Mariska Breland demonstrates a move that builds foot strength: Hook your foot into the reformer strap and flex your foot toward you.

When Mariska Breland, the founder of Fuse Pilates in Dupont Circle, was developing a program for training clients with multiple sclerosis, she examined all the research she could find, studied up on the science of neuroplasticity, and took a look at her own body.

“Who better to design this than someone who has it?” says Breland, who was diagnosed with the neurological disease in 2002.

Her doctor had advised her to take up yoga or Pilates as a low-impact form of exercise. And although neither sounded particularly exciting to the former trail runner, she followed his prescription into a whole new way of life. Within a year, Breland was teaching Pilates, and by 2005, she was adding in elements from yoga and barre fitness to create the Fuse method.

Unfortunately, as she launched into this career to help others, Breland realized she was sometimes hurting herself. At one point, she had a cervical spine issue that caused a “pins-and-needles feeling” down her back whenever she tucked her chin to her chest.

“At the time, I was doing headstand and shoulder stand,” she says. “I shouldn’t have been doing those things.”

Her left arch collapsed, and her foot was rolling in severely when she walked, but she didn’t notice the change until it triggered a cascade of additional problems.

That’s why Breland is so fired up about the idea of teaching Pilates teachers more about MS — and other neurological issues, such as stroke — so they’ll understand how to identify these symptoms earlier and treat them before they can cause any additional damage.

For maintenance, Breland now has herself doing lots of foot exercises to build up strength. She practices pointing her feet without pointing her toes, lifting one toe at a time off the ground (“like a little wave”), and other moves.

To build ankle strength, sit with a foam roller in between your lower legs. Lengthen your feet by pointing your feet toward the floor. Press into the foam roller with the inside edge of your feet. Hold for a count of 10. Repeat 5-10 times.

“The hardest thing about working with MS is you can’t be laissez- faire about it,” she says. “You can’t work on it for 20 minutes once a week and expect results. I’m working on this every day.”

What helps her won’t necessarily be the answer for other people with MS because it’s such a variable disease with a wide range of severity and symptoms. What started as a simple resource for Breland’s Pilates for MS training course has ballooned into a 350-page document designed to cover as much as possible.

“What I’ve tried to create is almost like a cookbook. You can tweak the recipes,” says Breland, who’d like to turn her research into something for the general public, so everyone can access these exercises.

Putting together the program has been a somewhat depressing process for Breland, who’s been reminded of potential worst-case scenarios and what else might be in store. Her way of dealing with those fears? Being proactive about keeping up her strength, balance and range of motion.

“Maybe MS can’t be cured,” Breland says. “But it can be bettered.”

Breland’s first Pilates for MS teacher training will be held April 26-28 at Fuse Pilates (2008 Hillyer Place NW; She’ll offer the $800 course again in May in California.