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Regular physical activity (PA) is known to benefit individuals with multiple sclerosis (MS) but people with MS tend to do less PA than the general population. Thought processes such as positive thinking may help to explain PA motivation among individuals with MS. The present study investigated thoughts about PA motivation in one man with MS (aged 70 years; pseudonym Norman). We asked Norman to think aloud while completing standardised measures of PA, stages of change, self-efficacy and in response to planned and spontaneous questions. The data were subjected to inductive thematic analysis and two major themes were formulated: positive thinking as Norman’s way to fight against MS; and goals give a positive purpose to Norman’s engagement in PA. Theme one consisted of three subthemes: coping with MS by choosing to think positively; using positivity to maintain control; and using PA to think positively. Theme two consisted of two subthemes: viewing PA as a necessity for goal achievement; and goals providing determination. Norman’s case has implications for enhancing future physiotherapy interventions. In particular, addressing positive thinking and purposeful goal setting may help physiotherapists to increase PA motivation in individuals with MS and thereby encourage more regular engagement in PA.