Freezing
Physiotherapist Bhanu Ramaswamy considers ways to manage freezing, and make walking smoother and safer.
What is freezing of gait?
"Freezing" – not being able to complete a usual movement – is a common symptom of Parkinson’s. If it happens while walking, it is sometimes called freezing of gait.
Almost half of people with Parkinson’s will have freezing of gait (freezing) at some point. It’s more common for people who have had the condition the longest.
We don’t fully understand what causes freezing. But we do know that freezing is more likely to happen, or get worse, when you:
- start to walk
- walk towards or through doorways
- walk through a narrow or closed-in space, or a crowded area
- try to turn
- are in a rush
- are distracted or anxious
- move from 1 type of flooring to another.
Why do I freeze while walking?
Freezing is different for everyone. How we move is affected by how we think about movement, and how our bodies and brains are working.
For example:
- how confident or fearful we are feeling
- whether our brains can plan the movement correctly
- our physical ability – things like muscle strength, balance, co-ordination, hearing and eyesight.
Freezing can be very tiring, and can cause people to lose their balance and fall. So it’s a good idea to have a few techniques ready to manage freezing if it does happen.
Strategies to help you move
Pay attention and plan ahead
- Give yourself plenty of time. That might mean allowing more time for hobbies, bathing, dressing and cooking.
- Reduce distractions. For example, turn the radio or television off.
- Break a task down and do 1 part at a time, starting with the most important.
Use sound or vision to help
- To start moving, some people count themselves in: “1-2-3-and-step”. Someone else can also count out loud for you, or say trigger words, such as: “Ready, steady, STEP”.
- To get through a narrow or cluttered space, it might help to lift your knees higher and march along to a piece of music with a good beat.
- To move more smoothly from 1 room to another, some people use the music as a cue and picture themselves waltzing or skating.
- Floor strips can help you place your feet, especially in tight spaces or on a bend.
- If you feel anxious about walking safely, stand and calm your breathing, then gauge how many large steps it will take to cover the distance. When you have an estimate, take a large breath in. As you breathe out, count the steps in your head as you walk towards your target.
- A free metronome app on your smartphone can provide a useful beat.
Adjust the body to feel able to take a step
- Our brain feels confident to step when the weight of the body is in the correct place.
- Many people with Parkinson’s find that their posture becomes stooped over time, with their weight too far to the side or too far forward, over their toes. This can cause freezing.
- Getting your body weight back over 1 leg can prepare your brain to lift the other leg forward. Try to straighten your body and stand tall as you walk. You may need to slow your pace and stretch the leg stepping forward.
Placing the heel down first triggers a brain reflex to straighten the body, making you more upright.
Other ways to shift your weight include:
- kicking a walking stick to get the first step
- rocking from side to side until the brain feels confident to step
- straightening and feeling your weight over the heels
- taking a small step backwards first.
For most people, it’s easiest to move their weight onto their better leg, and step forward with the other.
"Off" and "on" periods
When the effects of your medication are wearing off or haven’t yet started to work, you are likely to freeze more often and for longer. But being "off" is different from freezing, and should be managed differently.