Walking, Cycling and Dancing: Ankle Mobilization in Parkinson's Disease

Introduction

In this article, we explore, with the assistance of my friend and mentor, Cheryl Townsley, Health & Wisdom Coach, how the concepts of stress interruption and nervous system resetting help us understand why walking, cycling and dancing - exercises that inherently involve mobilization of the ankle joints - are so beneficial for People with Parkinson's Disease (PwPs), and why we need to keep practicing these regularly.

The ideas presented here are based on both Cheryl's vast knowledge and real world experience, and the Out-Thinking Parkinson's perspective that PwP are stuck in the "freeze" response mode of their nervous system. These suggest that by constantly interrupting autonomic nervous stress, and improving our "vagal tone", this will help to re-train (reset) our nervous systems, such that they begin defaulting back to the "rest & digest" relaxational state. Our experiences show that this can greatly reduce PD symptoms.

For more background information to these concepts, please also see:

A Unified Explanation for Parkinson's Disease via the Vagus Nerve

Introducing Cheryl Townsley, Naturopath

When I was researching the Vagus Nerve for the above article, I came across this video by Cheryl Townsley - I'm now using this "Sparking" technique, each morning and night, in order to reset my Vagus Nerve:

Intrigued, I started to browse Cheryl's Facebook Page to look for more Vagus Nerve Stimulation ideas.  As usual, I put these new (to me) ideas to the test through experimentation on myself - and indeed have found major benefits in exploiting them. I'm also now enrolled in the online (paid subscription) course called "The EASY Approach" developed by Cheryl and her husband, and finding it highly beneficial to my thinking about PD too - in fact, I've somewhat adopted Cheryl as a mentor. Since we've already had extremely useful discussions on how to apply and develop the concepts she teaches to help people with PD more specifically, I asked Cheryl to help me write this article, and to introduce the techniques to the PD community.

Interrupting the Perception of Threat in Parkinson’s Disease

by Cheryl Townsley, Naturopath and Wisdom Coach

"Is there anything that all diseases have in common?

Actually there is! When a person is dealing with any disease diagnosis, it indicates the body is having challenges healing. The biggest contributor to the body’s healing challenge is when it feels ‘threatened’. Our bodies have a unique ability to sense a threat, and then react automatically to protect us. That threat response is activated by our brain stem and nervous system. Let me give you an example.

For years, I had weak ankles and poor balance. Walking on a beach for five minutes could put me in bed for hours! Logically, a beach should not be threatening. However, with poor balance, those grains of sand represent a huge threat! Learning how to reduce that ‘threat’, I have been able to learn how to walk on a beach and actually enjoy it. Multiply that ‘beach threat’ by the hundreds of situations that can impact our brain stem/ nervous system and you begin to realize that our bodies are often totally focused on threat management instead of healing.

What if you could instantly assess the ‘threats’ in your life and reset? And, it could be very EASY?

As a Naturopath for 25 years, I’ve worked with many thousands of clients from around the world. This simple assessment tool and reset movements are helping me work with more people, more quickly to assess what is slowing down their healing process.

Since a picture (or video) is worth a thousand words, take a few minutes to see this process demonstrated. Discover what threatens you and, more importantly, how to reset.

The more balanced your body is, the more it can heal and keep the body from deteriorating. I love how this has helped Gary extend the efficacy of his meds and improve the quality of his movements. Let’s see what you can discover with these EASY assessment and reset concepts and techniques!"

~ Cheryl Townsley

Learning outcomes for parkinson's disease

PwP experience many issues with their extremities (feet and hands). As the disease progresses, we increasingly shuffle instead of walk, find it harder to lift each foot off the ground and eventually experience freezing of the feet to the floor. Just like Cheryl's example of walking on a beach, the quality (and gradient) of the surface matters. The feedback which Cheryl experienced between walking on shells and the threat perception of her nervous system, which the ground activated, is very important for us PwP to understand, especially as this occured even though she is a very healthy person. Furthermore, Cheryl has shown us how, by being mindful, it is possible to both observe and measure how such perceived threats lead to a loss of range of movement and an increase in ill feeling. This is vital information for us, because, undoubtedly, these feedback loops will be hugely magnified in PwP, who already have hypervigilant nervous system responses.

Thus, from what Cheryl teaches us, I now believe the shuffling gait and freezing, which many PwP experience, is actually the result of a vicious circle, that - when it is not interrupted - leads to further degeneration. In PwP, the effects Cheryl describes can create a super strong negative feedback loop between the nervous system's threat perception and the resulting loss of movement, leading to a deteriorating sense of balance and postural problems, which in turn increase the danger sense of feeling like we're about to fall over. If left uninterrupted, this vicious circle eventually results in the nervous system preventing us from moving at all.

If this is correct, Cheryl's work also points to the solutions - we need to keep breaking this habit as much as possible. One method, which she has demonstrated to us, is by practicing ankle mobilization techniques to stimulate the relaxational mode of the nervous systems. While Cheryl uses various specific "Range of Motion" tests to evaluate the efficacy of these techniques, PwP have their own way to measure the outcomes due to our profound motor symptoms. I've found that being mindful of those actions which alleviate my symptoms or, conversely, which make me more frozen, can be a very powerful technique for unravelling the conundrums of my condition. As Cheryl points out, these effects occur, and can be measured, near instantaneously.

The evidence and experience of PwP around the world does prove the benefits of persistently moving around in ways which break the habit of shuffling. Practicing walking heel-to-toe, if necessary with the help of visual cues, such as cracks in paving slabs, hand held "props", such as Norwegian walking poles or Smovey Rings,  and/or audio cues, such as metronomes or music, has been shown to have massive therapeutic value for PwP. Indeed, John Pepper from South Africa famously walked off his PD by consistently practicing mindful walking for a year.

For the same reasons, riding bicycles is extremely beneficial, not least because pedalling motions are significantly ankle mobilizing. Walking up and down stairs is also found to help. Last, but certainly not least, dancing, which requires extensive and wide ranging ankle joint movements, is probably the most beneficial exercise there is - and that is true for everyone, not just for PwP.

Unfortunately, many PwP may already have lost the ability to walk and have immobilzed ankles, due to the patterns of their nervous system never having been interrupted. So I started to consider what we might do in such cases to help begin a recovery process. I came up with idea of using assistive technology in the form of a vibrational plate:

Notes on Vibrating technique

• The exercises shown can also be done sitting down, with a caregiver placing the foot on and off the plate.
• Everybody's body is different, so the exact exercises might not work for you, but I believe with some trial and error most people will be able to find foot placements that work.
• The "Reviber" vibrating plate in the video is their fusion model, kindly donated to the Out-Thinking Parkinson's project for trialling as a PD therapy device.
• While we may be tempted to go at this fast and furious, it is very important to begin very slowly and only once per day, for just a few minutes at the start, with each foot placement only very quickly applied to the plate on the lowest speed. This is because the bodies of PwP are quite toxified and we need to be very careful about detoxing too fast, as this can wreak havoc too.