Feet problems and Parkinson's

Physiotherapist Bhanu Ramaswamy admits to being in awe of feet “in a way that only a physio, a podiatrist or Prince Charming can be!” In this feature Bhanu explains why she thinks you should pay them more attention.

Next time your feet are bare, take a good, long look at them. Marvel that under your skin are 26 bones of the ankle and foot (that’s nearly a quarter of the total number of bones in your body), 33 joints and more than 100 muscles, tendons and ligaments. These individual parts work together to keep your whole body balanced upright when you are stood on top of them.

As we age, natural changes occur in our feet, as well as alterations brought about by the shoes we wear, our activity habits, work patterns and any medical conditions we develop. Each of these stress the foot in different ways. Some can change the shape of our feet over time and also change the effectiveness of how we move, including our balance.

How can Parkinson’s affect your feet?

Many people with Parkinson’s gradually develop a stooped posture, which affects the feet in 2 ways.

Firstly your body compensates for your weight being held more to the front of your feet, and causes your toes to ‘claw’ as they grip the ground or your footwear. Over time, your toes get stuck in this position and cannot flatten properly to help you keep your balance.

The second change is in the length of the muscles around your ankle to cope with the shift in your weight. The changes in position mean that some muscles get stretched, while others shorten. Both of these changes alter how efficiently you walk and mean you don’t put your heel down first as much as you used to.

The heel striking the ground is the body’s signal to the brain to generate the power to push forward. If you’re not doing this it means that your steps will be shorter, you’ll have less power to propel yourself and it will be harder to balance when standing on 1 leg to step the other forward. 

People with Parkinson’s can also experience balance problems if their brain isn’t receiving the right messages from their body about movement and which areas are bearing weight. This means the brain can’t work out how to move the body safely. Without signals from the rest of the body, the brain resorts to judging things visually. For example, looking at the ground while walking, rather than looking straight ahead.

Muscle strengthening and balance exercises can help with this issue, but it’s important to get professional help to understand which areas of your body you need to work on.

If the condition of your feet affects how your body moves, and therefore affects your safety when walking, ask your GP if you can be referred to a physiotherapist who specialises in neurology.

Feet exercises to do at home

Exercise 1

  • Stand upright beside a chair or table, with your feet a few inches apart.
  • Gently move your weight forwards, making sure your toes do not curl and your heels remain on the floor.
  • Stay in this position for 5 seconds before moving back to upright. Again, keep your feet glued to the floor – don’t allow your toes to lift.
  • Repeat this exercise a few times, forcing your feet to relax as your body is slowly moved over them in a controlled manner.

Exercise 2 (good for swollen feet)

  • Sit on a chair and bring 1 foot up to rest on the other knee.
  • Gently massage the soles of your feet in a long, steady stroke from the base of the heel to the end of each toe.
  • Do this 5 times on each foot to stretch and loosen the skin, muscles and joints.
  • If you have become stiff at the knees and hips, you may find getting into this position difficult.
  • It’s worth practising, but if it’s not possible, see if you can find a willing friend or family member to massage your feet for you!

Read more about footcare and Parkinson’s