| What We Treat
Parkinson’s Disease
Big, deliberate, high-effort movement counteracts the shrinking that Parkinson’s produces. It works, and it needs to be practised at intensity.
Overview
What It Is
Parkinson’s disease reduces dopamine production in the brain, which affects the automatic scaling of movement. Movements become progressively smaller and slower without the person noticing, because the internal sense of how big a movement is has itself been recalibrated. Treatment works by deliberately overriding that with large, high-effort, externally cued practice.
Deliberately Oversized Movement
Movements shrink without you noticing because the internal sense of size is recalibrated. Practising big overrides it.
Symptoms
How It Tends to Feel
These are the features that point towards this diagnosis rather than another:
Slowness of Movement
Bradykinesia. The defining feature, and often first noticed by family.
Reduced Stride
Steps becoming shorter and shuffling, with reduced arm swing.
Tremor
Classically at rest and one-sided at onset. Not present in everyone.
Rigidity
Stiffness through the limbs and trunk.
Freezing
Feet feeling stuck, particularly in doorways, on turning, or under time pressure.
Balance Changes
Emerging later, and the main driver of falls risk.
Causes & Risk Factors
What Drives It
The usual contributors, in rough order of how often they turn out to matter:
Dopamine Loss
Progressive loss of dopamine-producing cells in the substantia nigra.
Age
The strongest risk factor, though young-onset Parkinson’s occurs.
Genetic Factors
A minority have an identifiable genetic contribution.
Environmental Exposures
Some pesticide exposures are associated, though causation is not established.
How We Can Help You
Treatment & Management
Treatment is built around what the assessment finds, but generally follows this shape:
When to Seek Help
Red Flags — Don’t Ignore These
Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:
⚠ Seek Medical Advice If You Notice
- A fall causing injury, or a sudden increase in falls
- Swallowing difficulty or choking
- Sudden marked deterioration, which may indicate infection rather than progression
- New confusion or hallucinations
If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.
Common Questions
Frequently Asked Questions
Does exercise slow the disease?
Vigorous exercise is associated with slower progression in the research, though it is not proof of cause. What is certain is that it improves walking, balance and quality of life.
Why do I freeze in doorways?
Narrow spaces and turns demand a change in movement pattern, which relies on the automatic system that Parkinson’s impairs. External cues bypass it, which is why counting or stepping over a line works so well.
How often should I exercise?
Most days, and it needs to feel effortful. Gentle activity maintains but does not build. Intensity is what makes the difference.
Not Sure If This Is What You Have?
An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.