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If you have diabetes, you already know that exercise is a staple for controlling this common disease. But once peripheral neuropathy sets in, being physically active can be a tricky issue.
Peripheral neuropathy is nerve damage that affects the feet and, sometimes, the hands. It affects about 15 percent of the 18 million people in the United States who have diabetes.
It can lessen the ability to feel cold, heat and pain.
And it can be dangerous. If you have this complication, you may not feel injuries in your feet. One of my co-workers who has peripheral neuropathy had no idea he had stepped on a nail until he saw blood. He also has had to give up his favorite way to stay active: playing basketball.
Nerve damage can lead to foot ulcers. In the worst-case scenario, ulcers and infections can spiral out of control, necessitating foot amputation.
This shouldn't scare diabetes patients into becoming sedentary. So far, studies show that there's a good reason to be physically active. Exercise can increase blood flow to the affected areas and even slow down neuropathy, according to a recent report in the journal The Physician and Sportsmedicine.
But you need to work closely with your doctor to determine your foot health and what kind of exercise is appropriate for you.
Here are some points to consider, according to the report's author, Sheila Ward, a diabetes researcher and exercise consultant at the Virginia Department of Health in Richmond:
If your feet are numb, or you have little sensation in your feet, try exercises that do not put much stress on your feet and weight-bearing joints. These include swimming, bicycling, rowing and other non-weight-bearing exercises, and a variety of upper-body exercises.
If you have active foot ulcers, avoid weight-bearing activities, such as walking on a treadmill, prolonged walking, jogging and step exercises. Those with previous foot ulcers may need to reduce or avoid these activities.
If you have open wounds, don't exercise in a pool until the wounds are completely healed.
If you have active foot ulcers and want to exercise while healing, try non-weight-bearing exercises such as chair aerobics or upper-body cardio activities.
You need to pay special attention to footwear, according to the American Diabetic Association.
Always check for objects that may have fallen into shoes before putting them on. Never walk barefoot in showers, locker rooms or pool areas or on hot sidewalks. Use orthotics, if needed, to ensure a proper shoe fit. Discard worn-out shoes. When choosing socks, pick those that provide adequate support and move sweat away from the skin. At the end of each workout, remove sweaty socks, dry your feet and check for cuts, bruises, scrapes or blisters. Do not use adhesive tape on your feet.
For a checklist of symptoms of diabetic neuropathy: www.diabetes.org/uedocuments /DNWebCheckList.pdf
For the report on exercise and peripheral neuropathy: www.physsportsmed.com/cover .htm
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(Lisa Liddane is a health and fitness writer for The Orange County Register and an American Council on Exercise-certified group fitness instructor. Write to her at the Register, P.O. Box 11626, Santa Ana, Calif. 92711 or send e-mail to lliddane(AT)ocregister.com.)
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(c) 2005, The Orange County Register (Santa Ana, Calif.). Distributed by Knight Ridder/Tribune News Service.
