Exercising When Diabetes Affects Mobility
Having an amputation or being in a wheelchair can make it hard to think about fitness — but diabetes management still requires activity. Try these ideas to get moving.
By Madeline R. Vann, MPH
Medically Reviewed by Lindsey Marcellin, MD, MPH
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People with type 2 diabetes may eventually find that they have lost mobility, either because a limb has been amputated or they otherwise need to use a wheelchair.
This change can make it hard to think about exercise and fitness, but successful diabetes management is still a priority — and still requires at least 30 minutes of activity five days a week. Even if you have lost a limb, the other joints in your body still need to be active, so your goal is to manage diabetes and also keep the rest of your body in motion.
Joints get stiff if you don’t move them, says Patrice Winter, a physical therapist at George Mason University and in private practice in Fairfax, Va. “Joints are like a well-oiled machine. [They] need to be active.”
Winter is sympathetic to the situation faced by people with diabetes who have reduced mobility. “With diabetes, there is that tendency — with any disability, really — that where there is pain involved you have less of a desire to move. But that works against what you are after.”
First Steps to Diabetes Exercise
Many people with diabetes who have impaired mobility will have to start with the basics before they can begin — or get back into — an exercise routine. This means focusing on range of motion and building up the strength of your heart and lungs so you can exercise. Winter says this is easier for people who begin their fitness training before surgery or loss of mobility.
Ideally, says Winter, you will be referred to a physical therapist or certified trainer who can help you plan a suitable fitness program and get you started with the first steps. You can also go online to find suitable programs; one is called SilverSneakers. Check with your health insurance to find out which types of rehab services and supplies are covered.
During rehab, you will also learn how to use your prosthesis or wheelchair. This may be a workout on its own! Once you have developed some strength, you will be able to move on to more strenuous exercise.
Here are some strategies you can try if you want to get back into an exercise routine:
Find a passion.Winter says that although loss of mobility feels like a limitation, the key to finding your way back to fitness is to ask yourself a counterintuitive question: “What did you like to do when you were little?” Almost every type of physical activity that thrilled you as a child can be managed with a wheelchair or a prosthesis — with some creative modifications — and it is exercise that you enjoy that will ultimately become a long-term part of your life. Here are some of the childhood-to-adulthood translations:
- Basketball.Join a wheelchair league. This works on your core muscles and arms as well as improving cardio-pulmonary endurance.
- Bicycling.People with prostheses can use bicycles (stationary or otherwise) with modifications.
- Swimming.Once your stump is healed and you have the strength to get in and out of a wheelchair or to be mobile with your prosthetic, you can get back in the water.
- Chair-based exercise.“Patients who have diabetes and are in a wheelchair still have upper body strength,” emphasizes Amy Kranick, a registered dietitian and certified diabetes educator with the adult diabetes program at Vanderbilt University Medical Center in Nashville, Tenn. This means that you can try weight training, chair yoga, chair tai chi, resistance bands, and other types of seated stretching and conditioning exercise programs.
- Lifestyle changes.Even while you are building a new fitness routine, you will have to support it with changes in diet and in your approach to managing your blood sugar. Loss of mobility is a reality check for many people living with diabetes, says Winter. “If someone is [undergoing an] amputation and says, ‘I am going to do what I have always done’ and they don’t have a good understanding of the disease, they will lose the other leg,” she warns. Work with a dietitian or nutritionist who can help support your goals for long-term fitness.
Coping With Emotional Issues
Winter advises being true to yourself as you plan your fitness routine. For example, if you are a private person and have always hated working out in public or at the gym, find a way to exercise at home instead of letting well-meaning family members or friends push you into a gym or pool membership. Physical therapists and trainers can come to your home, and some programs have videos that will give you home-based instruction for fitness.
And if you are angry about your situation, this is normal. The reality is that many people who lose mobility become angry, says Winter. While anger is an expected response, it does not further your goals. Seek therapy if you find that anger or despair is making it hard to get moving.
Losing your mobility doesn't mean giving up on fun and exercise. Use creativity and connections to get started on a fitness plan.
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