Stopping the Freeze and Freezing the Festinating

The other day in one of my Rock Steady Boxing classes, one of our fighters, who has been dealing with increased freezing in his gait, fell.  Thankfully, he fell without injury.  One of the other fighters who deals with freezing also, took him aside and gave him some ways to move out of a freeze without falling.  After watching that scene, I knew I needed to share some ideas about how to handle a freeze.

What is freezing?   “Freezing is the sudden and unpredictable inability to start moving or continue moving," says Rachel Dolhun, MD, from the Michael J. Fox Foundation (“MJFF”), “It can happen anywhere and at any time but walking through doorways and turning around are common triggers. Not only is this frustrating but it can lead to decreased mobility and falls.” 

According to the MJFF, here are 5 Tricks to Move Through Freezing Episodes in Parkinson's Disease

·         March in place or imagine or sing a military song.

·         Count out loud or in your head or sing a rhythmic melody. ...

·         Aim your next step at a specific spot on the floor. ...

·         Ask a family member or friend for help. ...

·         Try moving in a different direction, such as backwards or from side to side.

·         Talk with your neurologist or movement disorder specialist about other ways to manage freezing. Your doctor may be able to refer you to a physical therapist who specializes in treating the gait problems and freezing associated with Parkinson's disease.

In addition, stress can be a big factor in the number of freezing episodes.  Take more deep breaths during the day.  Try to reduce or avoid stressful situations.  Also, it is always a good idea to keep a journal of these episodes to share with your movement disorder doctor.  He may be able to adjust your medications to reduce these episodes.

My father, who had PD, didn’t experience freezing as much as he experienced festinating.  So what is the difference between freezing and festinating?  According to the, “Festinating gait or festination – A quickening and shortening of normal strides characterize festinating gait. While the steps are quicker, the stride is shorter, causing this to be a very inefficient gait, which can be frustrating and tiring for the person experiencing it.”  I have seen a few people, including my father, that started walking, then are suddenly on their tip toes and moving forward very fast, while leaning forward without any balance. 

Here are some strategies from the Parkinson’s Foundation for this type of episode:

·         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 festinate 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.

But it all comes back to one thing - EXERCISE!  Through programs that work specifically on balance, gait and posture, you will reduce the chances of either of these episodes. 

Written by Martie Vlcek

Parkinson's Place