Thursday, October 30, 2008



While these may not look like the exercises that you expected, they are the basics for people with Parkinson's and other neuro-motor diseases. We cover walking, turning, balancing, sitting, rising, arm swinging, daily tasks and yawning.

1. Toes up. No, I'm not asking you to be a leprechaun but just to remember that when you are taking a walking step: the motion is heel to toe. You rock forward. Your foot does the heel-toe roll.

Try it slowly with the weight shift to the off leg, putting your heel on the floor and then rocking forward to your toe, weight shift and ready to repeat with the other foot.
As you do take that heel and toe roll, you will feel your calf and ankle muscles stretch. That stretch will get you out of trouble when your calves cramp as they do in PD. Just heel and toe to work it out. This will also work for the "freeze" if you just put your heel down and your toe up. You will be able to work it through because you have practiced, practiced, practiced.
When you hear that foot drag, you are probably walking toe to heel... to trip.

The problem with wearing high heels is that your legs and feet are always in that toe-heel position and you can feel the pain in your calf muscles. As a general rule high heels and PD don't mix.

2. Broader wheel base to prevent tipover If you hear your pant legs brushing together with evey step you take, your legs are too close together. The optimal distance for your legs to be apart is about 10 inches. This will aid your balance and prevent falling.

3. Long Strides for walking - Short steps for turning. Practice by walking several strides and then turning and walking back. Repeat. A few times a day for a total of at least 15 minutes. You will notice that the shorter steps - with feet still spread apart - will get you through the turn without the danger of tripping over a leg crossed in front. Those short turning steps will help you balance.

You are not a morotcycle, don't lean into the turn. Don't lead with your shoulders. Balance will come from good counterbalance.

4. Many PD patients are leery of tight spaces because of balance issues. Try walking into, through and out of those tight corners of a room. You are teaching yourself to overcome the fear - not to panic.

6. Get out into and of that chair. Easier said than done. So do it as rapidly as possible. Quit fighting with gravity. Sit Down slowly. Your body will be bent forward and your butt will touch the seat. Knowing where the seat is can be aided by "feeling" it with the back of your knee. (A stage sit) 
5. Back to balance. You will be in public situations where there will be no wall or hand rail to support or catch you if you fall. You need to practice walking rapidly, stepping heel first with toe up, legs spread apart. Turn left, turn right, turn around. Don't hug the wall. Do the expectant father pace several times a day. Each time you stride try to lift you leg higher as if marching. That stretching is important with a disease that tightens your muscles.
Reach for the chair
8. Listing to one side. Since it is often difficult to find the vertical with your eyes and ears, let your body find it with the following exercise. While you are doing your striding and turning exercises carry a tote bag with books on the opposite side of the list. The additional weight should help to compensate for the lean. Let your body feel the straightness you achieve so that you can walk that way without a heavy weight.

7. Swing your arms Yes, both of them. Lots of good reasons. Practice by sitting in an armless chair and just swing. Now get out of that chair and stride across the room while you swing both arms. It will loosen the muscles, aid your balance, generally make you feel better by lessening fatigue. If you are already having difficulty moving one arm, get your arms moving before you begin to walk. It may sound odd but when you first try to walk and swing your arms, you will find it is easier if your arms are already in motion.

Reach higher

Warm up: Stretch your arms as high as you can before you begin the weight carry. Feel the stretch in your arms, neck, chin, shoulders, spine, stomach, small of your back and gluteal muscles. The better the stretch, the more you will feel it throughout your body. Don't overstretch, this is a warm up.
For finer finger tasks

9. Daily tasks are becoming difficult. If you are having problems buttoning your shirts you can buy an entirely new wardrobe and go western with snaps or you can retrain your fingers to button the shirts in your closet. Put on a shirt and button and unbutton 5 times the first day, 10 times the next, 15 times for the next session and finally 20 times. You will find that it becomes easier with repetition. You will have to bring this exercise back into your regimen many times as your PD progresses. My wife made me do this 20 times the first day but I think that easing into it would be better.

Perhaps it is buckling your seat belt. Practice 10 to 20 times every time you are in the vehicle. You have to consciously relearn that which may be hidden in your brain.

10. Yawn. Oh good grief! Just keep yawning that big, rude fake yawn until your body picks it up naturally yawns. But why yawn? One theory is to induce more oxygen into the body and to expel carbon dioxide. Paratroopers often yawn before jumping and Olympic athletes are known to yawn before competition.
Yawning opens the shoulders, that is it relieves some muscle tension by the very act of yawning. It may stretch the lung tissues and increase the heart rate. It also frees the diaphragm. And here is where it is really important, it is a step towards clearer speech. By opening the throat it helps you avoid choking by eliminating swallowing problems.  And don't just yawn, pandiculate. Get your arms and shoulders involved in the stretching that comes with a real yawn. You see it on TV. Arms out at the shoulders, hand to the mouth.  Throw out your chest and stretch back from the shoulder blades. Feel your throat opening.

Don't yawn alone. If possible get someone to yawn along with you. It is contagious so beginning with a fake yawn will usually result in real and productive yawns.

For a simple hand stretching exercise, try the tennis ball between the fingers. 
Thumb and indexfinger
Roll to index and middle fingers
Then roll to middle and ring finger
The ring and pinkie are the hardest
Although you feel as if you should be squeezing the ball, stretching is better for PD


  1. additional very important exercise

    after stretch and strength



  2. We'd love to hear the rest - this is an intriguing concept.
    For those with balance issues either do this between large but soft furniture or have a spotter standing close by.
    Perhaps jump with some support such as an hand on the back of a chair.
    Certainly good cardio stimulation.


  4. Dear Liz,
    You are not alone in your symptoms. I am sorry to hear about your difficulty writing. Do you use a Dragon Speak program on your computer?
    As to the lack of arm swing, I can only tell you what Steve did.
    For several years he tried different forms and brands of Creatine Monohydrate because he had read that it might be of some benefit in PD.
    Finally we found one form - a flavored powder - which helped to restore some arm swing to his left (PD) side.
    About a year later I found pharmaceutical grade micronized creatine monohydrate on eBay of all places. We upped his dose from 10mg to 20mg and within days we saw more arm swing as well as shoulder engagement, which is so crucial to balance (although postural instability is something else) Shoulder engagement also decreases the PD shuffle.


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