The MSing Link

Thinking about a vibration plate for MS? Maybe it's sitting in your online cart… or it's already in your living room and you're not sure how to use it. This episode is for you. In this episode, I'm sharing my own take on vibration plates and vibration therapy for multiple sclerosis (MS). As an MS-specialized physical therapist (and a vibration plate owner myself!), I'm walking you through how they work, what MSing Link members are noticing, and how to get started safely. Here's what we cover 🔑: How does a vibration plate work? A fast, repeated vibration acts like quick tapping on your muscles. That signal travels to your spinal cord and brain, and your muscles contract back automatically, like a reflex. It's your own body responding… which makes it a wake-up call for muscles that have gotten quiet, not a replacement for exercise. Vibration therapy vs. electrical stimulation. They can feel similar, but they work very differently. Vibration is like someone knocking on your door until you get up and open it yourself. E-stim is more like asking Alexa to open the door for you. Knowing the difference helps you set the right expectations. What MSing Link members are noticing. Less spasticity and stiffness (some time it for mornings), calmer restless legs, fewer pins and needles in their feet, and better strength and balance. These are individual experiences, not guarantees… everyone's MS is different. Is a vibration plate safe for MS? How to start: → Check with your healthcare provider first → Start with 2-3 minutes (even 1 minute counts) → Sit with your feet on it, or stand with support → Keep your feet closer to the center for a gentler vibration → Hold off on exercises until you know how it feels → Watch for fatigue that shows up later, not during Your questions, answered. How long until you notice a difference, what vibration plates cost (around $150 to $800+), the LifePro plate and Pulse device I use, and why weight matters if you'll be moving it yourself. This episode is for you if: ✅ You've been eyeing a vibration plate and want an MS-specific take ✅ You have one and aren't sure how long or how often to use it ✅ Spasticity, foot numbness, or balance are part of your daily life ✅ You want to understand why it works, not just that it does Resources mentioned in this episode:  The MSing Link Podcast, Episode 201, Improving Foot Sensation in MS: Vibration Therapy and Exercises with Dr. Splichal - Apple | Spotify The MSing Link Podcast, Episode 252, Pulse Device: Vibration Therapy for MS Symptoms with Ethan Pollak - Apple | Spotify The MSing Link Podcast, Episode 299, MS & Vibration Plates: Benefits, Risks, and How to Use Them Safely with Debby Pelletier - Apple | Spotify LifePro: https://lifeprofitness.com/DEBBYLP   Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: [email protected]  Website: www.MSingLink.com Social:  ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram: https://www.instagram.com/doctor.gretchen ★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1 → The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms → Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram → The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

Your MRIs look stable… your neurologist says everything looks good… but your walking feels harder and fatigue hits sooner. If that sounds like your multiple sclerosis (MS), this episode is for you. I’m joined by Dr. Jiwon Oh, MD, PhD, neurologist, MS researcher, and Medical Director of the Barlo MS Program at St. Michael’s Hospital in Toronto, where her team cares for over 12,000 people living with MS. We talk about BTK inhibitors, a new class of MS medications, and what the latest fenebrutinib clinical trial results could mean for people with relapsing MS and primary progressive MS (PPMS). Here’s what we cover 🔑: What are BTK inhibitors? BTK (Bruton’s tyrosine kinase) is an enzyme that helps B cells, a type of immune cell involved in MS, mature and multiply. BTK inhibitors are small molecules that can cross the blood-brain barrier (the protective filter around your brain and spinal cord). That means they may reach immune cells inside the central nervous system, like microglia (the brain’s own immune cells), which researchers believe help drive slow progression. Why “stable” MRIs don’t always tell the whole story. Many current disease-modifying therapies (DMTs) do a great job controlling relapses and new lesions. But some people with MS still notice slow changes in walking, energy, or daily function. Dr. Oh explains why this is real and why researchers are so focused on it. Fenebrutinib trial results. In two relapsing MS trials, fenebrutinib reduced relapses by over 50% compared to teriflunomide. In a PPMS trial, it was non-inferior to (meaning not worse than) ocrelizumab, currently the only approved treatment for PPMS. How fenebrutinib compares to other BTK inhibitors. Why evobrutinib, tolebrutinib, and fenebrutinib have shown different results, even though they’re in the same drug family. When might fenebrutinib be available? What the regulatory approval process looks like, plus what liver enzyme monitoring may involve. Should you join an MS clinical trial? Who Dr. Oh would consider for a BTK inhibitor, and how to weigh joining a trial (like one for remibrutinib) versus waiting. This episode is for you if: ✅ Your MRIs are stable, but you feel like your MS is slowly progressing ✅ You have primary progressive MS and want to know what treatments may be on the horizon ✅ Your neurologist mentioned a BTK inhibitor clinical trial and you’re not sure what to do ✅ You want to understand the latest MS research in plain language This episode was recorded in August 2026. As of October 19, 2026, additional information is available:• At 14:55, Dr. Oh discusses ARR findings from clinical trials of BTK inhibitors versus teriflunomide. This discussion reflects the available evidence at the time of recording.• At 20:35, Dr. Oh notes that approval typically takes at least a year after filing. Fenebrutinib has received priority review designation, which carries a six-month review timeline. Research can feel confusing… especially when it’s about medications and clinical trials. My hope is that this episode helps you walk into your next neurology appointment with clearer questions and a little more hope. 🧡 Resources mentioned in this episode:  Full Study on fenebrutinib - https://www.biospace.com/press-releases/roches-fenebrutinib-significantly-reduced-relapses-versus-standard-of-care-to-approximately-one-every-17-years-in-rms About Dr. Jiwon Oh   Dr. Jiwon Oh, a medical director at the Barlo MS Program in Toronto, Canada, where her team cares for over 12,000 people living with multiple sclerosis. She's also a leading MS researcher, running clinical trials and MRI research studies aimed at understanding MS progression.   Where to reach Dr. Jiwon Oh: MS Canada - https://mscanada.ca/ms-research/our-research-program/dr-jiwon-oh Genetech - https://www.instagram.com/genentech/?hl=en This episode is for educational purposes only. Always talk with your neurologist before making any changes to your MS treatment. Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: [email protected]  Website: www.MSingLink.com Social:  ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram: https://www.instagram.com/doctor.gretchen ★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1 → The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms → Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram → The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink    This episode is for educational purposes only and is not a recommendation for any specific treatment. Please talk with your healthcare provider about what's right for you.

Do the holidays leave you paying for it with MS fatigue for days afterward? You're not alone in this. In this episode, I'm breaking down why the holiday season can be a perfect storm for fatigue in people with multiple sclerosis (MS)... and sharing my 4-step plan to help you budget your energy, plan your recovery, and avoid the post-holiday crash. Last year, I said yes to all the things. Family events, daycare parties, the Polar Express, pictures with Santa. And I paid for each one for days afterward. For people with MS, that feeling can hit even harder. Here's what we cover: Why the holidays are a perfect storm for MS fatigue → Long stretches of sitting or standing. Staying in one position tightens your muscles, so getting up and moving takes more effort. Unfamiliar spaces. A lower couch or toilet, no grab bars, stairs, area rugs... each one asks you to lift your legs higher and move differently to stay safe. Travel, even down the road. Packing gifts or a dish to pass, plus the mental load of planning, is both physically and cognitively tiring. Disrupted sleep and routines. Different mealtimes, less water, less downtime, and more activity packed into fewer days. Temperature changes. Cold can increase muscle tightness (spasticity), and warm rooms or heavy layers can trigger heat intolerance. Both can slow the signals along your nerves, making movement harder. What MS fatigue actually is. It's your nervous system running low on the energy it needs to send signals around damaged areas of your brain and spinal cord. Being in "go mode" burns through that energy faster, even when you feel fine in the moment. My 4-step holiday plan: 1️⃣ Know your triggers. Look back at last season and write down what left you depleted. 2️⃣ Budget your energy in advance. Think spoon theory... if your event is at 4 PM, plan your morning so you still have energy left. 3️⃣ Plan your recovery on purpose. Decide ahead of time what a recovery day looks like. 4️⃣ Have a low-energy day plan. Two or three gentle movements, 10 reps, even in bed or on the couch, can help keep one hard day from turning into a lost week (and the balance changes and leg weakness that can follow). This episode is for you if: ✅ You love the holidays but dread the crash afterward ✅ You feel guilty canceling or bowing out of plans ✅ Unfamiliar homes, stairs, or low seating make you nervous ✅ Heat or cold tends to make your MS symptoms worse ✅ You want a real plan this season, not just hoping for the best Rest isn't failure. The holidays will ask a lot of you... but you don't have to brace for it and hope. You can walk into this season with an actual plan. You've got this! 🧡 Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: [email protected]  Website: www.MSingLink.com Social:  ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram: https://www.instagram.com/doctor.gretchen ★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1 → The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms → Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram → The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

Does MS make your voice sound shaky, hoarse, or quieter than it used to? You're not imagining it… and you're not alone. In this solo episode, I'm answering a listener's question about voice changes with multiple sclerosis (MS). It's not one of the most common MS symptoms, which is exactly why it can feel so isolating. But it's real, and there are things you can do about it. Here's what we cover 🔑: 1️⃣ Signs MS may be affecting your voice → A shaky voice (aka vocal tremor) → A hoarse, breathy, weak, or quiet voice (aka dysphonia) → Slow or slurred speech, or talking that takes more effort (aka dysarthria) → Running out of breath mid-sentence or trouble projecting → Pitch and volume that are hard to control 2️⃣ Why MS can change your voice Your voice is movement. It just uses much smaller muscles than your legs do. MS lesions can affect the nerves that control your breathing, your vocal cords, and your speech coordination. That includes the vagus nerve and one of its branches, the recurrent laryngeal nerve, which controls the small muscles of your voice box. And just like with walking, fatigue, weakness, and stress can make voice symptoms worse on some days. 3️⃣ The voice and swallowing connection If your voice changes during or after eating, or you cough, choke, or gasp for air when you swallow, mention it to your provider. Vocal cord weakness can keep your airway from closing fully during a swallow, so addressing it early helps keep eating safe. 4️⃣ Physical therapy-based strategies to support your voice → Diaphragmatic (belly) breathing, which creates the steady, controlled airflow your vocal cords need → Releasing tension in your neck and jaw → Seated rows to strengthen the muscles between your shoulder blades, plus a doorway chest stretch. Sitting taller opens your chest so your voice can project with less strain. → Energy conservation, like short check-ins and breaks through the day, since your voice often fades as your energy drops 5️⃣ Who can help A speech-language pathologist (SLP) is the go-to specialist for voice and swallowing. Bring this up with your neurologist, physical therapist, or primary care provider, and ask for a referral, not just a note in your chart. This episode is for you if: ✅ Your voice sounds shaky, hoarse, or weaker than it used to ✅ People keep asking "What did you say?" ✅ You run out of breath while talking ✅ Your voice fades as the day goes on ✅ You've noticed coughing or choking when you eat or drink Your voice is made of muscles too… and those muscles deserve attention. You're not alone in this 🧡 Do you have an uncommon symptom you want covered? Email Us!  Resources mentioned in this episode:  The MSing Link Podcast, Episode 178, Improve Your Movement Through Functional Exercise - Apple | Spotify The MSing Link Podcast, Episode 110, Speech & Language Pathology for MS w/ Pamela Miller, SLP - Apple | Spotify Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: [email protected]  Website: www.MSingLink.com Social:  ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram: https://www.instagram.com/doctor.gretchen ★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1 → The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms → Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram → The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

In this solo episode, I'm answering one of the most common questions I hear from MSing Link members and people living with multiple sclerosis (MS): "What exercises should I do if my goal is ___?" Whether you want to walk up slopes, climb stairs with more strength, turn without losing your balance, or stand up from the couch without plopping, I'm sharing the two-step thought process I use as an MS-specialized physical therapist… so you can build an MS exercise routine that matches your goals. Here's what we cover 🔑: 1️⃣ Mindset #1: Do the thing that's hard. Want stairs to feel easier? Practice stairs. Want to turn with better balance? Practice turning. It's the simplest place to start because you already know the movement. The key is making it easier first: a gradual slope with a railing before a steeper one, or an extra pillow on the couch so you're standing up from a higher surface. 2️⃣ Mindset #2: Break your goal into pieces. If the full movement is too hard or not safe yet, break it into the movements your body needs to do it. That's functional exercise (aka exercise that trains the movements you use in daily life). Stepping up a stair? You need to bend your knee, lift your toes so you don't scuff the step, and bring your knee up toward the ceiling. Each one becomes an exercise. 3️⃣ The 4 check-ins. Not sure where to start? Ask what your hip, knee, ankle, and balance (shifting your weight side to side) need to do. Any "yes" becomes your next exercise. 4️⃣ When it's not just weakness. If you try to bend your knee and nothing happens, but the front of your thigh feels really tight, spasticity (muscle stiffness) may be part of the picture. That can be a sign to add stretching, massage, or releasing that muscle. 5️⃣ Getting up from the floor. One of my favorite goals inside The MSing Link! Practice the pieces, like rolling onto your hands and knees, on your bed first so you build confidence without the risk of getting stuck on the floor. This episode is for you if: ✅ You're not sure which exercises match your MS goals ✅ Stairs, slopes, or turning feel harder than they used to ✅ You avoid the floor because you're not sure you can get back up ✅ You want to know why an exercise works, not just what to do You don't need a physical therapy degree to use this approach. If it feels like too much, look for an in-person physical therapist who is MS certified or neuro certified. My walking workshop (linked below) also has visual demos. You're doing more than you think. Progress, not perfection. 🧡 Resources mentioned in this episode:  The MSing Link Podcast, Episode 9, Improve Your Movement Through Functional Exercise - Apple | Spotify The MSing Link Podcast, Episode 60, Do The Thing That’s Hard - Apple | Spotify Multiple Sclerosis Walking Workshop - https://www.doctorgretchenhawley.com/Walking-Webinar Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: [email protected]  Website: www.MSingLink.com Social:  ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram: https://www.instagram.com/doctor.gretchen ★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1 → The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms → Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram → The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink