Physiotherapy

A physiotherapist (often called a physio) is a healthcare professional who helps keep people moving and functioning as much as possible when they have a long-term condition like Parkinson’s, or an injury or illness. They’re part of your ‘multidisciplinary team’ – the group of healthcare professionals who can help you manage your condition.

NHS physiotherapists work in lots of different settings, including hospitals and outpatient clinics, as well as community settings, such as care homes, GP surgeries, and people’s own homes. However, there may be a waiting list for their services. There are also a number of physiotherapists based in private clinics and some make home visits.

Clinical guidelines recommend that your GP, specialist or other healthcare professional considers referring you to a physiotherapist with experience of Parkinson’s when you’re in the early stages of the condition for assessment, education and advice, including about physical activity. The guidelines also say you should be offered physiotherapy if you have balance or movement problems.

They also recommend considering the Alexander Technique. This teaches you how to change your movements to help relieve stress and tension in your muscles. Other techniques, such as Pilates, also do this.

We recommend that you ask your GP, specialist or Parkinson’s nurse about a referral for physiotherapy as soon as possible after your diagnosis. In some areas, you can refer yourself at the local hospital or a community health centre, depending on the type of service available. If you’re referred to an NHS service, there may be a waiting list for appointments.

You can also self-refer to a physiotherapist in private practice, which you will need to pay for. The Chartered Society of Physiotherapy can help you find a private physiotherapist. 

Some Parkinson’s UK local groups have group sessions led by a physiotherapist – check with your local group for details. 

What type of physiotherapist should I see?

Any physiotherapist you see should ideally specialise in Parkinson’s.

Like many other healthcare professionals, physiotherapists specialise in different areas of practice. Some work specifically with people with neurological conditions like Parkinson’s, and some have additional qualifications in exercise and fitness training, especially those working in gym settings.

Your physiotherapist will assess how Parkinson’s affects your movement, whether you’re newly diagnosed, or you’ve had the condition for some time. This means they can help to keep up your fitness levels, and maintain good posture and balance as your condition progresses. This will help you remain independent.

You may feel that your mobility is very good and that you are keeping active without any problems. But a physiotherapist can also help you maintain your mobility to help avoid any future issues.

Your physiotherapist should form part of your support network, involving your family and carers, in helping you manage your Parkinson’s.

Seeing a physiotherapist can have a number of benefits for people with Parkinson’s and their carers. These are outlined below.

Helping you stay independent

People with Parkinson’s say certain movements become more difficult as the condition progresses. These include turning in bed, walking, and sitting down and standing up (especially to get into and out of a car). Your physiotherapist can teach you techniques to help make these movements easier.

A physiotherapist or an occupational therapist can also give advice on daily living equipment you could use or alterations you could make to your home to make it easier and safer to move around.

Always check with a therapist before you buy any piece of equipment or assistive device. Parkinson’s affects everyone differently, so what might work for one person may not suit another.

Equipment may also help your carer. See our last section for more information.

Helping to prevent or manage falls

Your physiotherapist can work with you on strength and balance training to improve any problems you may have with walking, especially when you’re turning.

People who experience freezing, or who are stiffer or weaker, are more at risk of falling.

Your physiotherapist can help you improve your confidence and reduce any fear of falling. They can also teach you techniques to help you get down safely on to the floor, and up again if you fall. Often, a physiotherapist will work with an occupational therapist to help you remove any tripping hazards from your home.

Providing pain relief

Parkinson’s can cause different types of pain. A physiotherapist can assess your pain to try to find the cause. Your physiotherapist can use different methods to help ease pain in your muscles and bones (musculoskeletal pain), and from involuntary muscle spasms (dystonic pain). These include manual therapy and stretching, as well as applying heat or cold to the affected area.

Not all pain is related to Parkinson’s, and you may have a condition like arthritis, or another injury that needs physiotherapy. So it’s important to mention any specific pain apart from your Parkinson’s to make sure you get the right support for you. 

Many physiotherapists are trained in complementary techniques such as acupuncture, which may also help to reduce pain.

Maintaining or improving effective breathing

Parkinson’s can cause stiffness in your chest muscles and make them weaker. This may lead to chest infections. A physiotherapist can use positioning therapy or other techniques, which focus on your posture, to help clear phlegm and keep your chest clear.

Speech and communication issues in Parkinson’s are common and can often relate to your breathing. A physiotherapist can teach you how to strengthen your chest muscles, and provide breathing exercises to improve your breathing pattern and volume. This can also help if your voice has become softer.

If you find that you have specific problems with your voice, a speech and language therapist can help.

Physical activity is good for you and it’s particularly good for you if you have Parkinson’s. Being active for 2.5 hours a week can help manage Parkinson’s symptoms, and has a positive impact both physically and mentally.

The activity you do can suit you and your condition. An intensive group exercise class could help manage mild symptoms or chair-based exercises at home could target complex issues.

A physiotherapist with expertise in Parkinson’s can give you advice and support about what will help you. They could give you an exercise programme to follow at home if you prefer to exercise alone. Or, they may give you advice on sports you can do, like golf, or an exercise class you could join, like yoga or tai chi.

They can show you how to stretch and move to keep your joints and muscles flexible too. This will help relieve stiffness and slowness, and help you move more smoothly.

As well as helping with your symptoms, physical activity can help with your general health, boosting your circulation and helping prevent heart and lung disease.

Physical activity can also help you manage stress and fatigue and boost your mood. It can help you sleep well too. The more you can do, the more benefits you’ll get.

Find out more about the benefits of physical activity and the different types to focus on. 

If you’re a carer and help a person with Parkinson’s move around, it’s important that you get advice from a physiotherapist about caring for your own body, most importantly your back.

A physiotherapist can also give you advice on the best way to help the person you’re caring for to move. If the physiotherapist recommends exercises to the person you care for, make sure you understand them. This will mean you can support the person with Parkinson’s to get the most out of them.

If it becomes necessary to have equipment in the house to help you with these tasks, a physiotherapist or an occupational therapist can advise you on the most suitable type to use and the best places to put it.