I'm a sixty one year old Australian man who has exercised vigorously for nearly eight years despite Parkinson’s disease. I have no formal medical or paramedical qualifications so other than for some safety tips, my remarks are descriptive rather than advisory.
My exercise regime is not alternative medicine. I visit a neurologist and take the medication he recommends. He’s aware of my exercise habits.
At Christmas 1999 in an exchange of emails with a friend, I learnt that she had advanced breast cancer but was getting out each day and running as far as her energy permitted. Mary reminded me that long ago I’d been very fit.
Fit no longer. I was now flabby, overweight, and with little stamina after sitting down for most of the past twenty-five years to thirty years.
It was time to pull myself into line. Getting PD had been beyond my control. Succumbing to heart disease or stroke was largely within my control. For the latter conditions, we know we should eat less, lower the proportion of fats in our diet, and devote regular time to physical activity.
I knew that Parkinson’s disease was as yet incurable but wondered whether anything I could do might delay its symptoms?
In January 2000 my lifestyle changed. I located a gym and introduced myself. Michelle, the gym manager took seriously my wish to train hard. She certainly obliged me on that score. When she called for ten repetitions of some exercise, it was made clear that ten was not the same as nine. Michelle mapped out a program based on improved flexibility, improved stamina, and improved strength. She assessed my capabilities then set targets requiring near-maximum effort.
My routine was, and remains, based on improving flexibility, stamina, and strength. I speculated that stretching should ameliorate the rigidity of PD, running or riding would maintain my heart and lungs, and strengthening my body may delay a stooped posture. Regardless of its impact on PD, exercise could only be good for my general health.
As for anyone starting afresh on vigorous exercise it’s mandatory to ensure through a medical practitioner that our hearts are up to it.
Setting small targets has been critical to my improved performances. Focus on tiny gains in the near future rather than big goals in the long term. You can surprise yourself how far you reach. For example in 2001 I would have worked hard to bench press 60 kilograms (132 lbs.). By 2005 I’d achieved a bench press of 105 kilograms (231 lbs.). I weigh around 87 kilograms (192 lbs.).
My training regime has never been shaped specifically as therapy for Parkinson’s disease. Flexibility, stamina, and strength are as relevant for someone without PD as someone who has PD. Further, when exercising I work out vigorously. You’d get a very dark look if you told me to “take it easy.”
Specific weights exercises are not repeated at the next session nor are weights lifted on consecutive days. This helps prevent muscle soreness through overuse and helps retain enthusiasm. Each activity has a required time, resistance, or number of sets and repetitions. Discrepancies are marked when a target is significantly overachieved or underachieved. When a target is exceeded, the level reached becomes the new target. Around every six weeks, I analyse my performance on each routine, set new goals, and change some of the exercises.
I broke with this discipline for several months after shifting to a new gym this year. Performances were recorded without targets being set. Attained levels suffered. I’ve resumed the target-setting discipline that’s served me well.
My sessions last for around an hour. Typically, I stretch for around five minutes. Then I might take up to five to ten minutes “loosening up” with push-up variations or sit-ups on a fitness ball. For example, I’ll do three sets of push-ups, 25 being performed with feet on top of a 65 inch fitness ball and hands on the floor, 25 done with feet on a weights bench, then as many as possible done in standard position. Half an hour follows with weights, working on different areas of my body. I finish with around fifteen minutes on the treadmill or bike. The treadmill is my weakest exercise area. I run at 10 km./hr. for up to eight minutes before fatigue through shaking and rigidity in my right arm causes me to walk. I’ve set a goal is to run for ten minutes by the end of next month.
Whatever activity you choose, it has to be something you’ll enjoy. We’re not talking of a 10 week weight loss program or a 10 week program to make you look great in swimming attire. We’re talking of a lifetime habit that’s as normal as a daily shower. I go to a gym. You might prefer walking long distances, swimming, dancing, or something else. Just do it as vigorously as you can.
If increasing strength is an essential part of an exercise program then it’s just as important for women as men. Lifting weights as outlined here won’t make women look like Arnie.
If gym activity is your goal, gain advice on appropriate exercises and technique from someone qualified and working at a gym belonging to the relevant professional association.
Safety must be paramount.
· With a new weights exercise, commence with a weight well short of what you feel you can lift. Increase from there.
· Always ask that a “spotter” (an assistant) stands ready to help in lifts where the weight could fall on you. Pick a spotter who can lift more than you can. Otherwise, pick two.
· Never lift free weights above you when you’re alone in the gym.
· If you have problems with balance, hold on when on the treadmill or any other equipment from which you could fall.
· If it hurts, don’t do it. Stop immediately.
· If you become dizzy, stop. Find out why you became dizzy.
· If a muscle is sore, give it a rest.
Some tips I’ve found helpful include:
· Stretch at the beginning of your session.
· If you wish to emphasise the aerobic side, then do your cardio before the weights. If your focus is on beating your lifting targets, then do weights first but don’t ignore the cardio.
· Begin slowly with the cardio or lightly with the weights. My experience suggests that starting with lighter weights may be even more important for someone with PD. Our muscles are more rigid and may require more gradual stressing. Start at, say, 50% to 60% of your maximum. For example, my bench press routine is 8 x 60% of maximum, 6 x 70%, 5 x 80%, 3 x 90%.
· Don’t ignore resistance level when riding the static bike. Anyone can ride quickly downhill. On bikes with a resistance scale of 1 to 20, my default position is an rpm of close to 80 (it tends to wobble between 78 and 82) at a resistance of 12. I take three or four minutes to build up to 80 rpm. This default rate applies to me only. Other people will differ. My default hasn’t decreased in my years at the gym.
· Aim to strengthen a number of parts of the body during each session rather than concentrating on one area (e.g. arms). This should assist in preventing muscle soreness from overuse.
· Don’t bench press, leg press, or squat your maximum lift (the most you can do in one set of one repetition) more than once every 3-4 weeks. Our rigid muscles seem more prone to strain and may take longer to recover from peak stress.
· Work near your maximum. As a rule of thumb, an appropriate weight would be a level at which you fail at the end of three sets of eight to ten repetitions. As you become more experienced, you may increase the weights but lower the number of repetitions at your heavier weights.
· Record your performances. You will then more easily note whether there’s a problem through fatigue, medication off period, or something else. I have difficulty writing, so my targets are typed in 16 point size. I only write a notation when a target is over or underachieved.
· Don’t compare yourself with others in the gym. Your best effort is as good as someone else’s best effort.
· Wear clothing that is comfortable, clean and appropriate for what you’re doing.
In a report handed to Parkinson’s Australia in June 2007, Access Economics noted that death attributed to respiratory diseases had a 50% higher incidence in people living with PD than in the general Australian population. Deaths specifically from pneumonia and influenza were at double the rate of the general population. ( Access Economics, Parkinson’s: Economic Impacts and Positive Steps, 2007 ). The report can be found at: www.parkinsonsnsw.org.au > About Parkinson’s Disease > 2007 Report on PD (Access Economics)
This is confirmation enough for me that a little regular huffing and puffing is important for those of us with PD.
Whether or not vigorous exercise has slowed progression of my PD symptoms, I don’t know. My situation is that at 61 years of age, nine years after diagnosis, I remain working full time from my home office. I take one medication only, Sinemet, 100 mg. levodopa, 25 mg. carbidopa, at six tablets per day. I belong to my local Parkinson’s support group and served on Council of Parkinson’s New South Wales for two years until 2007.
I work out at Aquafit gym at Campbelltown, New South Wales at: http://www.cathclub.com.au/index.cfm?page_id=1079
Generous assistance has been given to me in exercise nomination and technique by gym staff. I’m also indebted to the excellent website of Krista Scott-Dixon in Toronto at: www.stumptuous.com
This article has been written as general observations only. Seek professional advice for your own situation.