It’s Tuesday Fitness Friend, which means I am back. Today I’ve got another installment for the Exercise Guides. Parkinson’s Disease is one of those similar to MS; a tough diagnosis to receive and huge implications on your life. Similarly to many of the degenerative chronic illness I’ve talked about this year, though, exercise and movement can provide huge benefits to those living with it.

Like MS, Parkinson’s is neurological in nature. Unlike MS where the immune system attacks the body’s own neurons, Parkinson’s is a loss of neurons in certain areas of the brain that produce dopamine. Dopamine is both a neurotransmitter and a hormone. As a hormone, dopamine regulates pleasure, reward, and motivation. When you feel good after crossing something off your to do list, that’s dopamine hyping you up. As a neurotransmitter, dopamine plays important roles in planning movement in the brain.

With MS, the long term mood implications (i.e. anxiety and depression) are secondary issues. To be clear, that doesn’t mean they are any less important, it means that they come further down the disease progression line. Parkinson’s Disease has mood disorders as one of the primary markers. Again, because dopamine serves a mood regulating function in the brain.

And for those readers who have been with me for awhile, you probably know where I’m headed with this. Movement boosts dopamine. That runner’s high we used to think was caused by epinephrine? It’s actually caused by dopamine. As you move dopamine is naturally released in the brain. Even better, if you move regularly, the brain will increase the number of dopamine receptors it has, making it easier for the brain to use the dopamine it has. This can be hugely important if dopamine-releasing neurons are being lost. If we can at least partially replace dopamine through other pathways, we can keep symptoms of anxiety and depression more manageable longer.

Obviously, regular exercise can play a huge role in the physical symptoms of Parkinson’s Disease. Slow movements, spastic or poorly controlled motions, unplanned stops and starts, muscle rigidity, and balance issues are all common hallmarks of Parkinson’s. Again, similarly to MS, regular practice will attenuate some of the worse symptoms and help slow disease progression.

Unlike MS, though, there isn’t the same concern for raising body temperature. Meaning that exercise is actually one of the best long term treatments for Parkinson’s. Especially in the early stages, most experts agree that starting and maintaining a well rounded routine that includes cardio, strength, and stretching is the best bet. Cardiovascular work is going to have the biggest impact on those dopamine receptors in the brain we talked about. Strength training is going to have the biggest impact on coordinating movement and stretching will make its practice felt through improved balance and posture.

In the early stages, there is no reason to alter current recommendations. Aim for 150 minutes per week of moderate (to vigorous) intensity cardio and two days of total body strength work. Pop in stretching as warm up and cool down and you’re good to go.

As Parkinson’s advances and balance and stamina start to decline, it’s generally advised to do as much as possible without introducing more risk. We especially want to be careful of falls as balance becomes shakier. Switching cardio to more moderate bouts of supported exercises (think stationary cycling, elliptical training, or swimming) is useful. You’ll still get a similar dopamine boost while keeping physical safety in mind.

I also think it’s smart to start focusing a bit more on strength and stability work as Parkinson’s advances. The more strength you can maintain, the better. Plus, asking your body to complete repetitive strength exercises forces the muscles to talk to the brain. This pushes the brain to plan motion more completely. In other words, shifting a bit of focus to strength training at this point will, in theory, help alleviate those slower or more jerky movements. It’s not a cure all, but every bit helps.

I also like to add balance work. Again, with safety in mind. At early stages this might be as simple as making sure lunges or bicep curls while balancing on one leg are included. As Parkinson’s progresses, balancing on one leg next to a wall or low wall or adding seated yoga or Pilates exercises can be extremely useful.

Parkinson’s Disease can be a scary diagnosis, but with some well planned exercise starting early, there is no reason to panic.

Until next time, be well friends!