Getting the most out of physiotherapy

Ideally you should see a physiotherapist as soon as you can after your Parkinson’s diagnosis.

Physiotherapists who specialise in Parkinson’s are experts in looking at subtle changes in the way you move, even if you’re not aware of any changes. 

They can look at what might be causing these changes and give you advice about how to deal with issues before they become more difficult to manage.   

Your physiotherapist can support you with ways to keep physically active and help build or maintain your fitness levels. They can also help you with strategies to keep you motivated.

A physiotherapist can help you manage changes in how you move due to muscle strength and control, balance, posture, or general fitness levels. If you experience pain that limits your confidence to move, a physiotherapist can also work with you to reduce or manage the symptoms.

Sometimes, they will refer you to an exercise professional or to a class to build specific areas of strength, endurance and balance. They may also suggest you see an occupational therapist to look at mobility aids and adaptations to keep you moving independently. 

If you’ve had a fall, a physiotherapist can advise you on how to rebuild your strength and movement. 

As your Parkinson’s symptoms change, you may not always be aware of how they affect the way you move. 

If you’re concerned, it can be helpful to ask your family or friends. Do they notice you leaning to one side more than the other as you walk, for example? Do you walk more slowly than you used to, with smaller steps, so you can’t always keep pace with other people? Or do you have more trouble turning in bed at night? 

Your physiotherapist can help you and your family to recognise when changes are affecting your movement, whether you’re on your feet, or sitting or lying down, and work with you to improve these motor symptoms. 

There are a variety of apps available which can help you monitor your activity levels. Many apps focus on areas that can monitor and improve your general wellness, such as mood, sleep or relaxation. Physical activity can help with this. 

If you experience freezing (when you suddenly aren’t able to move forward for several seconds or minutes because your feet feel like they are glued to the ground), physiotherapists often recommend a metronome or music to restart your walking. You can download and listen to a metronome app on your smartphone.   

Depending on your symptoms, how well you move may change over time. This can make it harder to stay active, so it’s important to put effort into exercising and learning ways to move as your symptoms change. 

It takes effort to maintain your fitness over time, so regular practice is really important to keep you as active and as mobile as possible, for as long as possible. 

You may find your motivation also changes over time, so think about ways to keep going - exercising with a friend, dancing around to music at home, or trying a new activity can all help keep you motivated.

Taking your medication at the correct times can help to manage your symptoms more effectively. If you think your medication is affecting your movement, especially if you’re experiencing wearing off, speak to your physiotherapist, specialist or Parkinson’s nurse. Wearing off happens when the Parkinson's medication you've been taking is no longer working as effectively as it used to.