline strategies for people with MS mobility issues. Both have their merits, but they also have their blind spots.

Physical therapy (PT) usually concentrates on maintaining or improving strength, flexibility, and endurance. A therapist might design a programme of stretching, balance training, or aerobic exercise to help reduce stiffness and slow muscular weakening. For many, PT provides the tools to counteract spasticity, improve posture, and conserve energy during walking. These interventions can certainly make a difference, especially when combined with aerobic activities that promote overall cardiovascular health.

Occupational therapy (OT) takes a more practical approach, focusing on the daily activities that MS can complicate—dressing, cooking, driving, or simply moving around the home. An occupational therapist may recommend changes to the living environment, like grab bars, railings, or repositioned furniture to reduce fall risks. They also introduce assistive devices, such as ankle-foot orthoses (AFOs) or functional electrical stimulation (FES) units designed specifically for foot drop. These can dramatically improve walking ability by helping the foot lift properly during each step.

Yet, while OT can be a boon, I sometimes feel it leans too heavily on the physical mechanics of movement, as though the muscles themselves are the sole culprits. In MS, the real challenge often lies in the neurological control—signals failing to travel efficiently from brain to body. Strengthening muscles is valuable, but it doesn’t always address the deeper issue of disrupted nerve pathways. That said, when OT and PT work together, their combined approach can restore confidence and preserve independence, even in the face of profound mobility challenges.

The most promising outcomes often come from innovative pairings: for instance, research shows benefits when tdcs paired with aerobic exercise is used, helping the nervous system and muscles relearn movement patterns more effectively. It’s in these overlaps—where therapy acknowledges both the muscular and neurological—that real progress can happen.

Balance and Walking Issues: A Closer Look

Balance problems in MS stem from a mix of nerve conduction delays and disrupted sensory feedback. The brain depends on constant signals from the muscles, joints, inner ear, and eyes to keep us upright. When MS interferes with any part of this system, stability becomes fragile.

For many, this shows up as:

• Unsteady stance – standing still may feel like swaying on a boat.
• Veering or drifting while walking – a straight line becomes a challenge, especially in crowded spaces.
• Sudden missteps or stumbles – even on flat, familiar ground.

One particularly tricky scenario is the loss of balance when the eyes are closed. Many people don’t realise how much they unconsciously use visual cues to steady themselves. For someone with MS, closing the eyes—whether to wash their face, pull a jumper over their head, or bend to remove shoes—can feel like the floor has shifted. Dressing and undressing, ordinary tasks for most, can become moments of real vulnerability.

These issues often contribute to what outsiders call a “drunken gait”—a walking style that appears erratic or unsteady. But unlike alcohol-induced imbalance, this is the result of faulty nerve signalling, not choice. Such gait changes are not just physical but emotional too, drawing unwanted stares and forcing people to explain an invisible illness.

Coping strategies vary. Some rely on assistive devices like canes or walkers, while others pace activities carefully, build rest stops into routines, or adapt their homes with supportive features. And sometimes, even with the best strategies, balance falters. That’s when kindness from others, and accessible environments like sturdy benches or handrails, make all the difference.

For a reflection on how MS alters our perception of time and rhythm as well as movement, see: MS Time Perception: The Clockmaker Lost Seconds.

Innovative Therapies and Research

Research into mobility in multiple sclerosis continues to uncover promising new ways to support walking and balance. Beyond traditional physical therapy, scientists are exploring techniques that directly target the brain and nervous system.

One of the most exciting areas involves transcranial direct current stimulation (tdcs). This is a non-invasive treatment that uses a very low electrical current, applied through electrodes placed on the scalp. The current doesn’t cause pain or trigger muscle contractions, but it gently stimulates specific regions of the brain. The idea is to make nerve cells more responsive, improving how signals are sent and received.

When tdcs is paired with aerobic exercise, research shows it may help people with MS improve walking speed and endurance. Exercise provides the muscular activity, while tdcs may enhance the brain’s ability to adapt and relearn movement patterns. Although still largely experimental, the combination offers hope for therapies that address not only muscle function but also the neurological control behind it.

Other areas of innovation include:

• Wearable sensors that detect subtle gait changes, helping therapists monitor progress and adapt treatment plans.
• Functional electrical stimulation (FES), which delivers small pulses to activate muscles directly, often used for foot drop.
• Robotic exoskeletons designed to support walking practice, giving patients more opportunities to retrain balance and coordination.

These technologies are not yet mainstream, and accessibility varies widely. But together, they represent a shift in treatment philosophy: supporting both the physical and neurological sides of MS, rather than focusing on muscles alone.

Lifestyle Adjustments

Simple lifestyle changes make a difference:

• Planning rest breaks on benches during walks.
• Wearing supportive footwear.
• Prioritising sleep (see: Sleep Problems MS).

Emotional Impact of Mobility Challenges

Mobility struggles are not only physical. They affect identity, independence, and confidence. Here, the dog in our fable reminds us: joy and companionship soften burdens.

Community and Accessibility

From public benches to wheelchair ramps, society has a duty to reduce barriers. Every thoughtful design echoes the Accessibility Bench’s wisdom: “I was made for you.”

Conclusion: The Bench, the Dog, and You

Living with MS mobility issues does not mean surrender—it means reshaping life with creativity and courage. Like the dog and the bench, we can learn to rest without shame, adapt with dignity, and carry on at our own pace.

Mobility is not measured in miles walked, but in moments embraced. It represents freedom and independence, factors which must never be underestimated.

Research consistently highlights the effect of exercise training on walking mobility in people with neurological conditions such as multiple sclerosis. Regular, targeted physical activity has been shown to improve gait speed, endurance, and balance, while also reducing fatigue and the risk of falls. These benefits extend beyond physical function, supporting independence and overall quality of life.