Quick answer. Parkinson’s affects movement through slowness (bradykinesia), stiffness, stooped posture and, importantly, balance problems, which together make falls a real risk. “Freezing of gait,” where the feet feel glued to the floor, is common and often triggered by turning, doorways or doing two things at once. Cueing techniques – counting, rhythm, stepping over a line – help break a freeze, and turning in a wide arc rather than pivoting reduces falls. A physiotherapist should fit any walking aid, since the wrong one can make things worse. If someone falls and cannot get up, call 995.
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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.
How movement changes
Parkinson’s changes movement in several ways. Bradykinesia makes movements slow, small or shuffling; rigidity stiffens the muscles; and posture often becomes stooped. Balance problems, or postural instability, tend to come later but are among the most challenging symptoms because they directly threaten stability. Some people also experience festination, an involuntary quickening into short, hurried steps with the body leaning forward, as if chasing their own centre of gravity. Understanding these patterns helps you and your carers anticipate difficulties and take practical steps to stay safe, rather than being caught out by them.
Understanding freezing of gait
Freezing of gait is a sudden, temporary inability to step forward, with the feet feeling stuck to the floor. It can last a few seconds or longer and affects more than half of people with Parkinson’s. It has typical triggers: starting to walk, turning, going through doorways or narrow spaces, changing floor surfaces, being rushed, doing two things at once, crowded or poorly lit spaces, and anxiety or fatigue. Recognising your own triggers is the first step to managing freezing. Importantly, trying to force through a freeze often causes a fall, so the safer response is to stop, reset and use a cueing technique.
Cueing techniques to break a freeze
Cues give the brain an external rhythm or target to bypass the freeze. Rhythmic counting works for many people – saying or thinking “one-two-three-step” or “ready, steady, go,” humming, or using a metronome app. Shifting your weight fully onto one leg and then stepping with the other foot, or gently rocking side to side to free a foot, can also help. Visual cues are powerful too: stepping over a line on the floor, a laser line projected from a walking stick, or an imagined line. Deliberately taking bigger steps and lifting the feet, as if marching, helps as well. Stop, reset, and cue rather than fighting it.
Turning and transfers safely
How you turn and move between positions makes a big difference to falls. Rather than pivoting or twisting on the spot, make a wide, U-shaped turn, taking several steps around. Avoid stepping backward, which is destabilising; step sideways instead. Pause before changing direction, and move in stages rather than all at once. When reaching for something or opening an appliance, use a wide-legged stance and stand slightly to the side of doors or the fridge rather than directly in front. These habits, which a physiotherapist or occupational therapist can teach, reduce the moments when balance is most vulnerable.
Choosing the right walking aid
Walking aids can help, but the wrong one can actually worsen your walking pattern. Parkinson’s UK warns that some walking aids are not recommended for people with Parkinson’s because they can affect gait and increase the risk of freezing or falls. For this reason, a walking aid should always be chosen and fitted with a physiotherapist, who can match it to your particular needs – whether that is a certain type of stick or a wheeled frame. Buying an aid off the shelf without assessment can do more harm than good, so make this a professional decision rather than a guess.
Making the home safer
Most falls happen at home, and simple changes reduce the risk. Remove loose rugs, clutter and trailing cords, add grab bars and handrails in the bathroom and on stairs, improve lighting, and use night-lights, especially along the route from the bedroom to the toilet. Keep walking paths clear. An occupational therapist can carry out a full home-safety assessment and recommend tailored adaptations. Regular exercise and physiotherapy are also protective, as they improve gait and balance and reduce falls, so staying active is part of fall prevention, not separate from it. Attend to dizziness on standing too, which is a distinct cause of falls.
After a fall
If you fall, try to stay calm and check yourself for injury before attempting to get up. Plan the moves first: roll onto your side, get onto your hands and knees, crawl or scoot to a sturdy chair or sofa, and use it to push yourself up. A carer can help using a transfer belt, but should never pull you up by the arms if injury is possible, and should not move you if a fracture or spinal injury is suspected. Even if you seem unhurt, arrange a medical review to find out why the fall happened, as the cause can often be treated.
When a fall is an emergency
Some falls need emergency help. If someone with Parkinson’s falls and cannot get up, call 995 for an ambulance, and keep them warm and comfortable while waiting. A fall involving a head injury, a possible fracture, loss of consciousness, severe pain, or where the person takes blood-thinning medication should be treated as an emergency. Do not try to move someone who may have a serious injury. Remember, too, that a sudden marked worsening of walking or freezing can sometimes reflect a missed medication dose or another problem, so after any fall it is worth seeking a review even if there is no obvious injury.
Related Parkinson’s topics
- Living with Parkinson’s
- Understanding Parkinson’s: causes, symptoms & stages
- Medication & managing treatment
- Exercise & staying active
- Speech & swallowing
- Non-motor symptoms
- Mental health & mood
- Eating well & nutrition
- Caring for someone with Parkinson’s
- Neurologists in Singapore
Sources
- Parkinson’s UK – Freezing: parkinsons.org.uk
- Parkinson’s UK – Falls and dizziness: parkinsons.org.uk
- Parkinson’s Foundation – Postural instability, balance and falls: parkinson.org
- Parkinson’s Foundation – Fall prevention: parkinson.org
- NHS – Parkinson’s disease treatment: nhs.uk