Pilates Exercise for Parkinson’s Disease
By Valerie Johnson, PT, DPT and Chrystal Kafka
Is Pilates good for Parkinson’s you ask? The answer is… Sometimes.
I’ve teamed up with the wonderful
Chrystal Kafka to tackle this Pilates/ PD predicament. She is a Pilates
instructor who also has Parkinson’s disease. As a Parkinson’s physical
therapist and Pilates instructor myself, we can help you optimize your exercise
program with a modified Pilates practice for PD.
We’ve applied PD-specific, research-based exercise principles to Pilates to help you maximize the benefits of your practice, drive back, and stave off your PD symptoms. If you are a fan of Pilates, there are special considerations for Parkinson’s. Sit back, take a deep, diaphragmatic breath and learn from the pros.
No single exercise program can check
all the PD boxes. This is great, because with the amount of exercise people
with Parkinson’s need, variety and choice is a plus. Exercising good
PD-specific exercise principles is important when practicing Pilates. For
people with Parkinson’s, there are some Pilates exercises that you should avoid
and others on which you should capitalize. Furthermore, Pilates instructors are
not given extra training in teaching people with PD. Therefore, it is helpful
for you to know some simple Pilates do’s and don’t’s so that you can advocate
for yourself and reap all the benefits of exercise for PD.
Before we dig deeper into this subject. Remember to check in with your Parkinson’s physical therapist every 6-12 months to keep tabs on the quality of your movements and your PD symptoms at bay. Pilates should be considered one of your exercise maintenance programs between stints of physical therapy and not a substitute for it.
Find a Parkinson’s Physical Therapist in
your area here.
1. Building Neuro-pathways
Now THIS is where the magic happens for
people with Parkinson’s disease. Pilates is known for its positive effect on a
person’s physique. But let’s take a moment to consult your inner nerd and
consider its effect on the brain. Pilates involves whole body coordination and
timing, it can be a great tool for re-educating and re-wiring the neural
connections in your brain to make movement easier. Focusing your attention on
executing simultaneous trunk and limb movements required for Pilates carries
over into your daily life activities. For example, this skill enables you
to change positions with more ease in bed, in/ out of chairs, initiating walking,
and changing directions while walking.
These are transitional movement skills that become more challenging with the progression of PD. However, it is also a skill that you can relearn and maintain with practice. It may seem like you are going to extreme measures, but moving in novel and intentional ways is a fantastic way for your brain to learn new skills and maintain functional mobility. If the movements feel unnatural at first, you are probably doing something right. The goal is to use Pilates and other forms of exercise to get your brain’sattention, and then keep it by practicing over and over with effort!
Beyond Your Perceived Limits and Building Body Awareness
The very nature of Parkinson’s disease robs you of your ability to accurately perceive the quality of your movements. Larger and faster movements are challenging for people with Parkinson’s because the disease interferes with their ability to know if they are moving adequately. Building body awareness is 90% of the battle for people with PD. Pilates has moving and stationary straps, bars, handles, and platforms that can provide support and feedback while you intentionally stretch beyond your perceived limits.
Alone is Lonely
Remember, your brain gets a boost when
the activity is fun, fabulous, and social. Not just that,
but work out buddies compel you. Encourage you. It’s an amazing phenomenon that
I’m sure you’ve witnessed and is too important to disregard. Working out with a
Parkinson’s pal is even better, so if you don’t have any, Pilates could be a
great opportunity to partner up with another exerciser with Parkinson’s. We
know you aren’t alone in your fight against Parkinson’s, and you don’t have to
be. In summary, your Pilates practice should feel more like a dance party and
less like an individual sport.
With this in mind, at-home fitness
videos may not be the best choice for people with Parkinson’s disease. As part
of your overall PD fitness program, try setting up Pilates with a certified
instructor to cheer you on and help you maximize all the amazing benefits
Pilates has to offer. It is more advantageous for persons with
Parkinson’s to rely on a certified Pilates instructor to give you visual,
verbal, auditory, and hands on feedback, especially if you are new to Pilates.
As you gain experience and improve your ability to perceive your own movements,
you can graduate to duets, trios, or classes with occasional privates to keep
your movements and body awareness on point. Pilates duets and/or group
equipment exercise classes great ways to work out in the company of friends.
Sounds simple enough, right?
Diaphragmatic breathing is a complex subject and is invaluable to people with
Parkinson’s disease. Pilates is a mind/ body exercise, meaning the goal is to
use your breath as a guide for your movement. For example, you inhale as you
expand your body and exhale as you contract your body. It’s good to challenge
your brain to plan and execute movements while breathing at the same time.
Additionally, deep inhales and prolonged exhales are an effective way to calm
the nervous system and help you relax, which primes the brain to better learn
new movement skills. Utilizing breath is a wonderful way for anyone to stay
present and on task, and people with Parkinson’s get a brain boost from
While shallow breathing can promote
body tension, deliberate and deep breathing can make movement and speech feel
more automatic and add some much needed pizzazz to your movements. Vocalizing
your exhales with a sustained vowel sound. Perhaps and easier way for people
with Parkinson’s disease to promote relaxation, rhythmic breathing, and
diaphragmatic engagement is by vocalizing sustained “SSSSSSSSSS” sounds with
Pilates is a whole body exercise
program, meaning it engages multiple muscle systems at once. It’s good for your
Parkinson’s brain to practice using multiple muscle systems simultaneously,
just as you need it to do in daily life. By using the muscles required for
speech, breathing, posture, and limb coordination all at once, Pilates can help
person’s with Parkinson’s power through life with more finesse.
and Strengthening- Building muscle strength, upright posture, and range of
Now, this is where it gets tricky.
Pilates can be a great tool to hit PD right where it hurts by targeting the
muscles that get overly tight and weak. However, without the proper
PD-specific exercise precautions and a practitioner who specializes in PD,
Pilates can strengthen and stretch the wrong muscles and perpetuate the
symptoms and progression of PD such as stiffness, slowness, and stooped
The goal with any PD specific exercise
program is to stretch and open up the muscles in the front of the body and
strengthen the muscles in the back of the body that hold our posture upright
against gravity. Additionally, spine flexibility and core strength are vital if
you want to move with more ease and preserve your upright posture. All of these
components of movement can be well addressed with an informed PD-specific
In Pilates, there can be too much
emphasis on front body muscle contractions (think classic “Hundred” exercise in
the warm up. It is the exercise I’m demonstrating at the photo). This makes the
muscles in the front of the body overly strong and tightly bound. People with
Parkinson’s already have a tendency to be too tight and strong in these muscle
groups, especially in the hip flexors, trunk, pecs, and shoulders. Contracted
and tight muscles in the front of the body can promote rolled shoulders,
forward head, forward chin posturing and neck tension, and result in, you
guessed it, more stooped posture.
6. Keeping It
Movement timing is important and
degenerates with the progression of PD. For example, simple movements such as
walking and swinging your arms requires an internal sense of rhythm. Traditionally,
Pilates is not performed to music or sounds. However, for people with
Parkinson’s disease, adding rhythmic cues such as music or a metronome could
set you free.
Cardio in Your PD Workout Regime
We know that cardiovascular exercise increases blood flow to the brain and ignites its attention and memory centers. It’s important to balance your PD exercise regime with cardio. This makes it easier for you to learn and keep new functional movement skills.
If you are familiar with Pilates, the Pilates jump board is one way to bring in cardio. However, we do not recommend jump board activities for PWP, especially while laying on your back, as these exercises can promote muscle tension and foster rigidity for people with PD. Keep in mind, if you aren’t getting enough cardio from your Pilates program, you need to get it from another exercise mode you love such as running or cycling, etc.
There you have it. This article should be considered a broad heads up and not a comprehensive guide for Pilates for PWP. If you have any further questions or concerns, please feel free to contact me.
Valerie Johnson, PT, DPT