John Roche makes his way toward the door to his back garden, his walk slow and shuffling because of the Parkinson's disease he was diagnosed with 12 years ago. Stepping through the door presents a further challenge for him, as it often does for people who have Parkinson's, but once he enters the patio of his home in Liverpool, England, everything changes. There he steps up to a soccer ball and, as if by magic, starts juggling it like a pro. His movements are fluid, without a trace of the tremors his condition typically causes.

A video Roche shared of this on Twitter in May 2020 racked up more than 3,400 likes and 1,000 retweets. “I get the ball in my possession, and my body changes,” he says. “You can see there's a moment where it relaxes.” His ease with the soccer ball reflects an aspect of Parkinson's called kinesia paradoxa—the sudden ability to perform a task the person typically cannot, usually triggered by stimuli.

A former semipro soccer player, Roche, 61, co-founded a walking football (soccer) program in Liverpool for people with Parkinson's disease. Walking soccer is a version of the game in which players are not allowed to run or head the ball and must stay out of the goalie's designated area. Violations can result in a free kick for the opposition. The sport has been around for a century and allows people to play despite age or mobility restrictions, says Stuart Carrington, football inclusion officer for the Liverpool County Football Association and the coach of Roche's team.

Walking soccer programs for players with Parkinson's have taken off around the United Kingdom: The number of British teams grew from four to 20 in just one year, says Carrington.

The sport hasn't attracted only experienced players. “People who've never kicked a ball before who just want to see what this walking football is about are made to feel welcome,” says Carrington, who's also manager of England's national walking football team for people with Parkinson's. “Most of them come back because of the atmosphere and the relationships.”

Many studies have shown the benefits of physical activity—from stationary bike riding to noncontact boxing to tango dancing—for people with Parkinson's, says Joseph H. Friedman, MD, FAAN, professor of neurology at Brown University in Providence, RI. A phase 3 clinical trial now underway in the United States and Canada is studying the effects of endurance treadmill exercises on people in the early stages of the disease.

Walking soccer could turn out to be a terrific exercise for someone with Parkinson's, according to Dr. Friedman, since it is done with other people who have the condition, encourages stretching and moving around, and may help restore balance and coordination. But he points out that soccer could be more difficult than other sports for people with Parkinson's because they tend to experience “freezing”—the inability to move their feet, as if they were frozen to the ground—which can result in falls. “I think whatever works best for any individual is the one that person should do,” he says.

In general, exercise is protective for people with neurodegenerative diseases because it can reduce neuroinflammation and improve memory and may help delay disease progression, says Natalie P. Witek, MD, assistant professor of neurological sciences at Rush University Medical Center in Chicago. “We can clearly see that a healthy body leads to a healthy brain,” she says, although she cautions that players may risk injury if they play on unlevel ground or have problems with balance. Adjusting medication or working with a physical therapist may help reduce that risk, Dr. Witek adds.

Joining a walking soccer team is also a way to alleviate the isolation many with Parkinson's experience. “People with Parkinson's often withdraw and become less active,” Dr. Friedman says. “I tell my patients that medications help them today. Exercise helps them in the future.”

The idea for Roche's team grew out of a chat he had with a man sitting beside him at a local soccer match: James Clark, who also has Parkinson's. “It was like we were meant to sit in those two seats,” says Roche, who learned that Clark had helped organize a team to play in the Ray Kennedy Cup, an international soccer tournament for people with Parkinson's, named for a famous Liverpool footballer who had the disease (and died in 2021).

The coed walking soccer team Roche and Clark established meets a few times a week. Participants range in age from 30 to 70, must have their doctors’ okay to play, and must sign liability waivers. Carrington coaches them through warm-ups and drills and incorporates lots of breaks so players don't tire. For the same reason, he says, matches are limited to 20 minutes.

Roche believes playing not only brings back happy memories but also gets the dopamine flowing—a key benefit for people with Parkinson's, since many symptoms result from the loss of the dopamine-making neurons in the brain. Evidence shows that exercise can modulate the storage and release of dopamine, says Dr. Witek.

The team's workouts are designed to “make sure we're doing everything we can to every muscle in the body,” Roche says. He has tremors, but his muscles relax on the field, and he moves freely.

For Roche and other players, workouts and games are an opportunity to socialize. “The camaraderie is amazing,” Carrington says. “The Parkinson's community is getting stronger and stronger. When these players come for the first time, they're made to feel extremely welcome, which relaxes them and allows them to just enjoy themselves.”

Rod Houghton, who was diagnosed with Parkinson's in 2007, says playing again “makes me feel like I'm 10 feet tall.” The 71-year-old Liverpool resident says the sport is embedded in his brain—“and Parkinson's can't get at it.”

Walking soccer hasn't really caught on yet in the United States, but anyone interested in starting a team can email Carrington at stuart.carrington@liverpoolfa.com. You can get in touch with Roche through the website of Northern Lights, a local support group for people with Parkinson's that he co-founded, and follow England's Parkinson's team at @ParkinsonsPride.

In addition to playing, Roche has been educating professional soccer players in Britain about Parkinson's, speaking with visiting teams when they come to play in Liverpool. With 20 visiting players per game and 20 games per year, he can reach 400 people—and they can go home and share what they've learned. “If I can get the message to 1,000 people, I'll feel I've done my best for Parkinson's,” says Roche, who is working with people in Rotorua, New Zealand, to set up a club like his.

He also continues to work with Northern Lights, which offers activities such as golf and fishing. Roche's vow to participants: “If you come to me with something Parkinson's has taken from you, we'll fight to get it back.”

Soccer and Parkinson's in the States

Kicking Parkinson's, an organization founded in 2020 by 16-year-old twins Christopher and Anthony Stern of Newport Beach, CA, uses soccer ball juggling challenges to raise money for programs for people with Parkinson's disease.

“My sons have established fundraisers to support free exercise classes for people with Parkinson's disease” and “to assist with concussion education, intervention, and prevention in hopes of helping prevent Parkinson's disease in soccer players,” says the twins’ mother, Theresa, director of the Neuroscience Institute at MemorialCare Orange Coast Medical Center in Fountain Valley, CA.

Participants in Kicking Parkinson's challenges ask others to sponsor them for a certain dollar amount per juggle, just as those in walkathons are sponsored per lap, kilometer, or mile.

“They've also created exercise classes for people with Parkinson's that teach soccer fundamentals and techniques in a standing or seated position,” Stern adds about her sons. For more information, visit KickingParkinsons.org.