I’m uncomfortable going to the gym and I don’t know what to do once I get there, can you tell me what I should be doing?
Thanks for the question, and it’s a big one that requires more detail than I’m able to provide on an Ask Patrick, but I’ll try to give you a few ideas of exercises to perform that help with Parkinson’s symptoms, and exercises to avoid as well.
I also refer you to the many articles I’ve posted on my website that detail physiological objectives and points of focus for people living with Parkinson’s disease.
Being uncomfortable at the gym is not uncommon, even for those who do not live with Parkinson’s. I’d recommend getting a good set of headphones and slap them on with a song list of your favorite music or even a book on tape.
Immerse yourself in this and ignore the surroundings exercisers as much as possible. You have as much right to be there as they do and nobody’s perfect.
In addition to maintaining a Parkinson’s specific strength and flexibility program, you should also maintain a cardiovascular training program to be performed 3 to 5 times per week for 25 to 40 minutes.
Any mode of exercise you enjoy is fine, power walking or pole walking, biking, treadmill, elliptical, swimming, boxing, etc. Your level of intensity should be anywhere between 6 to 8 on a 10 scale, 10 being the most intense possible.
Don’t be intimidated by this schedule, this is intended to be something you will build up to. Depending on your current activity level, a 5 minute bout of exercise performed a few times throughout the day may be an appropriate place to start.
In addition to your cardio you’ll want to maintain a functional strength training program as well. Resistance training or weight bearing exercises are my favorite for PWP because they often involve function movement patterns that expand range of motion and require repeated neurological navigation of the body through patterns, precise movements and pace controlled repetitions.
Free weights are fine unless there are range of motion limitations or motor control issues such as tremor or dyskinesia. In this case, weight machines are the most safe and effective substitute.
Exercises to avoid
It’s not necessarily true that these exercises would be bad for you, but as a PWP who maintains a strength training program, your primary objective is to maintain or improve your function. These are exercises I have found to be a waste of time, or rather, there are other exercises that address these muscle groups more effectively.
I can think of rare exceptions to both of these, but this should hold true for the majority of PWP
1. The Benchpress. Although the bench press involves a very common functional movement for the upper body, the bench provides artificial stabilization of the spine which means you’re wasting time training only your chest and arms when you could be simultaneously training the muscles that support the spine and posture.
Replace this exercise with either a standard push up or a modified push-up (on your knees instead of toes). You will also avoid putting on bulk on the chest which is something you definitely want to avoid if you have Parkinson’s.
Muscles on the chest and the anterior part of the body tend to become tight and short so the last thing you want to do is add bulk. Another great substitute or addition is the bear crawl which, when performed correctly, reinforces reciprocal leg and arm pattern of walking.
2. The Bicep Curl
Another nice functional pattern for the arm and upper body, but really a waste of time for someone with PD. You’ll be training your biceps whenever you perform a pulling movement such as a row or a pull down, and this should adequately train the bicep for functional activities.
If you are determined to perform bicep curls, combine them with an alternating step back lunge so it’s more of a full body strengthening routine. This will be much more functional and useful for coordinating movement, balance and neuroplasticity as it’s a complex and sophisticated movement for the body.
If you’re having trouble getting started with an exercise program and can’t afford a personal trainer who understands Parkinson’s disease, try an exercise class or ask your doctor for a prescription for physical therapy and find a therapist who works with PWP. IMPORTANT: Make sure the therapist provides you with a discharge program for you to maintain on your own once your therapy has concluded. They should be willing to do this.
There are also exercise DVDs available online that are Parkinsons specific if you’d rather workout in the comfort of your home. There are three different Parkinson’s DVD programs available to you on my website if you’d like to try my approach.
I also teach a Parkinson’s exercise class at the Westside Jewish community center on Wednesdays and Fridays at 10:30 am.
I hope you find this article useful. Keep moving, and keep the great questions coming. I will see you at the gym!
Ask Patrick is an advice/opinion column based on my experiences working with people with Parkinson’s disease as a trainer and an advocate. It is not intended to replace the instructions of your doctor. Always consult with your doctor if there is a change in your status or if you have questions about their instructions. All exercise has an inherent risk of injury so proceed cautiously.