Physical therapist, MS specialist and MSing Link Founder
Welcome to “7 Questions with A Couple,” a monthly series on our blog that includes quick conversations with a variety of experts and influencers from throughout the MS community. For our November conversation, we are so excited to welcome Dr. Gretchen Hawley, PT, DPT, MSCS. Dr. Gretchen is a Doctor of Physical Therapy and Multiple Sclerosis Certified Specialist who is making worlds of difference in the MS community. Her captivating style and MS expertise come through in her keynote presentations and encouraging videos throughout social media and YouTube to connect with people right where they are. Like right now! You’re here and Dr. Gretchen’s here, and we hope her connection with you at A Couple Takes on MS will encourage you (as it did us) to get moving toward wellness.
1. You earned your undergraduate degree at Elmira College and doctorate at Simmons University. What led you to pursue an education and career in physical therapy?
I majored in Biology but was very uncertain of what profession I wanted to pursue when I attended college. However, there was a moment in my third year at Elmira where an alumni from the biology program mentioned that after attaining her Bachelor of Science degree, she became a physical therapist. As soon as she said that, I knew it was what I was meant to do. It was as if it just clicked for me. As an athlete with an interest in how the body worked, physical therapy seemed like the perfect job. I’d be able to help others get rid of pain and get them back to their daily activities, encourage wellness, and have a job where I’d be up and moving all day! Plus, it was a profession where I would be able to create connections with my clients which was important to me.
2. How much did you know about MS before you started treating patients during your first year of professional practice?
Physical Therapy education is a three-year graduate program (followed by four years of undergraduate) focusing on a broad range of conditions, so often there isn’t sufficient time to delve into specific diagnoses. As such, we had a neuromuscular class where we learned about various neurological diseases, but Multiple Sclerosis was only covered in one two-hour lecture where we covered the basics: types of MS, various symptoms, and some medications. Therefore, I didn’t know much about MS before I started treating patients… but I knew enough that I was intrigued to learn more and jump in to help this population when the opportunity presented itself.
3. Physical therapy is very hands-on. What gave you the confidence to move forward with developing an online wellness program (the MSing Link)?
When it comes to MS, the muscles that have a tendency to get weak and/or tight tend to be the same. In my seven years of working as a physical therapist and five years of treating people with MS, I found I was giving specific movements, strategies, and exercises to all of my patients regardless of the progression of their disease or their level of weakness, since MS attacks similar muscle groups. Therefore, if you’re starting off with good strength, you can do these exercises to keep the strength you already have and continue building that strength. Whereas if you have weakness, the same exercise can help you build strength – even if you’re starting at a point where there is little to no movement. These common MS-specific exercises have helped my in-person and online clients improve foot drop, reduce tightness, lessen fatigue, improve walking, and so much more. I knew that if everyone with MS was made aware of these MS-specific exercises, they’d be able to start getting stronger and able to start participating in life. The feedback I hear on a daily basis from my online MSing Link clients continuously builds my confidence that this virtual program is an effective and safe way to exercise at home with guidance from a Physical Therapist and can help improve daily movements and mobility.
4. What’s fun for you about being a physical therapist?
Brainstorming! I love that every session brings different challenges and therefore different exercises! There are so many factors that come into play during PT sessions, including heat intolerance, fatigue, sensory changes, etc. It makes me think on my toes and keeps each session interesting!
5. When we speak to students in the Central Michigan University Doctor of Physical Therapy program, Jennifer always tells them that neuro patients are going to be their favorite patients. Do you agree? 🙂
Absolutely! Physical therapy exercises for MS and neuro patients are very different than exercises for an orthopedic patient. These exercises are all about training the brain to increase the neural pathway to strengthen the correct muscles. This leads to continually brainstorming new exercises that increase neuroplasticity through functional movements, which is fun and exciting!
6. What are three simple exercises that everyone should do whether or not they have MS?
1) Squats. This is a functional movement that everyone performs often throughout the day. Picking something up from the floor, standing up from a chair/couch, getting up from the ground, sitting down on the toilet… all of these movements require squatting with good strength!
2) Marching. The marching movement (ie. sitting or standing and bringing your knee up toward the ceiling) is another movement that we do a lot throughout the day, meaning we need good strength in those muscles! We use this marching position when walking, stair climbing, getting into a car, getting out of bed, etc.
3) Calf stretch. There are so many ways to stretch the calf muscle (the muscles on the back of your lower leg) and they’re an integral muscle group for walking without foot drop and improving ankle mobility. Improved flexibility and strength in the ankle can help improve balance, gait, and general mobility.
7. For people living with Multiple Sclerosis who don’t think physical therapy can help them, what would you say to convince them otherwise?
If you’ve tried physical therapy before and it didn’t help, it’s likely that you weren’t doing MS-specific exercises. There are many different types of exercises but the only ones that help those with MS get stronger, walk better, improve flexibility and fatigue, etc. MUST be MS-specific. This type of exercise focuses on neuroplasticity (aka: training your brain to find a new pathway to get your muscles stronger) and they also must be “functional.”
For example: walking requires strength in at least four different muscle groups, single leg balance, staggered stance balance, weight shifting, and so much more. Therefore, exercises to improve walking should include all of these movements… not just simply “walking” in a room or balancing.
Additionally, these exercises promote neuroplasticity, which is the reason it IS possible to improve strength, walking, balance, etc. when you have a progressive disease like MS. Neuroplasticity is the brain’s ability to rewire itself to find new neural pathways and strengthen muscles. If you have weakness in any muscle, perhaps there is no movement or just a little movement. By practicing the correct exercises, your brain is actually able to rewire itself to find a neural pathway that will increase the strength of that muscle. As long as you’re consistent and doing the correct exercises, over time you’ll begin to notice improvements in strength, balance, walking, fatigue, etc. Research has proven this time and time again. So, if you haven’t tried MS-specific exercises, I’d encourage you to try it out and stay consistent.