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The MSing Link: Daily Summaries Delivered
by Dr. Gretchen Hawley PT, DPT, MSCS
Do you have Multiple Sclerosis and have goals of improving your mobility, energy, and motivation? On this show, you’ll learn MS-specific exercises and symptom management strategies to help you gain control over your life with MS. I also bring in other MS Experts in the healthcare industry to share their insights and advice so you’ll be armed with research-driven education. You’ll leave each episode feeling empowered and ready to take action!
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- 4 days ago30 min
309. Vibration Therapy for Multiple Sclerosis: Spasticity, Balance, and How to Start Safely
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 - <a href="https
- 1 weeks ago32 min
308. Fenebrutinib and BTK Inhibitors: The MS Treatment Everyone's Asking About
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.i
- 2 weeks ago20 min
307. MS Fatigue During the Holidays: How to Save Your Energy Before You Crash
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: hello@doctorgretchenhawley.com Website: www.MSingLink.com Social: ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram:</spa
- 3 weeks ago21 min
306. MS Voice Changes Are Real: What's Happening and What You Can Do
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 - <a href="https://p
- Oct 7, 202621 min
305. Stop Guessing: What MS Exercises Actually Help
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: <s
- Sep 30, 202639 min
304. Electrical Stimulation for MS: Can It Help Foot Drop and Walking? with Mandy Jacques
I'm so excited to welcome Dr. Mandy Jacques, PT, DPT, MSCS, a physical therapist and Multiple Sclerosis Certified Specialist, for an in-depth conversation about electrical stimulation (e-stim) for multiple sclerosis (MS). We talk about the Neubie device from NeuFit, how it's used, and how it fits into a real-life exercise routine. Here's what we cover 🔑: → What is electrical stimulation for MS? E-stim sends a gentle electrical current through pads on your skin to activate your nerves and muscles. When MS disrupts the wifi connection between your brain and your muscles, stimulation can give that signal extra support while you move. → What makes direct current e-stim different? Dr. Mandy explains what sets the Neubie's direct current apart from other types of e-stim, and why that matters for people with MS. → Foot drop, spasticity, and fatigue. How targeted stimulation is used for foot drop (aka toe drag), spasticity (muscle tightness or stiffness that makes movement feel harder), MS fatigue, and overall mobility. → Using the Neubie at home or in a clinic. The practical steps for getting started, so you know what a session actually looks like. → Neuroplasticity and MS-specific exercise. Why stimulation works best alongside movement, plus Dr. Mandy's advice on safe, effective exercise strategies to help you get stronger and walk with more confidence. This episode is for you if: ✅ You deal with foot drop or toe drag✅ Spasticity makes your legs feel tight or stiff✅ Fatigue limits how far you can walk✅ You've been curious about e-stim but didn't know where to start✅ You want to understand why a tool works before you try it E-stim isn't a magic fix, and it looks different for everyone with MS. But the right tools, paired with the right exercises done consistently, can help you see what's possible in your daily life. Progress, not perfection. You've got this 🧡 Resources mentioned in this episode: NeuFit for Patients - https://www.neu.fit/patients/ About Dr. Mandy Jacques Dr. Mandy Jacques is a physical therapist and MS certified specialist, and I can just say from experience, that is a rare combo. Dr. Mandy has spent the last five years at NeuFit working with people with MS, first in the clinic and now leading the department that helps people use the Neubie device right in their own homes. Where to reach Dr. Mandy Jacques & NeuFit: YouTube: https://www.youtube.com/@NeuFit/videos Website: https://www.neu.fit/patients/ Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: hello@doctorgretchenhawley.com Website: www.MSingLink.com Social: ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram: https://www.instagram.com/doctor.gretchen ★ YouTube:<a href=
- Sep 23, 202619 min
303. The 7 Types of Rest Every Person With MS Should Know About
If multiple sclerosis (MS) fatigue has you sleeping eight hours and still waking up empty… this episode is for you. In this episode, I'm sharing my own recent experience with unexpected rest (the kind you don't plan for) and why understanding the seven types of rest changes how you manage MS fatigue. Not in a "just take a nap" way, in a "here's what's actually draining you and here's what refills it" way. Here's what we cover 🔑: MS fatigue vs. regular tiredness. These are not the same thing. Regular tiredness responds to sleep. MS fatigue often comes from a nervous system working overtime… when nerve signals have to travel damaged pathways, your body burns more energy to do the same task. That's why you can sleep well and still start the day at half a tank. Just because others don't feel it doesn't mean it's not real. Why sleep alone doesn't fix it. Sleep covers one kind of depletion. If your energy is draining through your senses, your emotions, or your mental load, more hours in bed won't touch it. The seven types of rest. Physical, mental, sensory, creative, emotional, social, and spiritual. I walk through what each one looks like day to day with MS, how to spot which one you're low on, and what actually restores it. Strategies you can start today. → Sensory rest: 10 minutes with the lights off and no screen before dinner → Mental rest: write tomorrow's list tonight so your brain stops rehearsing it → Physical rest: lie down flat for 15 minutes instead of sitting upright, so your postural muscles fully let go Rest and your nervous system. Recovery is when the work sticks. Neuroplasticity (your brain's ability to build new pathways to your muscles) does a lot of its building during downtime, not during the effort itself. That wifi connection between your brain and your body gets stronger while you rest. Forced rest days and the guilt that comes with them. If a rest day feels like falling behind, this part is for you. This episode is for you if: ✅ You sleep well and still wake up exhausted ✅ Rest days leave you feeling guilty or behind ✅ Brain fog hits hardest by mid-afternoon ✅ You've been told to "just rest more" without anyone explaining what that means ✅ You want to understand why something works, not just be told to do it Rest isn't the pause in your progress. It's part of it. Progress, not perfection. You've got this 🧡 Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: hello@doctorgretchenhawley.com 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 <span style=
- Sep 16, 202637 min
302. Is Your MRI Telling the Full Story? A New Way to Measure MS Disease Activity
If you've ever walked out of an MRI appointment still wondering what's actually happening inside your body right now… this episode is for you. In this episode, I'm joined by Jennifer Chester, a neurology nurse practitioner who works with Octave Bioscience, to talk about a blood test (available in the US) built specifically for multiple sclerosis (MS). Not a diagnostic test, and not a replacement for your MRI. It's a way to measure MS disease activity between scans, using proteins in your blood. We get into what biomarkers actually are, how the test works, what the number means, and how to bring it up with your neurologist without feeling like you're overstepping. Here's what we cover 🔑: 🔬 What a biomarker actually is. A biomarker is anything measurable in your body that tells you something about what's going on inside it. Cholesterol is a biomarker. Blood sugar is a biomarker. In MS, researchers have identified specific proteins that show up in the blood when there's inflammation, myelin breakdown, or nerve fiber damage happening. Measuring those proteins gives your care team information they can't get from asking how you feel. 🩸 How an MS-specific blood test works. The Octave MSDA (Multiple Sclerosis Disease Activity) Test measures 18 different proteins in a standard blood draw, then factors in your age and sex to generate a disease activity score. Why 18 and not one? Because MS isn't one process. It's immune activity, inflammation in the nervous system, myelin biology, and nerve fiber damage happening at different rates in different people. A single protein only tells you about one of those. A panel gives a fuller picture. 📊 What the number actually means. The test produces a score from 1 to 10, along with subscores tied to those four biological pathways. On its own, one score is a snapshot. Tracked over time, it becomes a trend line, and the trend is where the useful information lives. Your neurologist is looking at whether your number is holding steady, climbing, or dropping while you're on a particular treatment. 🧠 Blood test versus MRI (they're not competing). This is the part I want you to hear clearly. An MRI shows lesions, which is damage that has already occurred. A blood-based biomarker test is designed to reflect biological activity that's happening now, at a level that may not have shown up on a scan yet. Jennifer explains why the test is intended to complement imaging and your clinical exam, not replace either one. More data points, not fewer. ❓ "Is this MS, or is it something else?" If you've ever had a new symptom appear and spent three weeks trying to figure out whether it's a relapse, an old symptom flaring in the heat, stress, perimenopause, or a virus… you know how exhausting that guessing game is. An objective disease activity score gives your neurologist one more piece of information to weigh alongside your history and your exam. It isn't a yes or no answer by itself, and it can't tell you what a symptom is caused by. But it can help your team sort signal from noise. 🗣️ How to bring this up with your neurologist. Jennifer walks through what that conversation can sound like, what to ask, and why it's completely reasonable to bring a testing option to your provider rather than waiting for them to bring it to you. You are allowed to ask questions about your own monitoring plan. 💵 The practical stuff: coverage, cost, and timing. We talk through how the test is typically ordered, what to expect around insurance coverage, and how often testing tends to be repeated. Coverage and cost vary quite a bit depending on your plan and where you live, so this is a "confirm with your own provider and insurer" situation rather than a one-size-fits-all answer. This episode is for you if: ✅ You've had an MRI come back "stable" but you don't feel stable✅ You're not sure whether a new symptom is a relapse or something else entirely✅ You're on a disease-modifying therapy and you want to know if it's working✅ You want more information about your MS than a scan every 12 months can give you✅ You like understanding the science behind a recommendation, not just being handed one<
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About The MSing Link
Do you have Multiple Sclerosis and have goals of improving your mobility, energy, and motivation? On this show, you’ll learn MS-specific exercises and symptom management strategies to help you gain control over your life with MS. I also bring in other MS Experts in the healthcare industry to share their insights and advice so you’ll be armed with research-driven education. You’ll leave each episode feeling empowered and ready to take action!
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