How To Spend More Time Outdoors With Neuromyelitis Optica

Spending time outdoors with neuromyelitis optica spectrum disorder (NMOSD) can feel like a challenge. When fatigue, pain, balance issues or vision changes are part of your daily life, it makes enjoying time in the great outdoors an exercise in overcoming barriers. But it is so worth it.

This doesn’t have to mean pushing through or pretending those challenges don’t exist. It’s about finding ways to make it work for you. You might prefer walking, wheeling, adaptive cycling, canoeing, or just getting somewhere green and sitting for a while. The list of outdoor activities that can be adapted to suit your abilities is growing all the time.

How can you prepare for getting outdoors with NMOSD?

Start small

With all of the energy that goes into planning and preparing for time in nature, there can be a strong urge to make it feel “worth it” by going further or doing more. That’s usually where things fall apart.

Starting small is a great strategy, even if it’s a little frustrating at first. A short, accessible day out that goes well will do far more for your confidence than an ambitious plan that leaves you exhausted halfway through.

Don’t bite off more than you can chew! It might not feel exciting at first, but it’s how you build something sustainable. Then before you know it you have a new hobby and an entire social circle linked to it. That’s what happened when I first got into adaptive cycling. Now I’m hooked!

Work with your NMOSD, not against it

NMOSD symptoms don’t politely step aside just because you’ve decided to go outside. Fatigue can hit without notice, balance can be unreliable, and optic neuritis symptoms can turn a straightforward plan into something more complicated.

Planning around that makes a huge difference. For example:

• Build in rest breaks before you feel like you need them
• Keep your route flexible so you can turn back without it feeling like failure
• Choose equipment that gives you more stability and control
• Don’t forget snacks. Snacks massively improve any adventure!

NMOSD barriers are real

When you think about the outdoors, some challenges are obvious. Uneven terrain, mud, steep gradients, and gates that clearly weren’t designed with accessibility in mind, for example.
Others are not so apparent but just as limiting. I find there’s a constant calculation of whether I’ve got enough energy to complete the activity I’ve chosen. There’s a hesitation that comes from not seeing people like me in outdoor spaces. Then there’s mental effort of trying something new when my body is unpredictable.

None of that is me being negative, I just know my reality. Accepting that and working with it rather than pushing against it has helped me overcome some of the barriers. Sadly, it won’t remove locked gates or make paths nice and even, but it’s a good start!

Let planning alleviate some pain points

I plan and prepare a lot. It’s a lot more than I used to do pre-NMOSD when I could just turn up and wing it. Now, a bit of preparation turns something potentially stressful into something enjoyable. And I always overpack snacks, but hey, can you ever have too much cake?

I check routes online in advance where I can and seek out reviews from other disabled people. If the information isn’t there, I assume it might be slightly harder than it sounds and plan accordingly. Having a shorter backup option or an easy stopping point can take a lot of pressure off in the moment.

It’s also worth planning around your energy levels, not your optimism. Yeah it would be cool to tackle that big hill, but less cool calling Mountain Rescue out because you got stuck!

Groups that can help

This part makes a bigger difference than most expect. There are groups and organisations specifically set up to help disabled people access the outdoors, and they remove a lot of the guesswork.

Joining a group or guided session can:

• Take care of route planning and logistics
• Give you access to equipment you might not have
• Build confidence in a low-pressure way

It’s also just easier to try something new when you’re not doing it alone. When I started handcycling, being around people who understood the barriers was reassuring. I would never have had the confidence to try it alone, nevermind access to the right equipment.

I’ve also been on a canoeing adventure where I wild camped on an island! The support from the organisation, volunteers, and other participants made it possible. I have great memories of cooking pizza on a campfire, and waking up to bird-song.

Next I’d like to try climbing, or kayaking, or maybe a big overseas multi-day handcycling trip. These are things I just wouldn’t have considered a few years ago, but now I’ve got the bug. Not just that, I’ve developed the skills to manage my NMOSD alongside my adventures.

Adaptive equipment tips for NMOSD

Adaptive equipment can open up a lot of options, but it can also be expensive and feel like a barrier in itself.

You don’t need the perfect setup to start. Using what’s available, hiring where possible, and building up gradually is often a more realistic way in. The same goes for clothing. Staying warm and dry isn’t just about comfort, it helps manage fatigue and pain. If you’re in Scotland like me, you should pack for four seasons in a day regardless of the time of year!

Building confidence to get outdoors with NMOSD

Getting outdoors with NMOSD might look different. Slower, shorter, more planned, sometimes a bit unpredictable. It still counts.

A short outing that feels manageable and enjoyable is far more valuable than pushing too far and paying for it later. Over time, those smaller experiences build confidence in a way that actually lasts, which is far more useful than a one-off “good day” that leaves you wiped out.
And once it starts to feel possible, it becomes a lot easier to keep going back.