Why Parkinson’s Can Make It Hard to Get Started on a Movement

Have you ever known exactly what you wanted your body to do, but struggled to get it moving?

You stand up from a chair and hesitate before taking your first step. You want to walk toward the kitchen, but your feet seem slow to respond. You reach for an object, yet getting the movement started takes more effort than you expect.

For people living with Parkinson’s disease, this can be a frustrating part of everyday life.

Parkinson’s can affect not only how quickly you move, but also how easily you start a movement in the first place. This is often related to bradykinesia, or slowness of movement, one of the main motor symptoms of Parkinson’s disease.

Understanding why movement initiation becomes difficult can help you recognize the problem and explore strategies that may make daily activities easier.

Why Is Starting a Movement So Difficult?

Parkinson’s disease affects brain circuits involved in controlling movement, including pathways that use dopamine.

Dopamine helps the brain regulate movement. As dopamine-producing cells are lost, the brain has more difficulty coordinating movements that would normally happen smoothly and automatically.

You may notice that starting a movement requires more concentration than it used to.

For example, getting up and walking may involve several separate efforts: shifting your weight forward, standing, stabilizing yourself, and taking the first step.

Before Parkinson’s, these actions may have felt like one continuous movement. Now, each part may feel slower or require more deliberate effort.

You May Find the First Step Hardest

One common example is difficulty getting walking started.

You may be standing upright and ready to go, but your first step doesn’t come as easily as expected.

Once you begin walking, your movement may become more consistent. However, starting again after stopping can bring the same difficulty back.

This can happen when you’re:

• Getting up from a chair
• Starting to walk after standing still
• Leaving a doorway
• Beginning to walk after a conversation
• Getting out of bed
• Resuming movement after a brief pause

Not everyone with Parkinson’s experiences the same pattern. If starting to walk becomes increasingly difficult, it’s worth discussing with your neurologist or physical therapist.

Getting Out of a Chair Can Take More Effort

Movement initiation doesn’t only affect walking.

Standing up from a chair requires you to lean forward, shift your weight, push through your legs, and straighten your body.

Parkinson’s can make this sequence slower and less coordinated.

You may rock forward several times before standing, need extra time to get upright, or feel as though your body isn’t responding when you first try to move.

The height and firmness of the chair can also make a difference. A low, soft sofa may be much harder to rise from than a firm chair with armrests.

Physical therapy can help you practice transfers and identify movement strategies or environmental adjustments that make standing safer.

Why Everyday Routines Can Take Longer

Difficulty starting movements can affect activities you might not immediately associate with Parkinson’s.

You may take longer to begin brushing your teeth, reach for a cup, start getting dressed, or move from one room to another.

The difficulty isn’t necessarily that you don’t know what to do. It may be that your body needs more time and attention to initiate the action.

This can make a normal morning routine feel rushed, even when you’re trying to move as quickly as possible.

Giving yourself more time and organizing tasks to reduce unnecessary rushing may help. An occupational therapist can also assess which parts of your daily routine are most challenging and suggest practical adaptations.

Is This the Same as Freezing of Gait?

Not exactly.

Bradykinesia refers to slowness of movement and can affect both starting and continuing an action.

Freezing of gait is a more specific problem in which your feet feel temporarily stuck, even though you intend to walk. It may occur when starting to walk, turning, approaching a doorway, or navigating a crowded space.

The two can overlap, but they aren’t the same thing.

If you experience freezing, notice repeated hesitation before taking a step, or feel at risk of falling when trying to get moving, tell your healthcare team. A therapist familiar with Parkinson’s can help assess what is happening and identify suitable strategies.

How Physical Therapy Can Help

Physical therapy for Parkinson’s can address movement initiation alongside walking, balance, strength, and coordination.

Treatment should be based on your specific symptoms and daily goals. Depending on your needs, it may include:

• Practicing movement sequences: Breaking a difficult action into manageable steps, such as shifting forward before standing.
• External cues: Using a visual target, rhythm, counting, or another cue to help initiate a movement when appropriate.
• Walking practice: Working on starting, stopping, and restarting under supervised conditions.
• Transfer training: Practicing getting up from a chair or moving safely between sitting and standing.
• Balance and weight shifting: Improving control as you prepare to move.
• Functional practice: Applying strategies to everyday situations rather than only performing isolated exercises.

Some people respond well to external cues, while others need a different approach. Your therapist can help determine which strategies are appropriate and teach you how to use them safely.

Simple Ways to Make Movement Easier

A few adjustments may help reduce the pressure you feel when starting a movement.

Give Yourself Time

Avoid rushing to stand or walk. Pausing to prepare your movement can be more useful than trying repeatedly to force it.

Focus on One Action at a Time

If standing up is difficult, concentrate on the steps involved rather than trying to complete the entire movement at once.

Reduce Distractions When Needed

If you find it harder to initiate movement while talking or multitasking, give yourself a moment to focus on moving before adding another task.

Make Your Environment Work for You

A stable chair at an appropriate height, clear walking paths, and good lighting can help make everyday movement more manageable.

These suggestions aren’t a substitute for an individualized assessment, especially if you experience freezing or have a history of falls.

When Should You Talk With Your Healthcare Team?

If movement initiation is interfering with your independence, tell your neurologist or rehabilitation team. They can assess your symptoms, review how they affect daily life, and determine whether changes to your treatment or therapy plan may be appropriate.

Don’t change your Parkinson’s medication schedule or dosage on your own.

Seek urgent medical attention if you experience a sudden, unusual change in movement, particularly with new weakness, facial drooping, speech difficulty, or other possible stroke symptoms.

You Don’t Have to Stop Doing the Things That Matter

Parkinson’s can make the beginning of a movement feel harder than the movement itself.

That hesitation can affect walking, standing, getting dressed, and many other everyday activities. But understanding the specific difficulty is an important first step toward managing it.

With appropriate neurological rehabilitation, you can work on movement strategies, practice daily activities, and explore ways to move more safely and confidently.

Learn More About Parkinson’s Rehabilitation

• Internal resource: Synaptic Rehabilitation Neuro Rehab Services
  Learn about neurological rehabilitation for movement difficulties and other challenges associated with neurological conditions.
• External resource: Parkinson’s Foundation: Physical Changes
  Learn more about movement-related symptoms of Parkinson’s disease, including slowness and difficulty with mobility.
• External resource: Parkinson’s Foundation: Finding Care and Support
  Explore educational resources and support for people living with Parkinson’s and their families.

Schedule a Neurological Rehabilitation Evaluation

Synaptic Rehabilitation
1200 Route 22 East, Suite 4
Bridgewater, NJ 08807
Call: 908-801-6425

If Parkinson’s is making it harder to start walking, stand up, or begin everyday activities, contact Synaptic Rehabilitation to learn how physical therapy may help you work toward safer, more controlled movement.