Being an informed “exerciser” with Parkinson’s

… To follow up from Tuesday’s post, here are a few things to incorporate and/or consider when you are exercising…

1. Cues/Attentional Training

Attentional training provides a non-automatic drive for movement scale and timing; what this means is, attentional training and cues MAY compensate for faulty brain circuitry and improve performance.

The ability to move in PD is not lost; rather mechanisms that initiate movement are defective (i.e. corticol control). This can be applied to yoga, where physical performance in persons with PD may benefit from specific external cues emphasized in yoga because they utilize intact premotor cortex, rather than basal ganglia circuitry (Morris, 2000).

Yoga also breaks up complex sequences and/or postures into component parts. Focused attention on individual aspects of postures may improve performance by providing a non-automatic drive for movement scaling, and serves to bypassing basal ganglia circuitry.

… What can you do?

  1. Utilize visual cues to help coordinate movement (i.e. laser pointer)
  2. Utilize auditory cues (i.e. music, sound of walking stick hitting pavement) to help you “keep the beat”
  3. Focus on one aspect of movement at a time, like in yoga, to maintain your attention on the present moment
  4. Do rhythmic activities, i.e cycling, to keep the pace

2. Follow “brain training” principles

  1. Your body needs to be ready, your brain needs to be focused and the task needs to feel important (or fun!) for change to occur. Make your exercise engaging!
  2. Use equipment to get the experience of the full movement safely, then take supports away as you progress
  3. Seek exercises that gain core stability
  4. Starting your exercise program with progressive aerobic training, then follow up with skill acquisition-type exercises.
  5. Increase useable muscle and focus on functional movements in your exercises… not just “curls for the girls” but apply that experience to everyday movements! (adapted from PWR! by Becky Farley)


3. Address Rigidity

Otherwise known as that “cogwheel stiffness”… the inability to get out of a chair

 … What can you do?

  1. Don’t hold postures as long… the can cause tremor or rigidity… try and move in and out of postures with your breath
  2. Address rigidity and bradykinesia in torso muscles and spine by focusing on deep diaphragmatic breaths

4. Focus on Posture

Stooped posture in PD is attributed to shortened contractile elements of spinal flexors and lengthening/weakening of extensors… the we shift our head forward and tilt our chin up to compensate, creating pressure in the neck too!

… What can you do?

  1. Strengthen your core *especially your transverse abdominal muscles
  2. Stretch your psoas muscle… the thick muscle (size of your forearm!) that runs from under your armpits to your hits
  3. Practice gentle backbends
  4. Building your posture (more info HERE!) from the ground up, engaging your feet, legs, core, open chest and align head over shoulders
  5. Check out your posture EVERY TIME YOU WALK BY A MIRROR… it’s not vanity, it’s anatomical alignment!

… So, how do those resonate with you and your exercise experiences?

I’m happy to be home, for now… no more travel… until next week when I head to Kelowna for some yoga and Time Out for Caregiver workshops… see you there! Much love

p.s. I saw this ad in the Chicago airport on my way to Kripalu… seemed appropriate 😉


open your heart : yoga workshop for parkinson’s

Hi Parkinson’s Yogis!

If you live in the victoria area, join me on August 11th for my next yoga workshop for Parkinson’s at Moksana yoga centre.

We’ll focus on targetting the muscles of the upper back and opening the chest. Specifically the postures will help address stooped posture and postural instability, creating more space in the upper body.

Please contact me at: or 250.589.2046 to register or for more information.

Looking forward to seeing you there! much love.


perfect posture

WHAT? “every inch of forward head posture can increased the weight on the spine by 10lbs?” Mom was right, stand up straight!

Stooped posture is commonly associated with long term Parkinson’s disease. Postural instability can cause patients to have a stooped posture in which the head is bowed and the shoulders are drooped. As the disease progresses, walking may be affected – slow or shuffling gait.

Maintaining and strengthening the body structure is an aspect of managing PD. This severe forward head carriage, increased curvature of the upper back an forward flexed arms. This posture is caused by many factors, including spinal rigidity, loss of normal subconscious posture control, poor balance, and a loss of normal proprioception (movement sensation of the joints).

The structure of the spine is the foundation of posture, and abnormal spine is associated with unhealthy postures. Abnormal posture causes and worsens disc decay, causes pain,contributes to spinal arthritis, and is associated with disability. Poor posture is associated with many health conditions such as limited range of motion, breathing difficulties, cardiovascular disease, headaches, poor balance, jaw pain, shoulder/arm pain, and numbness/tingling.

Specific to PD, the cervical spine (neck) and the thoracic spine (upper/middle back) are regions greatly stressed due to the development of “hyperkyphosis.” Hyperkyphosis is related to early morbidity and mortality. The hyper-kyphotic posture is not only physically stressful but it potentially shortens lifespan.

Posture is a subconscious state.

Do you know what works? Repetitive movements with medium to long holds that involve whole body movements, and challenge balance/stability. This, however, is more difficult for patients with PD because the areas of the brain that help control posture are simply deficient. Therefore, persons with PD must utilize concentration or “cognitive” activity to compensate for the lack of reflexive control. An analogy of this concept is driving a “standard” automobile instead of an “automatic.” The “automatic” car shifts gears on its own (reflexive) but in a “standard” the driver must know when to shift to make the car move efficiently (cognitive).

The best initial treatment involves management of your pain, physical therapy to recover lost range of movement, and adjustment of your meds to help mobility. Also, YOGA (of course!) … here is some details on Tadasana, or Mountain Pose to improve posture in PD.

Another tip from Parkinson’s Society Canada:  Emphasize the anti-gravity muscle group! “These are the muscles that straighten you or make you taller.” Back extensors, knee straighteners, triceps – the muscles at the back of the elbow that straighten the arms, enabling you to reach up, to the side and behind the back, shoulder blade squeezes. “These work against the typical stooped posture in Parkinson’s.”

Open your heart and stand up tall! much love.

Some other references: How Do I Treat “Stooping” Caused By Parkinson’s?, Parkinson’s Post