Neuropathy and Exercise
Pain, muscle control problems, and overall health complications can make even everyday activities for your patients suffering from neuropathy harder to manage. For some of those patients, the prospect of exercising will seem not only unrealistic but an almost ironic misplacement of their priorities. As you know, though, exercise is important for everyone. In your patients, it can actually help control blood sugar and slow down the progression and symptoms of the condition.
Exercising regularly greatly decreases anyone’s risk of diabetic neuropathy, and has been shown to control symptoms and deterioration in neuropathy patients by elevating overall blood flow to the limbs and controlling cardiovascular atrophy. Depending on a patient’s specific type of neuropathy, the areas affected, and the extent of their damage, neuropathy patients should be advised to adjust conventional workout routines to accommodate their condition. Advise patients with neuropathy to consult you before they begin any workout program. When they do, be sure to inspect their feet and legs for signs of potential problems, and make sure their shoes are properly fitted so as to avoid neuropathy-related injuries. Contact us if you have any questions about how to advise patients interested in starting a fitness program; NeuropathyDR® has resources that can help.
Here are some general guidelines to pass along to patients, to help them avoid neuropathic complications:
- To use silica gel or air midsoles
- To use polyester or polyester/cotton blend socks to keep their feet dry
- To avoid any workout clothes that rub against their skin in the same area.
Ann Albright of the Division of Diabetes Translation in Atlanta cautions that neuropathy patients will want to steer clear of most repetitive or weight-bearing exercise, such as running, walking, or extensive weight training (although some sources advocate weight training as beneficial, in moderation). So which exercises are the most beneficial while reducing risk?
Swimming is one of the best exercises to recommend, as it is an activity adaptable to any age, fitness level, or degree of neuropathy symptoms. Swimming is also a full-body, “no-impact” workout, and so is less harmful to a patient’s joints, legs, and feet than most other forms of exercise, without sacrificing circulation. As such, it is highly recommended for almost anyone.
Bicycling, rowing, and use of a stationary bicycle are other excellent, low-impact activities that can be safely integrated into a neuropathy treatment program. Some organizations have even developed exercise programs for senior citizens suffering from neuropathy, incorporating a heavy emphasis on seated exercises.
In the event a patient does not have regular access to facilities or equipment for more extensive exercise, there are some basic exercises you can teach that can help your patients control their dexterity and neuropathy symptoms:
- For hands, touch the pad of your thumb with your index finger, running the finger down to the base of your thumb. Then, repeat the movement with the index, middle, ring, and little fingers. Do this exercise several times.
- For legs and feet, straighten one knee and point your foot. Flex your ankle five times, then circle your foot five times in each direction, clockwise and counterclockwise.
- To increase balance, try this exercise: from a standing position, rise up slowly on your tiptoes, and then rock backward onto your heels. Keep your knees straight, but try not to lock them.
Additional precautions are vital for neuropathy patients to observe. Advise patients that, after every workout session, they should remember to check their feet and any relevant extremities for blisters, irritation, or sores. These could be vulnerable to infections, which themselves could elevate risk for amputation.
It is especially important for neuropathy patients to be mindful of their heart rate and blood pressure. Especially if they suffer from autonomic neuropathy, which can greatly increase risk of heart failure or cardiac arrest, advise them of their limitations when it comes to exercise. There is an appropriate level of exercise for almost everyone, even those with heart risks, but the degree of exercise you advise will obviously vary on a case-by-case basis.
Finally, be sure to make your patients aware that neuropathy sufferers are at high risk when it comes to overheating, since some types of neuropathy can reduce the body’s ability to temperature-control. Advise them to keep a close monitor on their body temperature, and to let you know immediately if their sweating seems overly profuse or the opposite, less than normal.
If you have any questions about how patients diagnosed with neuropathy should exercise, contact us. NeuropathyDR® can answer your questions and has the resources you need to help your patients stay fit, healthy, and active while living with neuropathy!