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Gardener

Balance issues

73 posts in this topic

I am two years from diagnosis (about 5 yrs since symptoms started) and have had balance issues early on.  I first noticed problems walking down steps and now have problems on uneven surfaces, tight spaces or isles, etc.  Tremor has not been a dominant issue for me.  I'm wondering if this is typical parkinsons or something else.  My MDS has stayed with the typical parkinsons diagnosis for now.  I would like to know if others have had the same balance problems with parkinsons.  Thanks.

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Gardener, hi ! I have some-mild- balance issues too, which started early in my diagnosis, and improved  with levodopa...I think that many patients with early stage PD experience mild balance difficulty-as the one you describe.  Postural instability is one of the four cardinal features of PD ! just make sure you are not under-medicated, as balance issues may respond to dopamine replacement therapy. Poor balance may lead to falls and should be addressed timely  and  effectively.

Edited by christie

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Gardener - My answer is 'yes and no'. I developed instability but as I felt myself tipping what I call my autonomic tendency to NOT fall automatically causes my leg or arms to extend in a manor that prevents a tumble. Kinda like the mechanism many PWP have when walking called a 'festinating gait'. I trust you are not overlooking what might in actuality be a self-stabilizing capacity for the instability you are experiencing...if that makes any sense. best regards from R.

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Mild tremor in left leg here.  My big issues are slowness, freezing of the legs when taking short steps, muscle weakness, cramping of left toes, and stiffness.  I think the stiffness is from not moving my muscles enough.  Instability comes from my upper body wanting to go and my lower body saying no.

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Thanks to all.  I'm not sure if I would characterize this as "mild."  I have been an athletic person all my life but recently when I tried to get on a bicycle I was unable to ride it any distance.  I have not actually fallen to the ground - so far, I do catch myself.  From your responses, it sounds like this is not unusual for early stage Parkinsons.

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Balance has been my most persistent and troublesome symptom since diagnosis 5 years ago.  I found that physical therapy helped me somewhat. My lack of balance requires me to hold on to someone when walking.  When standing, I need to hold on to a wall or a counter.  I've never fallen, but that's only because I am very very cautious.

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 I have been an athletic person all my life but recently when I tried to get on a bicycle I was unable to ride it any distance. 

 

Gardener, you should definitely mention this  to your neurologist. Keep us posted.

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The following are balance exercises I was prescribed while in Physical Therapy.  (Plus some extensions of the exercises I’ve added myself.)  The first one is fairly elementary (if your symptoms aren’t too severe, but many people will still find it challenging):

 

A. Stand on two legs

  • Extend your arms out from shoulders, if you need to do so to maintain balance
  • Bend your knees slightly, if you need to do so to maintain balance
  • Look forward
  • Slowly rotate your head left, then right
  • Eventually do this exercise with your hands at your sides
  • Eventually do this exercise with your eyes closed and your head steady
  • Eventually do this exercise with your eyes closed and your head rotating slowly from side to side

 

The next one is considerably harder:

 

B. Stand heel-to-toe (right leg in back, left leg in front)

  • Extend your arms out from shoulders, if you need to do so to maintain balance
  • Bend your knees slightly, if you need to do so to maintain balance
  • Look forward
  • Slowly rotate your head left, then right
  • Eventually do this exercise with your hands at your sides
  • Eventually do this exercise with your eyes closed and your head steady (this will likely be really hard)
  • Eventually do this exercise with your eyes closed and your head rotating slowly from side to side

 

Then switch legs (left leg in front, right leg in back) and repeat.

The next one is about as difficult as B:

 

C. Stand on one leg

  • Extend your arms out from shoulders, if you need to do so to maintain balance
  • Bend your knees slightly, if you need to do so to maintain balance
  • Look forward
  • Slowly rotate your head left, then right
  • Eventually do this exercise with your hands at your sides
  • Eventually do this exercise with your eyes closed and your head steady (this will likely be really hard)
  • Eventually do this exercise with your eyes closed and your head rotating slowly from side to side

 

The next one is also about as difficult as B:

 

D. Stand on one leg

  • Hold a five or ten pound dumbbell in one hand
  • Slowly swing the dumbbell counterclockwise around your waist
  • Switch hands as needed
  • Repeat 5-10 times
  • Reverse direction
  • Eventually do this with your eyes closed

 

I do a couple of these exercises every day, and have found them to dramatically improve my balance.  For the record, the only exercise I can do with my eyes closed is A.

Edited by StrkL
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Thank you all for the suggestions.  I did mention this to my MDS and she said that she felt my balance issues were within the normal range of PD.  She suggested Yoga, water exercises, and walking.  I do walk, but since we live in a very rural area, there are no yoga classes or water exercise programs nearby.  I need to be more proactive about this but I'm having a hard time finding the energy and time to devote to these exercises.  Walkwoman, you describe my balance issues well.  I feel uncomfortable in unfamiliar territory. 

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Please keep us posted. Believe me I know how exhausting this can be. Physical Therapy is worth the effort though. Even if your balance only gets a little better, it might help you feel more empowered. Please don't give up!

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Can someone explain how the balance issue feels?

 

Is it something that you feel going on your head that makes you sway and feel uncordinated or more of your legs dont do what you tell them what to do.

 

Im curious because im not diagnosed and want to know if my balance issues are similar.

 

thank u.

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Can someone explain how the balance issue feels?

 

Is it something that you feel going on your head that makes you sway and feel uncordinated or more of your legs dont do what you tell them what to do.

 

Im curious because im not diagnosed and want to know if my balance issues are similar.

 

thank u.

 

 

 

Can someone explain how the balance issue feels?

 

Is it something that you feel going on your head that makes you sway and feel uncordinated or more of your legs dont do what you tell them what to do.

 

Im curious because im not diagnosed and want to know if my balance issues are similar.

 

thank 

I cant speak for every one else,  but tjere is no feeling.  I just lose my balance.  A great test for me is trying to stand on one leg.  I cant, period.

 

The pull test where the neuro sneaks up on you and pulls you over backwards is also a good way to get a feel.  I damn near fell on mine when he did it.  

 

 

 

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My balance issue, far less pronounced since DBS surgery, would present when my center of balance  was lost.  Standing erect even when atop a ladder cleaning out gutters is not a problem.  Nor do I lose my balance once in the shower though I generally hold onto a grab rail for certain stability.  Balance issues for me occur when walking forward and my feet don't propel my lower extremeties as quickly as my torso, head and upper extremeties move ahead. Feet planted (frozen) my body starts to topple and the fall is averted when my autonomic system, sensing a fall, automatially and at the last second commands my foot to take the step to restoring my center of gravity.  Basically the defenestrating gait exhibited by many PwPD.

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Afroney and Roger thank you.

 

I tried that standing in place and have someone pull your shoulder back, it wasnt a suprise but i was able to catch myself and not fall... im able to stand on one foot and i have zero problems running... when i walk i usually feel that its a sensation in my head that makes me feel off... it comes and goes as in i feel normal sometimes and feel no balance issue... ive been having this for about nine months out of no where when i got offf a elevator..... early on did your balance issues come and go?... most importantly does this sound like PD balance?

 

Thanks agian guys.

Edited by Elmstreet

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I don't have any general balance issues standing on two feet, walking, or riding a bicycle. In fact, I can ride "no-hands" on my bike. However, I sometimes feel as if I'm walking a curved path when I'm walking straight. I can't put on socks, shoes, or pants without sitting down or holding onto a wall. Standing on one foot is impossible and I recently fell off a ladder. My left foot often strikes the step when I'm going up a step or two (as if it doesn't know to raise up high enough to clear the step). I tried Roger's physical therapy exercises (above) and can't do b, c, or d, although I'll start practicing them today.

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Hi PatriotM,

When I first went to PT after my diagnosis, I hadn't had the ability to swing my arms when I walked for over 15 years. With teaching and practice, practice, practice, my arm swing returned. The brain can be retrained! It is a daily commitment.  Function can return!

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Dianne,

 

Thanks for your last post! I have been wondering if I should be deliberately making my arm swing when I walk. Starting now, I will concentrate on making that arm move when I walk. Maybe I can retrain my lazy arm also!

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My PT trained me to put my right arm forward when my left foot went forward and my left arm forward when my right foot went forward. She trained me by having me hold one end of ski poles while she pushed from behind, alternating arm and leg movements as suggested, around and around the PT department three times/wk. My husband used some smooth wooden dowels and we also practiced every day at home for about 45 minutes/day. There is no replacement though for a thorough PT evaluation done specifically addressing YOUR needsm which can be ordered by your doctor, neurologist or MDS.

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gardner:  having balance issues and a strange gate, is the main reason i was diagmosed after 10 years of mostly shakes.   i gardened, and when i first lived there i could hop up on the bench. top of later no problem.  then i fell off of the deck a few times ( felt uncordinated ) and stopped using anything but the bottom rung.since i moved to a smaller place, i find i trip just as much,  and have a lot of falls.   i do anything not to fall, bacause i can't get back up.  took me 3 hrs. one night.   i usually roll up onto the bed if i feel strong enough.  balance is a big issue for me.   elmstreet :  i could no more stand on one leg than i could run.   it is not something i feel in my head, it is a total body thing.  i run into a wall, and i wonder how it got there.   have you had an MRI ?  that would be helpful.   i'm going to play dr. here for a moment, and wonder if you might have an inner ear something-or-other.  this might sound silly, but  i used to have panic attacks, that are definately in your head, and sometimes i would concentrate so hard, i would be completely out of balance.   aside from that, for me, i don't feel balance issues in my head first, just my tripping or heading sideways, and that is it .   good luck to you both,  lu

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My balance issue, far less pronounced since DBS surgery, would present when my center of balance was lost. Standing erect even when atop a ladder cleaning out gutters is not a problem. Nor do I lose my balance once in the shower though I generally hold onto a grab rail for certain stability. Balance issues for me occur when walking forward and my feet don't propel my lower extremeties as quickly as my torso, head and upper extremeties move ahead. Feet planted (frozen) my body starts to topple and the fall is averted when my autonomic system, sensing a fall, automatially and at the last second commands my foot to take the step to restoring my center of gravity. Basically the defenestrating gait exhibited by many PwPD.

That is exactly how I have would describe it. If both my feet are planted, eyes open, and I'm not walking quickly balance is not an issue.

 

In fact Dad and I (we both have Parkinson's), installed a roof on my house. No troubles there. I think forcing yourself to concentrate on balancing really helps. In our case, concentrating on not falling to our deaths helped with balance.

 

Walking around the Wally World, however, is a different story. I'll trip over my own feet there. Too many distractions

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Sorry to resurrect an old topic, but I was wondering what counts as normal balance issues in those of us diagnosed for less than one year. I sway when standing with feet together and eyes closed. I also cannot walk toe to heel in a straight line for more than 5 or 6 steps without a corrective side step. When I walk along hallways I tend to run the tip of my fingers on one side for stability. Have others experienced this early on? I've been thinking about getting a cane a lot lately, but am reluctant.

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TNDad,

 

You described me perfectly.  Like you, I am early on in my diagnosis with PD.  I have a cane left over from my back surgery days.  I only use it now to help me get out of bed in the morning.  I also have drop foot on my right side from the nerve damage in my lower back.  I get around fairly well, so I've been holding off on using my cane when I'm out and a about.  My MDS thinks I should get a brace for my foot or a stimulator that would help with the drop foot.  I'm used to it and have adapted how I walk around it, so it doesn't bother me.  If you're walking with me, that's a different story because every step I take you can hear my foot slap the ground. My PCP did sign off on my application for a handicap placard so I can park up front on those really bad days last week.

 

Dave

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Dave, you bring up an interesting point that I have been thinking about lately.

A lot of people here have other health complications from things that occurred long before their PD diagnosis.

 

As a newly diagnosed person, I know that I have to carefully weigh out what I read from posters and their symptoms, 'cos some of the things may have little to do with Parkinson's by themselves. Some people may be grossly overweight, have severe depression, failed back surgeries, be terribly out of shape, have bad arthritis, you name it. Even without a PD diagnosis they may have all sorts of health problems.

 

For the most part, I am in very good physical shape (except for some arthritis in my back). I am perfect weight, normal BP, good cholesterol. I exercise everyday. So other than a right hand tremble, I don't think I have much other symptoms from PD. I suppose that could change quickly tho. But I certainly don't have balance issues. I run up and down stairs in the dark, ride a bike no handed, can balance on one foot with my eyes closed.

 

Everyone is different tho. It would be nice to know a persons other health history besides PD when they post a question about their PD symptoms....

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Musicman,

 

Exactly. Not everything is because of PD.  The  first MDS I went to had a lot of  difficulties seeing the forest through the trees because of my nerve damage.  He kept wanting to lump that in with my new problems or associate my new issues with the old problems.  Sometimes it takes a skilled individual to figure everything out.  I was getting ready to see a rheumatologist this past spring because my hands were hurting so bad.  My MDS said it would be a waste of time and he was right. Once I started taking Sinemet, the pain in my hands went away when I'm ON.  There's a lot of underlying issues that can make our symptoms worse.  My doctor put me back on B12 because I was a little low.  He prefers his PD patients to be on the high side of the reference range for B12.  I wish I could say I'm the picture of health as you, but alas I have some bad genes.  I will say that all of my other medical issues are well managed and have been for many years.

 

Dave

 

P.S. I have no problems running up and down stairs in the dark or riding a bike.   Ask me to walk a straight line and sometimes it'll look like I have one too many.

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