Physiotherapy

A physiotherapist (often called a ‘physio’) is a healthcare professional who helps keep people moving and able to carry out daily tasks for as long as, and as safely, as possible. They should form part of your support network who can help you manage your Parkinson’s. 

They will support you alongside other healthcare professionals, such as your Parkinson’s nurse or an occupational therapist. This group is often known as a ‘multidisciplinary team’.

Physiotherapists who specialise in Parkinson’s are experts at seeing small changes in the way you move, even if you’re not aware of any changes. Your physiotherapist can give you advice about how to deal with these issues before they become more difficult to manage. 

They can also support you with ways to keep physically active and help build, or maintain your fitness levels, through exercise. Some of this activity will be tailored to you and your abilities. Others will be more specific to targeting movement symptoms you may experience with Parkinson’s. 

Physiotherapists can also help people recover more quickly after an injury or an illness, and prevent future problems.

It's recommended that you see a physiotherapist who specialises in Parkinson’s as early as possible after you've been diagnosed. You should also be offered physiotherapy if you have balance or movement problems. 

The Alexander technique is also recommended. The technique teaches you to be more aware of your body, improves posture and helps you move more efficiently. You may be able to access Alexander technique lessons on the NHS in some areas. They are also available privately. 

You should speak to your physiotherapist or Parkinson's nurse if you would like to learn more. Other techniques, such as Pilates, can also help.

Whether you’re newly diagnosed or you’ve had Parkinson’s for some time, your physiotherapist will assess how Parkinson’s affects your movement. Seeing a physiotherapist who specialises in Parkinson’s can help people in different ways. This includes:

Helping you stay independent

Some people with Parkinson’s may find certain actions more difficult. These include walking, turning in bed, or sitting down and standing up from a chair.

Your physiotherapist can teach you ways to help make these movements easier. A physiotherapist or an occupational therapist can also give advice on aids and equipment you could use or alterations you could make to your home. This can help make it easier and safer for you to move around independently, both at home and while you’re out and about. 

Always check with an occupational therapist before you buy any aid or piece of equipment. Parkinson’s affects everyone differently, so what might work for one person may not suit another.

Helping to prevent or manage falls

Your physiotherapist can work with you on strength and balance training. This can improve any problems you may have with walking, especially when you’re turning.

You may be more likely to fall if you’re stiffer or weaker. People who experience freezing are also more at risk of falling. If you experience freezing you may suddenly not be able to move forward for several seconds or minutes. You may also feel like your lower half is stuck, but the top half of your body is still able to move. 

Your physiotherapist can show you ways to overcome freezing and reduce your risk of falling. They can also teach you ways to help you get down safely on to the floor, and up again if you do fall. 

Often, a physiotherapist will work with an occupational therapist to help you identify any tripping hazards in your home.

Providing pain relief

There are different types of pain that can affect people with Parkinson's. This can include musculoskeletal (muscle) pain, which is related to Parkinson's rigidity and reduced movement of the joints. It usually feels like an ache in the neck and back, but any part of the body can be affected.

Dystonia is another type of pain that is common in Parkinson's. It's caused by involuntary muscle contractions and for some people the pain can be severe.

A physiotherapist can assess your pain to try to find the cause. They can use different methods to help ease the pain. These include manual therapy, when your physiotherapist moves parts of your body using their hands, and stretching, as well as applying heat or cold to the affected area.

Not all pain is related to Parkinson’s. You may have a condition like arthritis, or another injury that needs physiotherapy. It’s important to mention any specific pain to your physiotherapist so you can get the right treatment for your problem. Some physiotherapists are trained in complementary techniques, such as acupuncture, which may also help to reduce pain.

Maintaining or improving effective breathing

Parkinson’s can cause stiffness in your chest muscles and make them weaker. This may lead to chest infections because you breathe less deeply. A physiotherapist can show you ways to focus on your posture to help clear phlegm and keep your chest clear.

Speech and communication issues in Parkinson’s are common and can often relate to your breathing. A physiotherapist can teach you how to strengthen your chest muscles, and give you breathing exercises to improve your breathing pattern and volume. This can also help if your voice has become softer. If you find that you have specific problems with your voice, a speech and language therapist can help.

You may feel that your movement is good and that you’re able to be active without any problems. But research has shown that regular, moderate to vigorous physical activity can help relieve some of the motor symptoms of Parkinson’s. A physiotherapist can help you to increase or maintain your physical activity levels. A physiotherapist can also help you maintain your mobility to help avoid any future issues.

They could give you an exercise programme to follow at home. Or, they may recommend an exercise class you could join. There are many different types of classes that can help with movement and mental wellbeing. These include creative dance, pilates, yoga and tai chi. More vigorous physical activity may include cycling, aerobics or Zumba. 

To help relieve stiffness and slowness, and help you move more smoothly, your physiotherapist can show you how to stretch and be active. This can keep your joints and muscles flexible. Your physiotherapist can support you with strategies to keep you motivated. They can also help you keep good posture and balance, which will help you remain independent.

Find out more about the benefits of physical activity and the different types to focus on. 

If you help care for or support someone with Parkinson’s, a physiotherapist can give you advice on the best way to help them to move. This might be helping them get up from a chair, or managing freezing, for example. 

If the physiotherapist recommends exercises for your loved one, make sure you understand how to do the movements properly. This will mean you can support the person with Parkinson’s to get the most out of them.

A physiotherapist can recommend equipment you can use at home to help you care for your loved one. They can also give you advice about looking after yourself physically, especially your back.

Physiotherapy is available on the NHS or privately. 

NHS physiotherapists work in lots of different places. This includes in the community, such as at GP surgeries and care homes, as well as hospitals and outpatient clinics. They can also visit you in your own home. You may also be offered a video appointment.

Your specialist, Parkinson’s nurse or GP can refer you for physiotherapy. In some areas, you will be able to self-refer. If you’re referred to an NHS service, there may be a waiting list for treatment. You can also choose to see a physiotherapist privately, which you will need to pay for. 

The Chartered Society of Physiotherapy can help you find a private physiotherapist. Some Parkinson’s UK local groups have group sessions led by a physiotherapist. Call our helpline on 0808 800 0303 or use our local support tool to find your local group.