“Right Now”: How Clay Walker Embraces Exercise While Living With Multiple Sclerosis
Nneka L Ifejika MD MPH
Associate Professor of Neurology, Director of Neurorehabilitation
McGovern Medical School at UTHealth, Houston, Texas
Most people know Clay Walker as the award winning, platinum recording artist with unstoppable energy and a gleaming smile. His life seems like a dream, but in fact, Clay is very much like you and me. He’s a real person – balancing work, home, volunteer activities with Band Against MS (BAMS), along with navigating the ins and outs of living with a neurological disease.
Multiple sclerosis is a condition that may seem insurmountable, but Clay has an approach to living with MS that may seem, like his persona, unattainable. This glimpse into a year with Clay will hopefully help you realize that Clay, like all patients with MS, puts his boots on one foot at a time.
I know Clay in a slightly different capacity. As a member of his physician team at the McGovern Medical School at UTHealth, I care for his Neurorehabilitation needs. What is Neurorehabilitation you might ask?
Neurorehabilitation is the comprehensive treatment of impairments caused by neurologic disease. It requires being creative and being consistent. Progress is measured in functional gains, with the goal of maximizing independence and patient dignity.
In May 2013, I saw Clay in Houston, and we reviewed his goals. We decided to start a structured exercise program in preparation for the busy year ahead. We were fortunate enough to have a trusted person in house (actually, in tour bus) to help! Ken Smith has been touring with Clay for over twenty years and became certified as a personal trainer two years ago. Because of their history and need for a higher level of fitness as a part of their job, the pairing of Clay and Ken was a perfect match.
“My fitness program has been critical in helping me not only survive but thrive as a touring musician, especially considering the physical demands of being a drummer.” Ken says.
Clay was evaluated by a physical therapist at the start of the structured program, who documented areas for improvement. While Clay was able to perform daily activities without assistance, he had some difficulty getting out of a chair without using his arms. He has some weakness in his right leg and muscle tightness, also known as spasticity. The spasticity affected his walking speed, and caused some pain.
Based on these findings, Ken started a tailored exercise program with Clay that suited his needs. Using a combination of work on his ranch, personal training and equipment, Clay was able to exercise in most locations. The band got involved, participating in golf as a group activity.
He improvised, using parking lots while on tour as outdoor gymnasiums; it would not be unusual to see five or six bandmates throwing around a football before a show.
Ken’s physical conditioning goal for Clay was to improve Clay’s fitness level while finding the most effective way to manage spasticity, helping him to find balance between physical strength, flexibility and fatigue, which can prove challenging in those with multiple sclerosis. Ken states, “We want to help him be the best he can in every aspect of his life.”
There were some challenges. Maintaining a healthy meal plan proved difficult, particularly in the setting of a hectic travel schedule. This required a proactive approach. Provisions were made to have nutritious foods available on a regular basis, with variety to keep Clay from getting bored. For example, Clay has Baked or Grilled fish with a vegetable almost every evening on tour.
Five months later, Clay went back to the physical therapist with a twinkle in his eye. The strength was better in some muscles of his leg, the same in others. The spasticity in the right leg was unchanged. However, due to his exercise program, in October of 2013 Clay considerably increased his walking speed and he was able to get up out of a chair faster and with greater ease. He was a testament to the benefits of exercise and conditioning – the importance of performing tasks that are meaningful to your life, despite obstacles set in your way.
Mr. Walker looked good, and felt better with exercise as a part of his routine.
Then…life happened. After the Christmas holidays, Clay took a siesta from exercise. He returned to the studio in Nashville, recording an album with at least eleven new tracks. One of the songs, titled, “Long Live the Cowboy” resonates considerably with Clay. When asked whether MS affects the song choices that he makes, Clay replied with a smile, “MS affects every choice that I make. It’s something that I live with all the time, I feel like it has impacted me more in a positive way than a negative way.”
Clay and Jess had a bouncing baby boy, Elijah Craig Walker. The frequency of his tour dates increased. He became even more active with Band Against MS. This translated to a seven month period of less activity. He continued to run his organic farm, but the days of roadside workouts were on hold.
In clinical research, physicians call a time period where one thing stops before moving on to another a “wash out period”. Clay understood the importance of resuming his exercise program, not because it was recommended by his doctors, but because he knew that exercise made a difference in his quality of life. Jess noticed differences as well, saying his gait was noticeably worse. Subtleties that only a wife knows, like the sound of his steps on hard floors, had increased.
In July 2014, Clay put his sneakers on, and started working out again. Our physician team decided to check the impact of physical exercise over a 20 week period, to see whether it made a difference in his walking speed, endurance, coordination and balance. He again saw a physical therapist, and compared to before the wash out period, his scores improved. The added benefit of exercise can also be heard in Clay’s voice. When asked whether Clay can tell a difference in his endurance when performing if he does not exercise, Clay says, “Absolutely. Singing requires proper breathing and I can hold notes longer without getting out of breath. I am actually able to move around on stage and sing without being taxed.”
Unfortunately, most people who undergo a wash-out period do not resume their exercise program. Making time for physical activity isn’t easy! I am familiar with these feelings, both as a physician, and a person who is juggling many priorities. Time can be viewed as a luxury.
With the passage of time, age becomes another factor in returning to best exercise practices. We asked Clay about the impact of exercise over the years. Clay replied, “Exercise is imperative. I feel very young on stage, especially with MS. I see other people who have not maintained a good physical routine and the majority of them seem to not be doing as well as those who have maintained a good physical routine.”
The addition of a multiple sclerosis diagnosis adds perceived barriers. MS patients are cautioned to avoid overexertion, extremes of heat and exercising to fatigue. This is sometimes interpreted as MS patients should avoid exercise. However, research has shown that people who exercise regularly have improved productivity in their personal and professional lives, better sleep and lower rates of depression. Add on the health benefits and time for exercise becomes a luxury that cannot be missed. Clay is on tour 180 days per year. He has remained relapse free for many years due to a combination of exercise, diet and medications. Jen Tooher, a Neuro-trained physical therapist from Vanderbilt University Medical Center in Nashville, replied, “Clay’s abilities highlight the importance of physical activity for people living with multiple sclerosis. While the course of MS is unpredictable with variable symptoms between individuals, Clay’s commitment to exercise has led to very few changes in function.”
We all take a siesta from exercise. Clay’s return to the gym, to the track, to the parking lot on tour was a conscious decision for his health and well-being. Let’s learn from Mr. Walker. Tie up those shoe strings, grab a friend, and initiate an exercise program. Thirty minutes a day makes all the difference.