How to exercise with diabetic neuropathy

Exercise is a great way for improving control over your diabetes. But exercising can be difficult if you have diabetic neuropathy. Here’s what you can do to overcome the limitations imposed by this debilitating medical condition.

Your nervous system controls, among other things, your blood pressure, temperature, breathing, pulse rate and digestive system, as well as your ability to move, listen and talk. If you are a man, it also controls your erectile function.

The system consists of thousands of fibres that connect your brain and spinal cord to every part of your body.

Long-term diabetes can damage these nerve fibres … this is called diabetic neuropathy.

Diabetic neuropathy develops when you have had high blood glucose levels for several years.

This type of nerve damage is usually permanent, though there is some evidence that a low-fat vegan diet combined with regular vigorous exercise can reverse it.

But you can prevent it in the first place … by controlling your blood glucose levels through diet.

And you can allay the symptoms (and prevent the damage getting worse) through a change in diet and exercise.

Peripheral neuropathy

Peripheral neuropathy is the most common form of diabetic neuropathy.

In this form of diabetic neuropathy, the nerves in your feet and legs are usually affected first, followed by the nerves in your hands and arms.

The effects of peripheral neuropathy on your feet can range from mildly annoying to painfully sensitive. The symptoms are often worse at night.

These symptoms include one or more of the following:

  • Tingling or burning sensations―especially in the soles of your feet
  • Numbness or reduced ability to feel pain or changes in temperature
  • Sharp pains in your feet, especially in the sole
  • Cramps, most often in the calf muscles or in the angle between the foot and the leg
  • Heightened sensitivity to touch― even the weight of a bed sheet can be agonizing for some of us
  • Muscle weakness
  • Loss of reflexes, especially in the ankle
  • Loss of balance and coordination
  • Serious foot problems, such as ulcers, infections, deformities, and pain in the bones and joints.

Exercise can prevent these symptoms from getting worse. It can also help alleviate them.

The problem is that, depending on the severity of your neuropathy, these symptoms interfere with your ability to exercise.

So, how to exercise when you have diabetic neuropathy?

Here are some tips:

Stick to low-impact exercises

To protect your feet, you should restrict yourself to exercises that have a minimal impact on your feet.

These kinds of exercise include swimming (which does not put any weight on your feet) and water aerobics, yoga and tai chi, walking, strength training with weights, regular aerobics, and so on.

You need to avoid exercises such as jogging (especially on hard road surfaces) which will jar your feet continuously.

The movements you do in many low-impact exercises will also help your balance, as well as getting you to relax.

Build up slowly

What you need to do is to make exercising a routine part of your life. This can be difficult at first.

The trick is to start off with just five minutes or so every day and then build up from there, adding a little more each day, until you are doing 30 minutes a day, every day.

You should begin by concentrating on moves that improve your balance if your nerve damage is quite advanced and you are worried about falling.

Once your fitness has improved, you can try out new exercises such as golf, badminton, lawn tennis, bowling, kayaking or even ballroom dancing. There are dozens of sports that have a low-impact on your feet.

Exercises to improve balance

Here are some exercises to improve you balance … graded from quite simple to not too hard.

Rising up from chair … a simple movement to improve your sense of balance is to rise out of a chair three to five times in a row. At first you can use your arms and hands to steady yourself. However you should work towards being able to get up out of a chair using just your legs.

Tippy toe … use the back of a chair, a counter top, railing or other object for support. Rest you hands lightly on the support and rise up onto the balls of your feet and hold. Do this three to five times in a row. Try to stay on the balls of your feet for as long as possible. Do this every day. After a few days you’ll find that you can do it without holding on to the support.

Walking the line … walk heel to toe as if following a straight line on the floor, lining one foot directly in front of the other as you move forward. You can use your arms for balance. To see how good you really are, try doing it backwards.

Stand on one leg … with your hands on a suitable support such as a countertop, back of a chair or railing raise one foot off the ground so that you are standing on one leg. Try to hold your pose for at least 30 second. Then switch legs.

Once you are comfortable doing it, try it without resting you hand on the support. When you feel confident doing this exercise without a support, you can do it anywhere anytime; eg while doing the wash-up, talking on the phone and so on.

Walking tippy toe … once you are comfortable with the four ‘balance’ exercises above, you can try walking across the room on tippy toe. Raise your arms straight up over your head, hands touching, and go up on tippy toe. Look up at the ceiling so that your fingers, head, spine and legs are in one straight line.

Walk forwards for 10 paces, turn, and walk back. If you feel you are going to fall, just drop your heels and hands so that you are standing normally.

This exercise will improve you balance and strengthen your muscles. But before you start walking, make sure the floor ahead is clear of obstructions that could trip you up.

These exercises to improve you balance count as part of your daily exercises (minimum 30 minutes).

Sensible precautions

Common sense suggests the following precautions:

Shoes … to avoid foot injuries you need soft shoes or trainers that fit well. To avoid blisters, make sure they fit properly and have plenty of room around the toes. The kinds that protect your feet the most have a layer of shock-absorbing gel in the soles. They are also the most comfortable.

Foot check … after each exercise session, check your feet for injuries. If you find any scrapes, cuts, cracks, blisters etc, treat them immediately.

Blood glucose … once you have built up to more vigorous exercise you should start checking your blood sugar levels before and after exercising. This will give you a good idea as to how a particular exercise can affect your blood glucose. It should, of course, be within your target range of 5 to 7 mmol/L (90 to 126 mg/dL).

Glucose supply … once you have reached the point where you are fit enough for more vigorous exercises, you should carry a source of glucose, such as glucose tablets, boiled sweets (hard candy) or raisins, in case your blood sugar drops too low.

Provided you stick with exercising for at least 30 minutes a day, you will find that your diabetes is under better control (ie, you’ll have lower blood glucose readings) and that the problems you have with your legs are getting no worse … perhaps even improving a bit.

Author: Paul Kennedy

Paul D Kennedy is a qualified accountant and an international business consultant who used his skills as a researcher to uncover the mysteries of type 2 diabetes and gain control over his health and wellbeing.

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