Parkinson’s Disease: How Physiotherapy Improves Mobility
Jacob loved taking morning walks. He’d lace up his sneakers, grab his coffee, and stroll through his favorite park before the day got busy. But gradually, those walks became harder, and his steps got smaller. Sometimes, his feet would just stop, as if someone had hit the pause button mid-stride.
It wasn’t about aging - Jacob had Parkinson’s disease. And movement, something he’d never thought twice about, had suddenly become complicated.
The good news is that you can still move, and move well. By working with a physiotherapist trained in treating Parkinsons Disease, it's possible to regain at least some mobility.
What Is Parkinson’s Disease?
It’s a progressive nervous system condition that affects movement. It can also cause cognitive impairment (brain fog), mood disturbances, sleep problems, and autonomic dysfunction. According to leading medical research, Parkinsons Disease is caused by the loss of dopamine-producing brain cells and often the accumulation of "Lewy Bodies" in the brain. (See references 1-3 below for more details)
Dopamine helps control smooth, coordinated movement. Without it, signals between the brain and muscles also don’t work. The gradual loss of dopamine-producing neurons is what leads to the classic symptoms we see in Parkinson’s disease.
Here are the common symptoms affecting movement:
- Shuffling or slowed walking (bradykinesia),
- Stiff muscles and joints,
- Tremors,
- Balance problems,
- Freezing episodes (sudden inability to move).
How Can Physiotherapy Help?
Physiotherapy focuses on training the body to move better, even when the signals from your brain are mixed or delayed. Think of it as rewiring movement patterns; building strength, improving coordination, and boosting confidence.
Here's how it helps:
1. Improved Walking and Gait Training
Parkinson’s often leads to a slow, shuffling walk. Steps become shorter, and sometimes the feet don’t lift properly. Physiotherapists can help with:
- Cueing techniques, like visual or audio prompts (like lines on the floor or metronomes),
- Treadmill training to promote longer, rhythmic steps, and
- Walking drills to improve stride length and arm swing.
These strategies help break "freezing" episodes and retrain smoother walking patterns.
2. Better Balance and Fall Prevention
Injuries from falling are a major concern with Parkinson’s. Physiotherapists teach exercises that improve your balance and reaction time.
These may include:
- Single-leg stands,
- Heel-to-toe walking,
- Core strengthening, and
- Weight shifting drills.
Small changes in strength and coordination can mean big gains in safety and independence.
3. Increased Flexibility and Range of Motion
Stiffness is a big challenge with Parkinson’s. Muscles and joints can feel locked up, especially in the spine, hips, and shoulders. Stretching and mobility exercises can:
- Loosen tight muscles,
- Improve posture, and
- Make daily activities like dressing or reaching overhead easier.
Even a few gentle stretches each morning can set the tone for a more mobile day.
We recently spoke to Lalitha, a physiotherapist colleague of ours in Calgary that works at Brentwood Physio. Similar to our physiotherapists in Winnipeg, Lalitha also treats Parkinsons Disease. Lalitha said, "We always encourage Parkinson’s patients to focus on small wins. Like being able to tie your shoes or turn in bed more easily. We need to focus on the little things because they add up over time. These milestones add up and help you stay independent longer."
4. Improved Coordination and Dual-Tasking
With Parkinson’s, even walking and talking at the same time can feel overwhelming. This is called dual-tasking, and physiotherapy helps you improve. For instance, our physiotherapist Dana Bubenko often has clients practice:
- Walking with head turns or ball bounce
- Obstacle courses, and/or
- Ladder drills.
By practicing these skills, people regain the ability to handle everyday challenges like crossing the street or shopping in busy spaces.
5. Better Breathing and Voice Control
Parkinson’s can affect your breathing and voice, too. Teamed up with speech therapy, physiotherapy can improve posture, chest movement, and breath control. Physiotherapy still plays a big role in:
- Diaphragmatic breathing exercises,
- Postural corrections to open airways, and
- Thoracic mobility drills for chest expansion.
These exercises help with both voice volume and lung health.
What Does a Parkinson’s Physio Program Look Like?
Everyone is different. Our physiotherapists will assess your walking style (your "gait"), muscle strength, flexibility, balance, and daily habits. From there, they’ll build a personalized program that might include:
- 20 to 30 minutes of structured exercises,
- Gait training,
- Balance work,
- Strategies to handle freezing or falls, and
- Home exercises and movement homework.
Progress isn’t just about speed; it’s about consistency. Even just a few sessions a week can bring big changes over time.
Do I Need Physiotherapy if I'm Taking Parkinson's Medication?
Yes! Early and ongoing physiotherapy is medically recommended as part of a comprehensive management plan for Parkinson's disease. That's why your neurologist will recommend physiotherapy as well as medication. (References 1-2)
At a recent Parkinson's event in Winnipeg (Parkinson's IQ + You), our physiotherapist Dana Bubenko provided the physiotherapist perspective as part of a panel of experts. The panel also included a researcher (geneticist), a neurologist, and speech-language pathologist. The geneticist stated that based on current research "right now, exercise is the best medicine we have for Parkinson's."
Medication can help with some Parkinsons symptoms, but it doesn’t train your body how to move better. That’s where physiotherapy comes in.
Otherwise said, physiotherapy does not replace medication, rather, it complements your medication. To improve how you move, you'll get double the benefit if you're taking your medication correctly AND following your physiotherapy treatment plan.
Final Thoughts
Jacob was persistent with his physio routine plan. He practiced his drills daily, used visual cues to improve his stride, and even learned a few tricks to manage freezing. He’s now back to walking through the park, maybe a bit slower than before, but with more confidence and control.
Physiotherapy doesn’t cure Parkinson’s, but it can help people live better with it. It can slow the progress of the disease.
Our advice to people living with Parkinsons? Movement is more than medicine - with the right support, you can stay active, independent, and empowered longer.
Ready to try physiotherapy? Book a "Neurological Assessment" appointment with us online, or call us to book.
Not sure if physiotherapy is right for you? Call us to book a FREE 15-minute phone consultation with a physiotherapist:
References:
- Armstrong MJ, Okun MS. Diagnosis and Treatment of Parkinson Disease: A Review. JAMA. 2020;323(6):548-560. doi:10.1001/jama.2019.22360.
- Tanner CM, Ostrem JL. Parkinson's Disease. The New England Journal of Medicine. 2024;391(5):442-452. doi:10.1056/NEJMra2401857.
- Mayo Clinic. (2023, June 6). Parkinson’s disease – Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055