## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) - [Movement Symptoms](/understanding-parkinsons/movement-symptoms) ## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) - [Movement Symptoms](/understanding-parkinsons/movement-symptoms) # Trouble Moving or Walking ## 💡 Quick Summary - Parkinson’s disease affects walking, [balance](/understanding-parkinsons/movement-symptoms/postural-instability "Postural Instability (Balance & Falls)") and coordination, leading to shuffling, smaller steps, slower pace, reduced arm swing and difficulty turning. - Movement and sensory changes in PD cause [bradykinesia](/understanding-parkinsons/movement-symptoms/bradykinesia "Bradykinesia (Slowness of Movement)") (slowness), hypokinesia (small movements) and trouble starting, stopping or linking movements. - [Freezing](/living-with-parkinsons/management/activities-daily-living/freezing "Freezing") of gait — a temporary inability to move — can occur when walking, turning or in doorways. - Freezing increases risk of falling. - Tips for improving walking include adjusting posture, using visual cues and practicing safe turning techniques. ![Man's feet and legs walking on sidewalk with assistance from a cane](/sites/default/files/styles/no_sizing/public/images/troublemovingorwalking.jpg?itok=oC_3eyTW) People without Parkinson's disease (PD) do not often think about walking. Their arms swing naturally and their feet land on the heels with each step. They can walk and talk and carry bags, purses and plates of food, often without difficulty. For people with PD, walking becomes less automatic. As Parkinson’s progresses issues can develop, such as problems with walking (**gait abnormalities**), poor balance (**[postural instability](/understanding-parkinsons/movement-symptoms/postural-instability "Postural Instability (Balance & Falls)")**) and feeling like their legs are heavy or dragging. Feet begin to shuffle and multitasking becomes more difficult. Additionally, turning around can be tricky — sometimes leading to freezing or falls. ## Movement and Sensory Changes People with PD have trouble regulating the speed and/or size of their movements. Movements are bradykinetic (too slow) or hypokinetic (too small). ### Movement System Changes These changes can lead to challenges controlling movements, including: - Starting and stopping movements - Automatically controlling muscles - Linking different movements to accomplish one task (e.g., moving from sitting to standing) - Finishing one movement before beginning the next (e.g., not completely turning around before sitting down) ### Sensory System Changes These changes can lead to challenges, particularly noticing and correcting movement and voice issues, including: - Slowness or smallness of movements (e.g., when told to make the movement bigger, a person with PD may feel the movement is now “too big”) - Lack of movement (e.g., an arm that does not swing during walking) - Changes in posture - Changes in voice volume (e.g., when told to speak louder, a person with Parkinson's may feel they are shouting) ## Walking Changes Parkinson’s disease can change how a person walks. Slow movement, stiffness and rigidity make walking normally harder. There are many PD-related walking changes: - Smaller steps - Slower speed - Less trunk movement (especially rotation) - A narrow base of support (feet too close together) - Less or absent arm swing (on one side of the body or both) - Trouble turning - The feet land flat on the floor with each step instead of on the heel (can lead to shuffling and falls) - Heavy or dragging legs (feeling like legs are too stiff or weighted to lift easily) - Festination or shuffling (quick, small, involuntary steps forward; often accompanied by stooped posture) - Retropulsion (quick, small, involuntary steps backward) - ### Managing Walking Changes [**Exercise**](/living-with-parkinsons/treatment/exercise "Exercise") is as important as medication and other therapies for managing Parkinson’s symptoms and leading your best possible life. Reported benefits of exercise include: - Improved gait and balance - Reduced falls - Increased flexibility and posture - Improved endurance - Reduced freezing of gait - ### Walking Tips Being mindful when walking can prevent falls. Take care to: - Tell yourself to land with heel first. You can do this by thinking of each step as a big kick. By thinking about what you are doing, you use a different part of your brain than the part affected by PD. You re-route the message from the brain to the feet. - Focus on the size of your steps rather the speed of your steps. - Avoid carrying many things while walking. People with PD have difficulty performing more than one task at a time. - The moment you begin to shuffle or freeze, try to come to a complete stop. Take a breath, stand tall and start again, focusing on making that first step a big step. - Stand tall and look out in front of you. Do not look directly down at your feet. - Use a cane or walker/rollator if recommended by your therapist or doctor. - ### Turning Tips It's important to exercise caution when turning, too. Strategies to help you turn safely include: - When beginning a turn from a stopped position, be sure to lead with your foot, not your upper body. Planting your feet and turning your upper body frequently leads to a freezing episode. - If you want to turn right, shift your weight to the left foot and step out with the right foot. To turn left, shift your weight to the right and step out with the left foot. - Try not to pivot when you turn. Instead, focus on how you lift your feet. ## Freezing Some people experience “[**freezing**](/living-with-parkinsons/management/activities-daily-living/freezing "Freezing"),” the temporary, involuntary inability to move. This can occur at any time, though it tends to occur when initiating a step, turning or navigating through doorways. It can be a serious problem, as it may increase risk of falling. - ### Managing Freezing Some freezing happens when you are due for the next dose of dopaminergic medication (e.g., [**levodopa**](/living-with-parkinsons/treatment/prescription-medications/levodopa "Levodopa") or others effecting dopamine-producing parts of the brain). This is called “off” freezing. Usually, freezing episodes lessen after taking your medication. - ### Freezing Tips for Care Partners Freezing (feet glued to floor) is a significant cause of falls. Here's how care partners can help: - Freezing often happens while turning around in close quarters. Try to avoid tight turns whenever possible. Instruct the person with Parkinson’s to make wider turns. - If the person has a freezing episode while trying to walk, encourage him or her to stop, straighten posture, and shift weight to one foot before beginning to step with the other. - To help with freezing, count or clap a rhythmic beat. - Some people who experience freezing episodes do better with a visual cue, such as “step over my foot.” *Page reviewed by Dr. Kathryn P Moore, Movement Disorders neurologist at Duke Health, a Parkinson's Foundation Center of Excellence.* ## Related Materials Videos & Webinars ### [ Expert Briefing: Freezing or Sweating Falls When Walking ](/library/videos/falls) [Watch Now](/library/videos/falls) Podcasts ### [ Episode 90: Movement Strategies: Mobility, Falls & Freezing of Gait ](/library/podcast/90) [Listen Now](/library/podcast/90) Fact Sheets ### [ Exercise and PD ](/library/fact-sheets/exercise) [Read Now](/library/fact-sheets/exercise) ## Related Blog Posts ![couple walking outside](/sites/default/files/styles/500x360/public/images/walkingpd-bloghero.png?h=ed9ce7df&itok=uzUtPB_o) Raise Awareness ### [ Walking with Parkinson’s: Freezing, Balance and Falls ](/blog/awareness/freezing) READ NOW ![Woman stretching on a mat](/sites/default/files/styles/500x360/public/images/newexerciserecommendations-blog.png?h=ed9ce7df&itok=TJ4R-9-H) Raise Awareness ### [ New Exercise Recommendations for the Parkinson’s Community and Exercise Professionals ](/blog/awareness/exercise-recommendations) READ NOW ![pole walking blog](/sites/default/files/styles/500x360/public/images/polewalking-blog.png?h=c12e0b96&itok=c4v3uncw) Raise Awareness ### [ Pole Walking for Parkinson’s: How this Nordic Workout Improves Mobility ](/blog/awareness/pole-walking) READ NOW ### Order a Parkinson’s Hospital Safety Guide The Hospital Safety Guide is a resource for people with Parkinson's and their care partners filled with useful tools and information to prepare for and navigate a hospital stay. [ORDER NOW](/resources-support/pd-library/order-publications) [LEARN MORE](/resources-support/hospital-safety-guide) - Share on Facebook - Share on X - Share on LinkedIn