The story below is a composite, drawn from the experiences of many people we have worked with. Geoff is not a real patient, but everything that happens to him is real, and it happens often.
Autumn: the things that were easy to explain away
Geoff was 68 when his daughter first mentioned it, and he was annoyed with her for a fortnight afterwards.
“You don’t swing your right arm anymore, Dad.”
He didn’t, as it turned out. He also hadn’t noticed that his handwriting had shrunk to the point where his wife had quietly taken over writing the Christmas cards. Or that it now took him three attempts to get out of his armchair. Or that his golf swing had lost something he couldn’t put a name to.
Every one of those things had an explanation. The shoulder had been grumbling since he retired from the building trade. The handwriting was his eyes. The armchair was too low and always had been. The golf was just age, and everyone at the club was slowing down.
What he could not explain away was the tremor in his right hand while he was watching the news — a small, rolling movement that stopped the moment he reached for his tea, and started again as soon as his hand went still.
He booked the GP appointment on a Tuesday and cancelled it twice before he went.
Winter: the day everything had a name
The diagnosis came from a consultant neurologist in February, after an examination, a conversation and a wait that felt considerably longer than it was.
Geoff describes that appointment as strangely quiet. He had expected to feel devastated. Instead he mostly felt as though someone had finally turned on a light in a room he had been walking around in the dark.
He left with a prescription, a follow-up date, a leaflet, and the name of a Parkinson’s nurse specialist. He also left with a sentence that would take him nine months to properly hear: “Keep active — exercise really does help.”
Spring: the gap
Here is the part of the story that nobody prints in the leaflets.
Between diagnosis and doing something useful, most people spend months in a holding pattern. Geoff started his medication and felt better — noticeably better, in fact, which produced its own kind of complacency. He read a great deal online, most of it at two in the morning, and much of it about a version of Parkinson’s fifteen years further down the road than his own.
He stopped playing golf, because he was embarrassed. He stopped going to the club, because that was where the golf was. He started sitting down more, walking less, and letting his wife carry things.
None of this was caused by Parkinson’s. All of it was caused by the fear of Parkinson’s — and it was doing more damage to his life than the condition itself.
His daughter, who had been right the first time, booked him a physiotherapy appointment and drove him to it.
The first appointment: what actually happens
Geoff had assumed he would be given a photocopied sheet of exercises. What happened instead took the best part of an hour.
He was asked what he wanted. Not what hurt — what he wanted. He said, eventually, that he wanted to play eighteen holes again without being watched, and to get down onto the floor with his grandson and back up without an audience.
Then he was assessed properly:
- Walking and turning. How long his stride was, how fast he walked, whether his arms swung, and — critically — what happened when he turned around in a confined space.
- Balance under pressure. Not standing still with his eyes closed, but reaching, stepping, changing direction and recovering from a gentle nudge.
- Strength and power. How many times he could stand from a chair in thirty seconds, and how quickly. The number was lower than he expected and it irritated him, which his physiotherapist noted approvingly.
- The medication cycle. When he took his tablets, when he felt at his best, and when things got harder. His sessions were then scheduled to fall in his best window.
- What he was avoiding. This turned out to be a long list.
Nothing on that list was surprising to the physiotherapist. All of it was new information to Geoff.
Weeks one to six: the programme
The programme he was given was not gentle, and that surprised him most of all.
Twice a week, he worked hard on the bike — properly hard, breathing heavily, for intervals rather than a comfortable plod. The research linking vigorous aerobic exercise to better outcomes in Parkinson’s is the strongest we have, and intensity is the ingredient most often left out.
Twice a week, he did strength work. Sit-to-stands, step-ups, squats to a box, resistance bands. Building the power to rise from a chair is not glamorous, but it is the difference between independence and assistance.
Every session included balance work that made him slightly uncomfortable — turning tight circles, stepping over obstacles, walking while carrying and counting, reaching beyond his base of support. Safe, supervised, and deliberately challenging, because balance only improves when it is genuinely tested.
And every session included the exaggeration. Big steps. Big arm swings. Big reaches. It felt ridiculous and theatrical. It is also the single most Parkinson’s-specific thing in the programme, because the condition systematically shrinks movement while convincing you that nothing has changed. Training big is how you recalibrate normal.
By week six, Geoff’s chair-rise score had improved substantially, his walking speed had picked up, and his wife had stopped hovering behind him on the stairs.
Summer: the doorway
The moment Geoff talks about most had nothing to do with any of the above.
He had begun to freeze — a sudden, unnerving sensation of his feet sticking to the floor, always in doorways, always when he was in a hurry, and always worse when someone was waiting for him. It frightened him more than anything else in the first year.
His physiotherapist taught him three things in one session.
Stop trying to push through it, because that never works. Shift your weight side to side to break the pattern. Then give yourself a rhythm — count aloud, march to a beat, step over a real or imagined line on the floor — because freezing is a failure of internal timing, and an external cue steps neatly around the problem.
Within a fortnight, Geoff could get himself out of a freeze in seconds. Within a month, they had become rarer, because he had stopped bracing for them.
Freezing responds poorly to medication. It often responds remarkably well to being taught what to do.
A year on
Geoff plays nine holes most weeks, and eighteen when the weather is kind. He still takes his medication and always will. He still has Parkinson’s, and the honest truth is that it is a progressive condition — nobody has promised him otherwise.
What has changed is that he is no longer negotiating with it from a position of ignorance. He knows what his body can do, because it is measured. He knows what to do when things get harder, because he has practised. And he gets down on the floor with his grandson.
What Geoff would tell you
- Go earlier than you think you need to. The strongest evidence for exercise is in the earlier stages.
- Gentle is not the same as safe. Under-doing it is the most common mistake.
- Ask for a Parkinson’s-specific assessment. General fitness advice misses the things that matter most.
- Tell someone about the non-motor stuff — the constipation, the sleep, the low mood, the fatigue. Much of it is treatable and most of it goes unmentioned.
- Do it with people. The isolation does as much harm as the condition.
Quick answers to the questions we hear most
Is it too late for me to start? No. Benefits have been demonstrated at every stage. What changes with time is the programme, not the principle.
Will exercise interfere with my medication? No — but timing helps. Working during your best window makes sessions more productive and safer.
I’ve got a tremor. Does that mean I have Parkinson’s? Not necessarily. Most tremor is not Parkinson’s, and a significant number of people with Parkinson’s never develop a prominent one. A proper assessment is the only way to know.
Do I need a referral? No. You can contact us directly.
Book a free discovery visit
If any part of Geoff’s story sounds familiar — the explaining away, the shrinking world, the leaflet you never quite acted on — we would like to talk to you.
Simpson Physiotherapy offers a free discovery visit with no cost and no obligation. It is a straightforward conversation: you tell us what is happening and what you want back, and we tell you honestly whether we can help.
Contact us today to book your free discovery visit. The first step is usually the hardest one — and it is the one we can make easiest.
