Following Exercise Guidelines (or trying!)

Exercise used to be something I did to stay in shape and lose weight. I never gave it too much thought. I would go for a run when I felt like it, hop on my bike for a ride when I had the occasion, do some push-ups or sit ups when I was in the mood, take a hike with my kids when we had some free time together… You get it.

I was neither averse to nor in love with exercise.

Parkinson’s changed all that. I now see exercise as one of my chief coping mechanisms. It helps me keep my meds down to a minimum, stave off depression, build my appetite for healthy food, and get a good night of sleep.

Still, I’ve struggled in the area of setting goals for exercise and sticking with them. The daily demands of life, kids, unforeseen challenges, etc., often make it hard to maintain a regimen. 

Part of the challenge has been to know which exercises are most effective and for what duration and intensity. Sure, it’s a good idea to exercise in general, but when you have Parkinson’s it is imperative to know what exercises are most likely to help you with your symptoms and with the disease itself.

After all, your time and energy is limited so you want to make sure that you’re using them to good effect when you do exercise.

That’s where having guidelines can be extremely helpful. The Parkinson’s foundation has issued new recommendations for exercise based on research and the expertise of top health and medical professionals.

Let’s take a quick look at the guidelines and I’ll tell you what I’ve been doing that is or is not consistent with them. This will give you one real-world example of someone trying to do the right thing for his Parkinson’s when it comes to exercise, sometimes succeeding and at other times falling short.

Overall Exercise Guideline

The guidelines recommend 150 minutes of moderate to vigorous exercise per week for people with Parkinson’s. (Parkinson’s Foundation)

I have been fairly successful with this overall guideline and I make it a goal to get a minimum of 150 minutes of exercise per week. I don’t always break it up the same way. Sometimes I do 60 minutes three times a week, and other times 30 to 45 minutes four or five times a week.

I never exercise seven days a week, although I do sometimes exercise on consecutive days. I like to give myself breaks allowing my body to recover instead of pushing myself too hard. That said, I’ve been meaning to use the days that I don’t exercise to do things like stretching, yoga and get back to practicing Tai Chi, which has also been found very beneficial for people with Parkinson’s.

Aerobic Exercise Guidelines

3 days a week for at least 30 minute per session of continuous or intermittent movement at moderate or vigorous intensity. (Parkinson’s Foundation)

The aerobic guidelines are my personal priority simply because I feel like they give me the most tangible and beneficial effects. I alternate between using the elliptical, riding a stationary or road bicycle, rowing, boxing, jump roping, and running.

I like to mix up what I do because it makes things interesting instead of becoming just a routine chore. It also keeps me challenged cognitively when I do different exercises since each one places different demands on the brain and body. Aerobic exercises help me loosen up my muscles and joints and get my dopamine fired up so that I can overcome my stiffness, at least for a while.

Strength Training Guidelines

Strength training: 2-3 non-consecutive days per week of at least 30 minutes per session for 10-15 repos for major muscle groups; resistance, speed, or power focus. (Parkinson’s Foundation)

This is the one where I’ve been really falling short lately. There are number of reasons. One is just plain lethargy, as there are many days when I lack the spark to get myself to do strength training. I really prefer strength training in group classes so when I don’t have access to those, I either have to go to the gym and do solo workouts or push myself to do the workouts at home. (There is, of course, the Zoom option which I took advantage of during the height of the pandemic lockdowns and is now regularly available.) Also, I find that when I do strength training, the long-term effects might be desirable but in the short-term my symptoms are actually exacerbated.

In the past I have done some strength training with physical therapists and obtained great results, but currently it’s difficult for me to take the time to go to one on a regular basis. These are the kinds of trade-offs we have when it comes to Parkinson’s, right? You need to find the time and energy to take care of yourself.

Balance, Agility and Multitasking Guidelines

Balance, agility and multitasking: 2-3 days per week with daily integration if possible. (Parkinson’s Foundation)

The guidelines recommend activities like yoga, Tai Chi, boxing and dance, some of which I do as I previously mentioned. I try to integrate balance, agility and multitasking activities throughout the day, every day of the week, by challenging myself to do things like manually brushing my teeth, putting on my clothes while standing on one leg, throwing a softball with my daughter, cooking a meal, etc.

Some of these things may be hard to do for people with more advanced Parkinson’s but I think it’s important to try to maintain an independent mindset and avoid becoming too complacent and reliant on others, if possible. Do what you can but don’t resign yourself to feeling overly limited, so keep pushing yourself!

As for technology, it can be a friend or foe. Electric toothbrushes are great, for instance, yet they may deprive you of an opportunity to use your hands in ways that really help keep them flexible and build those neural pathways that allow you to maintain a degree of functionality. For instance, I’m convinced that  brushing my teeth with a hand toothbrush has helped maintain my handwriting.

Stretching Guidelines

Stretching: 2-3 days per week with daily stretching being most effective. (Parkinson’s Foundation)

This is the one I do quite well when I go to the gym and take classes but otherwise fail miserably to do at home on my own. It makes zero sense because I immediately feel the very positive effects of stretching and there are simply no excuses for not doing it.

These are low impact exercises, there are tons of YouTube videos to help you do them the right way, and stretching may help you identify areas of movement that might be experiencing additional difficulties you could have otherwise overlooked.

Stretching also has a meditative effect, helping keep your mind and body balanced. I think I just sold myself on getting my act together by stretching on a daily basis every morning when I get up!

So much to do!

The bottom line of exercising when you have Parkinson’s is this. It’s hard to keep up, there’s a lot of things you need to do to meet the guidelines, and it can feel overwhelming. But — you owe it to yourself as a person with Parkinson’s to get started and do the best you can to follow these guidelines

Take it from me, as someone who is not meeting all of the guidelines but believes in following them as best he can, they really work. They may not cure your Parkinson’s but they sure will help you feel like you have some agency over it.

Worst case, you do something healthy for yourself. Best case, you actually slow down the progression.

Just be careful when you do the exercises! Don’t push yourself too hard and don’t do anything challenging or unfamiliar without someone, preferably a physical therapist, to assist.

 Good luck! (Now going to go do some push-ups :-)