I was quite satisfied with life. My husband and I had two children, and I was enjoying my work as a physical therapist specializing in dizziness and balance impairments. I had completed my physical therapy degree just a few years before at the age of 42, and was very happy with the work I got to do each day. I loved interacting with my patients, and seeing the results of their hard work. 

When I noticed the tremor in my right index finger and thumb, it caught my attention immediately. However, because I was having spine problems, I thought I had a pinched nerve causing the tremor. Then I started having problems brushing my teeth, buttoning shirts, fumbling with small items, and problems writing. I realized my fine motor skills were being compromised, and I was also moving as if I were in slow motion. I decided to start researching my symptoms and looking for a diagnosis. In my research I kept coming across Parkinson's disease; but, I thought, "No, that's for old people." 

When I finally learned my true diagnosis, I was horrified. Although I was knocked for a loop with this life-changing news, I was determined to fight back the best way I knew how – exercise. Exercise is the fountain of youth. Certainly I saw the benefits of exercise as a physical therapist. However, I truly learned the value as a person living with Parkinson’s, just like you. After a refresher on Parkinson’s disease, I created my exercise program to help me stay moving and healthy. I have a husband, two teenagers, and a stepson who is about to be married. I plan to enjoy our life together for many years to come. I want to share some information with you as a fellow traveler. 

Rigidity

Rigidity is a primary problem with Parkinson’s. If you do not maintain muscle flexibility you can’t move. If you don’t exercise, with an emphasis on stretching, then your muscles will contract to the point where you cannot use them anymore. If you adopt exercises that you enjoy, and include stretching at the beginning and end of the exercises you will help your muscles, nerves and other tissues to stay as vibrant as possible.

Balance and Festinating Walk

Festination or ‘festinating gait’ is a symptom of PD where patients take small, quick steps forward, rather than a normal walking stride. (To see a movie showing festination, click here.) Aerobic exercise is particularly beneficial since it involves the large muscles of your legs, hips. and trunk. These muscles work as posture stabilizers. Furthermore, we think exercise helps the nerve pathways between the brain and the muscles work more effectively. Balance can become impaired due to postural instability, dizziness from low blood pressure, and freezing episodes. Exercise can help people maintain balance as well as a normal gait. 

Orthostatic Hypertension

Orthostatic hypotension is the sensation you feel when you stand up quickly, and sense that you might faint. The more you exercise, the less that happens. 

Orthostatic hypertension can also occur with exercise. Some people with Parkinson's, exercise on the treadmill 30 to 40 minutes. If they stop suddenly they could get dizzy, or even faint. They have to know how to slow it down gradually to where they are walking for a little while at a very slow pace. Then they gradually stop, stand there for a couple seconds, and then get off the treadmill. Anybody who exercises should have a cool down period. However, it is even more important for people exercising with Parkinson's.

Ideal Exercises

Treadmills are popular for some PWPs, because they can hold on for balance. Weight training and bicycling are also popular. The best exercises for me have been the ones that I do working in the swimming pool. It’s wonderful because it’s easy on the joints, and the water is soothing. Since I have a pool, I can do this any time I choose. I do a modified version of the front crawl. I turn over on my side, and stretch out with each stroke. I repeat it many times on each side. 

The stretching is important because PD progressively tries to take away our trunk rotation. It’s really important to maintain that trunk rotation and stretch those lats.

There are also other exercises you can do to stretch lats and your trunk. I happen to like my modified swimming stroke because I can stretch my trunk, and exercise the rest of my body at the same time.

Jumping Exercises in the Pool

People with Parkinson's need to strengthen their muscles. They also need to condition their muscles to respond properly when the brain sends them a command. You can strengthen and train your muscles by performing exercises called plyometrics. Plyometrics are popular among athletes, because they help them improve their quickness and coordination.

I do these exercises in the pool to reduce the damage that I could be doing to my joints. Quite simply, I do jumping exercises. My jumping routine includes:

• Jumping up and down in the pool
• Alternately hopping on one foot
• Pretending I'm jumping rope, including the arm motions
• Doing jumping jacks
• Jumping back and forth across the pool

These types of movements actually increase strength and muscle mass faster than ordinary exercise. Many other people who perform plyometrics in the pool report increased strength, and beneficial weight loss.

Even More Important than Physical Exercise

Emotional exercise is so important in maintaining a healthy state of mind to battle this life changing disease. My faith in God helps me make it through each and every day as I allow time for prayer and meditation. My relationship with my family and friends is also very important to my emotional health. We do not have to face this PD challenge alone. Even if someone has no family or friends close by, support groups through churches, hospitals, and even through this Web site are waiting for you with open arms!

If you are interested in learning more about exercise in general, I would encourage you to visit a physical therapist who enjoys working with patients with neurological challenges. Your neurologist should write you a prescription, and recommend therapists near you. 

If you are interested in learning how to work out in the swimming pool, you should seek out a physical therapist specializing in aquatic therapy. In addition to training you, they will also inform you about swimming pools in your area that have the tools that you need to perform your exercises.

Michelle Holderby, MSPT, is a physical therapist living in Florida. She practices physical therapy at Florida Ear & Balance Center, PA in Celebration, FL. She holds a Bachelor of Science degree in Health Science from the University of Central Florida and a Master of Science degree in Physical Therapy also from the University of Central Florida.