By Karl Burris, PT, DPT, PWR!Moves certified therapist
Falls are one of the most common concerns for people living with Parkinson’s, and one of the most treatable. Balance problems in Parkinson’s have specific causes, and each one can be trained.
Why Parkinson’s affects balance
Balance is not one skill. It depends on posture, step size, reaction speed and the ability to do two things at once. Parkinson’s touches all four.
- Smaller steps. Short, shuffling steps leave your feet behind your body, especially when you speed up or turn.
- Stooped posture. Leaning forward shifts your weight toward your toes and makes it harder to recover from a stumble.
- Slower reactions. The quick, automatic step that catches you after a trip comes late or comes too small.
- Freezing. Feet can feel stuck to the floor in doorways, in tight spaces or when you start to turn.
- Divided attention. Walking takes more concentration, so talking or carrying something can be enough to throw you off.
Walking: address it early and often
Walking deserves attention from the start, well before it feels like a problem.
Parkinson’s changes your sense of how big a movement is. A step can feel full-sized to you and still be short. Telling yourself to step bigger is rarely enough, so we use a range of strategies to remap what a “big” step actually feels like.
The second goal is to keep walking as automatic as possible. Right now, walking while you talk, carry groceries or look around probably feels natural. We train that kind of dual tasking on purpose, so it does not turn into a fall risk later.
Where falls tend to happen
Most falls happen during ordinary moments at home: turning in the kitchen, backing up to sit down, getting up at night, reaching into a cupboard. Knowing your own pattern is the first step in changing it.
If you have fallen, or caught yourself more than once in the past few months, mention it to your doctor and ask about a balance evaluation.
What physical therapy does
A balance evaluation finds out which of these factors is driving the problem for you. Then we train it directly.
- Bigger steps and turns. We practice large, deliberate stepping in every direction, using PWR!Moves.
- Reactive balance. We practice catching yourself, in a safe setting, so the quick step comes back.
- Strength. Strong hips and legs make every recovery easier.
- Strategies for freezing. Cues such as counting a rhythm, stepping over a line on the floor or shifting your weight before you step can help get you moving again.
- Getting up from the floor. Knowing you can get up takes away much of the fear.
Things you can do at home
These are general ideas. Your therapist can tell you which ones fit your situation.
- Turn in a wide arc and avoid pivoting on one foot.
- Clear walkways and remove loose rugs.
- Add a night light between the bed and the bathroom.
- Stop walking when you need to talk, read or look at your phone.
- Pause for a moment after standing up before you take a step.
Fear of falling counts too
Many people respond to a fall by doing less. Less activity leads to weaker legs and stiffer movement, which raises the risk further. Rebuilding confidence through practice is part of the treatment.
Balance evaluation in Santee
At Live Life Physiotherapy, care is one-on-one and in person, and Dr. Karl Burris, PT, DPT, is a PWR!Moves certified therapist. We are at 9225 Carlton Hills Blvd in Santee and see patients from El Cajon, Lakeside, La Mesa, San Carlos, and all over San Diego County. We accept Medicare and most PPO plans.
Learn more about our Parkinson’s physical therapy and our fall prevention and balance program.
Call (619) 800-8173 or request a call back on our contact page.
