“I’m 80 years old. Three years ago, a doctor told me he would write a prescription for a walker for me. That woke me up. I started a supervised weight-lifting program and am more stable and healthier than I was three years ago. If you look closely, I even have new muscles. Please tell your readers that even at 80, weight-lifting exercises really work. I threw the walker prescription away.”
—TERRY Z., PWP
Some of the first noticeable changes with Parkinson’s are postural. The typical Parkinson’s posture includes a forward head, rounded shoulders, curved upper back, and bending of the elbows and knees. All of these posture problems can make it difficult to breathe deeply and swallow, as well as speak clearly and loudly. Balance and the ability to move can also be affected, which increases the risk of falling.
Following are some tips and exercises to improve your posture.
Poor posture often results from decreased activity. If you aren’t moving much, your muscles and joints tighten up and can prevent you from standing or sitting as comfortably as you did before. Flexibility and stretching activities can help maintain good range of motion in all of your joints. Stretches that focus on opening the chest, neck, and upper back are good for helping to correct a forward flexed posture.
There are many different types of exercises you can do to keep your muscles strong. If you have access to a physical therapist, you can ask for an exercise plan tailored to your specific needs. If you have access to a gym, you can ask one of the trainers to help you choose the right exercises as well.
One thing you will want to focus on is improving the strength of your back muscles, which often become weak in people with PD. This will help your posture by keeping you upright for a longer period of time. Below are three strengthening exercises.
The goal of shoulder blade squeezes is to decrease the rounding of the shoulders. To start, sit or stand as straight as possible with your arms at your sides. Bend your elbows to 90 degrees. Pull your elbows back in a rowing motion and squeeze your shoulder blades together. You might notice that your shoulders are flexing up toward your ears in a shrug-like position—try to avoid this. Keep your shoulders down and relaxed and only move through the range of motion you can comfortably complete. Repeat 8 to 12 times.
You can also do this exercise with an elastic band, which can be purchased at any sporting goods store. First, wrap the band around a sturdy object at waist level, then grab each end of the band. With your arms at your sides, bend your elbows to 90 degrees, then pull the band back to move your shoulder blades toward each other. Return to the starting position and repeat 8 to 12 times.
The chin tuck is a simple, low-impact exercise that can help decrease forward head posture. You can do chin tucks when you are sitting or standing (or even lying down). When you’re standing, always picture yourself as standing tall with your shoulders back, head up, and chest out. When you’re sleeping, use only one pillow to support the small of your neck.
To do a chin tuck, gently pull your chin back and straighten your neck. Make sure you don’t tip your head back when you do this. Hold this position for five seconds, then relax. Try not to let your head drop all the way forward again when you relax.
The thoracic spine is composed of the 12 vertebrae of your upper back, ranging from your mid-back up to the line of your shoulders. Tightness or weakness in this area can cause pain, slumped posture, and discomfort with sitting and standing. If you are noticing a rounding of your upper back, then you may need to incorporate a thoracic strengthening exercise.
Thoracic extension can be done anywhere you have a good chair with a low back. While seated, clasp your hands behind your head with elbows wide. Slowly lean back over the edge of the chair, extending your upper back. When you’ve reached a position in which you can feel a stretch but no pain, tilt your chin up toward the ceiling. Inhale and exhale slowly, return to upright position, then repeat 5 to 10 times.
To help you maintain proper posture with Parkinson’s, you may want to add a yoga or tai chi class to your weekly exercise regimen. In addition, there are several PD exercise DVDs available that you may find helpful. You can find them by searching for “Parkinson’s exercise DVD” on Amazon.