It is now well accepted that exercises of many kinds are beneficial for People with Parkinson’s (PwP). I am not an expert in the field as I am not a licensed physical therapist nor have I formal training in treating movement disorders . However, I do have Pd and have turned to Recreational Movements* (RMs) of all kinds to combat my symptoms for many years. I don’t attempt to identify which activities are the most beneficial as it’s probably different for different PwP (and in fact, may not matter much). Instead, I offer the general guidelines I follow that seem to maximize benefit for me.
Parkinson’s disease robs us of the ability to move normally. In particular, problems with walking are common. This happens to be one of my chief complaints. Walking is a surprisingly complex undertaking. Smooth purposeful strides are achieved when, through mechanisms not fully understood, chemical messengers orchestrate a delicate symphony of muscles contracting and relaxing at just the right cadence and just the right amount of tension to coordinate the series of controlled falls we call walking. Normally, the astounding precision needed to accomplish this mostly takes place behind the scenes without the need for intervention by the person in control of the body. The person simply provides high level directives such as, “Go to the kitchen”. The body takes care of the fine mechanics involved in getting the person there, leaving the person free to consider what he/she wants for lunch. That is…unless that person has Parkinson’s disease. In which case, the person will find that his/her body cannot get them to the kitchen without needing their intervention. But the high level brain functions were never meant to be in the drivers seat. So, the trip to the kitchen is fraught with freezing, shuffling, stumbling and lurching. By the time the person with Parkinson’s gets to the kitchen they may be too worn out to make themselves a sandwich.
Recreational Movements (RMs) of many kinds seem to reduce stiffness, promote balance, and help restore our ability to move more naturally. As a Person with Parkinson’s (PwP) and an enthusiastic practitioner of RMs of many kinds, I have observed that I get the most benefit when I adhere to the following three general guidelines:
- High Intensity (or with high intent) – The higher the intensity, generally the better. For activities that allow one to physically push themselves beyond their comfort zone, I suspect this benefit may at least partially have to do with the release of endorphins and perhaps other brain chemicals that takes place after the activity that relax the body and brain and reduce stress. Stress absolutely wreaks havoc on PwP and any reduction of it will be helpful. Some activities such as Tai-Chi, or Qigong, or even juggling are more more meditative in nature and when performed with “high intent”, allow the practitioner to enter a kind of “flow” state. This “flow” state is achieved when performing the activity in such a way that it occupies the entirety of ones attention. While not quite the same as the post-exertion “high” gained from a High Intensity Interval Training (HIIT) style workout, the benefits seem to be similar.
- Regular Recreational Movement – Some form of RM needs to be performed regularly. Ideally daily. However, there is definitely such a thing as over-doing it. We do need to give our bodies time to recover. Wearing yourself down excessively is unhealthy, Pd or not. Nonetheless, I find it best if I don’t go more than a day or two without doing some kind of RM.
- Wide Variety – The more variety throughout the week, the greater and longer lasting the benefit. I think there might be a few reasons for this:
- Variety is the spice of life – I tend to get bored of the same things on repeat. Keeping things fresh helps keep me motivated. When I’m motivated I can keep my intensity level higher. Higher intensity makes the activity more effective at keeping Pd symptoms at bay.
- You can go harder more often – If I mountain bike with a high level of intensity on say, Monday, I’m not going to be able to turn around and ride as hard the next day. It’s going to take at least a few days to recover so that it may be Friday before I can ride again. However, because it uses different muscles and overall taxes the body differently than mountain biking, I could go climbing with a high level of intensity on Tuesday. Then I could do BJJ on Wednesday, etc….
- Reduced risk of Injury – Doing the same RMs too frequently sets you up for injury by not giving yourself enough time to recover. Also, being well-rounded in terms of physical fitness protects you from injury by making you more robust overall. For example, if I crash my mountain bike I’m less likely to get hurt because of the muscle I’ve put on, as well as the greater bone density I’ve attained from regular weight lifting. On the flip-side, when I’m doing my weekly deadlift sets, I’m less likely to get gassed-out and get injured due to sloppy form because of the endurance I’ve built up from mountain biking and other activities.
- Larger Social Circle – It’s well known that having a large social circle is good for us. Participating in a large number of RMs expands our social circle. I’ve got mountain biking friends, climbing friends, BJJ friends, ….you get the idea…
- Neurologic benefits – Neurologically speaking, it seems that challenging the brain in a variety of ways is simply better. This seems to make sense intuitively. The movements required for climbing are slightly different than those required for BJJ, etc… Resulting in overall reduction in Pd symptoms and improvement in function that carries over to everyday life.
The specific RMs that are the most beneficial are going to be different for each PwP and in fact, in may not matter much. While I do believe there are more complex neurologic factors at play, the benefit may largely boil down to this: any exercise, RM, or activity that generally makes you happy and improves health will reduce stress and improve your Mental Health (MH). This in turn will make you feel and move better, and generally reduce Pd Symptoms. The more activities I do throughout the week, the happier I am, the greater my MH, the fewer and less severe my Pd symptoms are. Of course, it’s undeniable that the level of physical fitness achieved by doing all of these activities is beneficial, Pd or not.
I have noted though that some activities I have done do seem to go beyond simply increasing my MH to directly countering specific Pd Symptoms. I list a few of those RMs and discuss my perspective on the benefit here.
So the good news is that it seems to be fairly universal that RMs of many kinds help PwP move better. This gives us a sense of control over the disease regardless of what your particular preferred activity is. The bad news…and there’s no way to sugar-coat this: Pd can get bad enough that exercise or RMs don’t work any more. I know this because…I’ve personally experienced it.
Though I was diagnosed with Pd at 38 years of age, I had PD symptoms long, long before that. Recalling symptoms as far back as high school, I have long gravitated towards exercise as a means to combat the stiffness, pain, and discomfort of the disease. I used to love to run. Yet, in my twenties I had to mostly give it up for other pursuits such as cycling and weight lifting. In other words, Parkinson’s forced me to change my preferred exercise at a relatively early age.
For about a decade I relied on cycling (and weight lifting, to a lesser extent) to combat the symptoms of the disease and stay functional. Unfortunately, the disease gradually worsened to the point that cycling was no longer effective either. At which point, I went down-hill fast. Now receiving treatment, I’m all good. But PD only worsens. That my Pd could potentially once again progress to the point to render exercise ineffective at countering it is a terrifying thought.
However, I can only assume that diversification of RMs helps ensure that day is either delayed as long as possible, or simply doesn’t happen. Moreover, it would seem that the more RMs I do, it’s more likely there will be always be something I can do to the fight off the disease as it inevitably progresses. For example, perhaps one day my balance will be too poor to mountain bike safely. But since I will be accustomed to climbing up until that point, it is likely I would still be able to continue climbing, and continue to enjoy its benefit. This provides some comfort.
In the meantime, it’s counterproductive to worry or stress out about it. Instead, I’m going to continue to Worry less and Live more!
*I use the term “Recreational Movement” because the term “exercise” implies that the activity is performed with the intent to increase strength or cardiovascular health. For PwP this is important, yet there seem to be other factors at play here. “Recreational Movement” encompasses any kind of movement as the result in engagement in sports or athletics such as basketball, climbing, running, karate, etc or active recreational activities such as juggling, fast-walking, ping-pong, dancing, or hiking.