Running and Parkinson’s Disease

Many people enjoy the effects of running on their daily lives and many regular runners participate in running events throughout the year. Running is not only a form of regular exercise, for many it is a way of life. What happens when you are suddenly diagnosed with a neurodegenerative disease such as Parkinson’s Disease? Do you need to immediately discontinue running? Not necessarily. Here are a few topics to consider when discussing with your medical team if running is safe to continue.

Parkinson’s Disease is marked by festinating gait, postural instability, bradykinesia, rigidity, and tremor but it can be accompanied by many other symptoms such as poor proprioception, impaired center of gravity, excessive anterior lean, excessive posterior lean, dyskinesias, poor balance, vestibular dysfunction, impaired trunk rotation, absent reciprocal arm swing, freezing episodes, limited ankle dorsiflexion at heel strike. Every person with Parkinson’s Disease presents differently and has a few of these symptoms but not necessarily all of them.

High intensity exercise has been proven to be neuroprotective against Parkinson’s Disease and can prevent quick decline in mobility, enhancing functional mobility over a longer period. Running can be a form of high intensity exercise for those who have been long time runners. For those who are newly diagnosed with Parkinson’s Disease and have mild deficits, running might be safe to continue.

Falls

One factor to consider is how many falls have you had and have any of those falls been while running. If you have not had falls running and have close to no falls otherwise, running with Parkinson’s Disease may be a safe activity to continue.

Balance

Balance is the ability to keep oneself upright and steady with either static or dynamic movements. When balance is impaired to a certain amount, there is a higher risk of falling. If you still have relatively good balance, running may be safe to continue. It is worth getting a formal assessment from a physical therapist to determine how good your balance is. You may think your balance is great but when challenged in various ways, you may feel otherwise.

Toe Floor Clearance

Another factor to consider is toe floor clearance while running on various surfaces. Typically gait becomes shorter, smaller, and slower with Parkinson’s Disease and this can occur with running as well. If you are finding yourself tripping over yourself or scuffing the floor while running or walking, running may not be safe to continue. This can contribute to a higher risk of falls.

Anterior lean

While running, are you able to have a controlled stop without continuing forward? Some people experience a forward lean in which their center of gravity is more anterior causing a feeling of falling forward. With this forward lean symptom, it is difficult to stop from running and the body just continues moving forward until you stop yourself with your arms or someone else. In this case, running would not be safe to continue for the higher risk of falling when starting to run but the inability to stop safely on your own.

If you have no history of falls while running, have relatively good balance, good toe floor clearance in running and walking, and do not have an anterior lean, then running may still be safe to continue.

But what if running is not safe to continue? What form of high intensity exercise can you safely perform? Some great alternatives for aerobic exercise include walking for exercise, a stationary bike, an outdoor tricycle (electric options), and a stationary nu-step machine. Movement specific exercises such as BIG program exercises, PWR! For Parkinson’s exercises, and Tai Chi are a great addition to aerobic exercise to provide neuroprotective effects and enhance functional mobility.

If you are concerned if running is safe for you after being diagnosed with Parkinson’s Disease, I highly recommend having a discussion with your neurologist, physical therapist, and family.

DISCLAIMER: This is not formal medical advice. Please consult your medical team including your neurologist and your physical therapist to determine if running is safe to continue after diagnosis of Parkinson’s Disease.

I am a LSVT BIG certified clinician and a Doctor of Physical therapy and I have been working with patients who have Parkinson’s Disease for 8 years. In the clinic, I work with patients across the spectrum from high level to low level. I have worked with many runners and athletes with Parkinson’s Disease.

References:

Chogle, Riya, et al. “Effect of Lee Silverman Voice Therapy (LSVT) BIG Exercises on Functional Gait Performance of Parkinson’s Disease Patients.” International Journal of Health Sciences and Research, vol. 10, no. 6, Galore Knowledge Publication Pvt. Ltd., Jan. 2020, pp. 75–83. www.ijhsr.org/IJHSR_Vol.10_Issue.6_June2020/12.pdf.

Koop, Mandy Miller, et al. “Mobility Improves After High Intensity Aerobic Exercise in Individuals With Parkinson’s Disease.” Journal of the Neurological Sciences, vol. 399, Elsevier BV, Apr. 2019, pp. 187–93. https://doi.org/10.1016/j.jns.2019.02.031.

Fernandes, Bianca, et al. “High-Intensity Interval Versus Moderate-Intensity Continuous Training in Individuals With Parkinson’s Disease: Hemodynamic and Functional Adaptation.” Journal of Physical Activity and Health, vol. 17, no. 1, Human Kinetics, Jan. 2020, pp. 85–91. https://doi.org/10.1123/jpah.2018-0588.

Mohammadi, Ziya Fallah, et al. “Comparing the Effects of Progressive and Mild Intensity Treadmill Running Protocols on Neuroprotection of Parkinsonian Rats.” Life Sciences, vol. 229, Elsevier BV, July 2019, pp. 219–24. https://doi.org/10.1016/j.lfs.2019.05.036.