Rigidity

How can rigidity affect people with Parkinson's?

Rigidity means stiff or inflexible muscles. It can stop your muscles from stretching and relaxing, which can lead to pain and muscle cramps and problems with balance.

If you experience rigidity, you may have problems with:

• swinging your arms because your muscles are too tight and stiff
• turning around, getting out of chairs, and turning over in bed
• doing everyday tasks, such as writing or doing up buttons
• chewing and swallowing. Stiff face muscles can make it harder to chew and swallow
• breathing and speaking clearly. Rigidity can also affect chest muscles and make them weaker. This can lead to problems with breathing and issues like chest infections. Breathing difficulties can also affect the tone and loudness of your voice, and make pronunciation harder.

Facial masking/ Parkinson's mask (hypomimia)

Rigidity can also stop your facial muscles working as well as they used to. This can make face movements slower and stiffer than before and limit the amount of facial expressions you have.

When this happens, it can sometimes look like you have a blank expression, even if you are actually experiencing a strong emotion. 

• The medical term is hypomimia, but it is often referred to as a Parkinson's mask, or facial masking. 
• Having a Parkinson’s mask is a common symptom.
• If someone can’t use their facial muscles to express themselves as easily anymore, it doesn't mean they are low or depressed. 
• Some people with Parkinson’s have apathy and problems with motivation, meaning they may not respond to emotions like they used to. It may seem like there is a link in some cases, but it may be two common aspects of Parkinson’s, happening at the same time.

What can help with rigidity?

Physical activity 

Staying physically active can help to strengthen muscles and improve flexibility and mobility. 

You may find low-intensity physical activity, such as muscle stretches or chair-based exercises helpful for easing stiffness and soreness.

Other low-intensity activities that can help to improve movement and flexibility include yoga, pilates and tai chi. Before starting a new physical activity or exercise, you should talk to a physiotherapist who knows about Parkinson's.

Simple exercises for rigidity

• Even when doing small activities, like walking to another room, stretch up tall each time you stand. Depending on how steady you are on your feet, reach one arm or both up to the ceiling for a better stretch, especially on your side that's more rigid. 

• If you've been sitting for a while, twist your body from side to side 2-3 times, then swing each leg backwards and forwards. This will help you loosen up before walking anywhere.

Physiotherapy

Physiotherapy may help with muscle cramps.

A physiotherapist can teach you ways to help ease cramps and make muscle movements easier. For example, stretches and exercises to improve posture and flexibility. This can help with reducing any stiffness and soreness.

They can also teach you methods for moving safely around your home and avoiding trip hazards. This is important if you experience stiffness or inflexibility, as it can make you more prone to falling.

We recommend seeking a physiotherapist who specialises in Parkinson's.

Speech and language therapy

Speech and language therapy may help with exercises to keep facial muscles flexible. This can help improve symptoms like having a Parkinson's mask. 

If you're experiencing stiff chest muscles, a speech and language therapist can teach you breathing exercises. This can help to relax and strengthen chest muscles and improve breathing and swallowing difficulties.

Seeing a therapist soon after diagnosis may make treatment more effective.

Massage therapy

Some people with Parkinson's tell us they find massage therapy useful as a way to relax. Massage can help to relieve stiffness and cramps, and reduce pain in muscles.

It's important that your massage therapist has experience in treating people with Parkinson's. For more information, see our complementary therapies page.

What treatments can help with rigidity?

• Levodopa, or a combination of levodopa and another Parkinson's drug, can be used to treat rigidity. Other types of drugs can also be used to treat this symptom, including anticholinergics and MAO-B inhibitors. If you're concerned about rigidity, please see your GP, specialist or Parkinson's nurse.
• Exercise therapy can help to improve rigidity and problems with movement.
  
  It involves using a structured programme of exercises to help you improve a specific health issue or condition. These exercises will be tailored around your personal symptoms and overcoming any difficulties they are causing in your daily life.
  
  The aim of exercise therapy is to gradually build your physical ability and confidence so that any movement difficulties will become easier and more natural to perform. 
  
  A combination of different exercises will usually be used during an exercise therapy session to help relax and strengthen stiff and inflexible muscles. This might include a mixture of breathing exercises, relaxation techniques and strengthening exercises.
  
  There are several Parkinson's-specific exercise therapy programmes available which address specific aspects of rigidity. These include:   
  
     • PD Warrior
     • LSVT-BIG