People with Parkinson’s disease (PD) can sometimes experience “freezing.” This is an inability to move your feet and has been described as feeling like your feet are glued or magnetized to the ground, though you may retain movement in your upper body (Parkinson’s UK, 2018). Freezing can last a few seconds to a few minutes, and is most common when negotiating narrow spaces, such as a doorway, or beginning a voluntary movement, such as getting out of a chair or walking. It may also occur as a result of missing a dose of your medication, or severe constipation (Parkinson’s UK, 2018). Individuals with Parkinson’s disease might encounter challenges in transitioning from a flat surface to an uneven one while walking, which may trigger an episode as well (Parkinson’s UK, 2018). Speech can also freeze, and you might not be able to begin a sentence, or you might suddenly stop in the middle of one.

Freezing usually develops when balance is also impaired. This combination can be dangerous and lead to falls because the beginning and ending of freezing episodes can be unpredictable and anxiety-provoking. Treatment by a physiotherapist or occupational therapist can be very helpful for dealing with freezing and other balance-related problems.

Coping with Freezing

Be sure to tell your doctor that you are experiencing freezing. Some medication adjustments may be helpful. If you regularly experience freezing episodes, avoid walking any distance alone. Don’t fight freezing by trying harder to step forward. Instead, stop trying to move and take a deep breath. Stay calm and check for obstacles around you, such as people and objects. When it is safe to do so, try some of the strategies below to get you going. You may have to try a few to find the strategies that feel the safest and easiest for you:

The cueing method:

• Say trigger words (out loud or in your head) such as “ready, set, GO” to get your feet moving. The same principles can be applied to other tasks you freeze in, such as swallowing: “ready, set, SWALLOW”.
• Use music or a metronome and walk to the beat. If you freeze often, you can walk with headphones connected to a music player. Both music and a metronome app can be downloaded to your smartphone or similar devices.
• Hum, sing, or count to yourself to establish a rhythm you can move to: “one, two, one, two” or “left, right, left, right”.
• Use visual cues, such as lines on the ground, patterns on a carpet, or cracks between tiles. You can also try shining a laser beam on the floor and step on the light (or attach lasers to your walker/cane). Lasers can be purchased at retailers such as Walmart and Canadian Tire.
• If freezing at a doorway, focus on a point beyond the doorway, rather than looking at the door itself.
• Have a companion put their foot in front of yours. Try to step over it.

The imagery method:

• Visualize stepping over a target in front of you, such as a line or a step.
• Imagine yourself in a different scenario that would require your feet to lift, such as marching in a parade, stepping on to a stage, or stepping through tall and wet safari grass.

The mental rehearsal method:

• Imagine or replay in your mind the detailed sequence of an action you are trying to perform. Once you have imagined the action in your mind, you can try performing it physically. For example, close your eyes and imagine the movement and feeling of bringing a spoon to your mouth. Then open your eyes and perform this movement.

The weight shifting method:

• Rather than thinking about stepping forward, shift your weight from side to side in a swaying motion (or rocking motion) several times before stepping. Rocking your head and shoulders side to side can help initiate the rocking movement easier.
• Stomp/march your feet on the spot several times before walking forward.

The distraction method:

• Change directions: walk sideways or in a diagonal before stepping forward again.
• Shift attention from moving the legs to moving the arms (e.g. swinging the arms), then resume walking.
• Raise an arm, touch your head, point to the ceiling, and then re-start.

Sources

Ashlkog, J.E. (2005). The Parkinson’s disease treatment book: Partnering with your doctor to get the most from your medications. New York: Oxford University Press.

Pacific Parkinson’s Research Centre, University of British Columbia, Vancouver, BC

Parkinson’s UK (2018, November). Freezing. www.parkinsons.org.uk/information-and-support/freezing

Last updated: April 27, 2021 by neuro physiotherapist, Shelly Yu