Falling Short
We use the term “fall short” in a variety of common activities. We say that golfers fall short of the green, basketball players fall short in their jump shots, and in business, we may fall short of hitting a budget.
With Parkinson’s disease (PD), too, there is a tendency to stop short of the target or to “fall short.” Those of us with PD may shorten our steps before we get to the place we intend to be, assuming the classic “festinated” Parkinson’s gait in order to finally arrive. Festinated comes from the Latin word meaning hurried or rushed. Those who walk in this manner may tend to walk on the front of the foot, almost tiptoed, and to lean forward. This way of walking may increase the tendency to fall because we stop well before we should.
Stepping Up
PD would have you believe that exercises to prevent the typical, festinated, gait are in vain, that nothing helps, that nothing can slow the illness in its ominous progression. But PD has not kept up with its own literature that says that gait and speech therapy may stave off swallowing problems and that aerobic exercise and high-intensity exercises have an impact of slowing disease progression among active adults with PD. We must not fall short in our efforts to educate more people about these therapies.
Parkinson’s tends to minimize all aspects of life: the size of steps, the voice, handwriting, smell, taste, bowel function, and balance are all common targets of this minimalization. Think about it, it does all these things. Even our “effort” would be minimized so that inertia steps in to override our hunter-gatherer nature of being up and out. We tend to minimize the effort we put out. We tend to fall short in all efforts to be more than we are.
Punching Back
I do non-contact boxing three times a week and I box with a PD crowd whose members are in various stages of the illness. I also box with people who put out various amounts of effort during each session. Some put out a good effort and some go through the motions but end up doing little more than stretches. I have nothing against stretching, I recommend it! But those who merely stretch are not exercising to sweat, get their heart rate up, or get tired. They exercise up to their existing limit of fatigue at most and sometimes settle for a little less. They don’t “push it.” They don’t punch back.
These same folks usually stay quiet during their time in the gym, too. Their non-PD spouses answer for them, talk amicably, and workout hard as if to set an example. Over and over, I see the person with PD going through the motions when they could do more, not realizing they are being reduced by the illness while in the gym.
I want to shout out a challenge them, to arouse their attention, to speak with a loud voice about WHY and HOW boxing is so important,–why moving is so important–and that just going through the motions, does not slow disease progression. I want to say to them, “You must “leave it all on the floor.”
Falling short is a good term to describe how PD works. The illness wants to make you fall short, to entice you to stay in your corner, to not come out when each bell rings. The illness says that the sweaty exercise you would do today will not matter in the long run, that lifting weights and running and practicing with your voice is useless. However, the science shows that exercise (like a treadmill) that gets your heart rate up to 80% of its max and sustains it there for 15 minutes does make a difference. No question, it helps. Walking on a flat treadmill for a couple of minutes, however, does nothing.
Let’s stay committed to doing the physical work of keeping PD at bay. And let’s hold one another accountable for going full out—for punching back—as long as we can.
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Dan Stultz, MD is a retired physician who was diagnosed with Parkinson’s disease 14 years ago at the age of 57. He practiced internal medicine in San Angelo, Texas, for 28 years and became the President/CEO of Shannon Health System. He served as President /CEO of the Texas Hospital Association from 2007-2014 working on medical and health policy. He served as guest faculty at the Texas A&M Medical School in Round Rock and retired in 2016. He and Alice live in Georgetown, Texas.