Exercising with diabetes & peripheral neuropathy

Michael See, MS, RCEP, Clinical Exercise Physiologist in the clinic at the Joslin Diabetes Center.

One of our readers sent in a request for suggestions for exercising with peripheral neuropathy.

We asked Michael See, MS, RCEP, Clinical Exercise Physiologist in the clinic at the Joslin Diabetes Center to tell us what he says to his patients:

Many health benefits come with exercise. But not every type of exercise is suitable for those living with diabetes.

In fact, some exercise can actually exacerbate some health problems associated with diabetes, especially those involving the feet.

Diabetes can cause nerve damage in the form of peripheral neuropathy, which presents itself as feelings of numbness, stiffness and/or burning pain. Numbness could quickly turn dangerous if you don’t feel pain and if you have an injury that goes unnoticed and untreated. This can result in ulcers (open sores) or wounds that get infected, which can be quite serious.

Peripheral neuropathy could also cause destruction of the arches in the foot, which termed Charcot Foot. (If this happens, proper foot wear with arch support is essential to stabilize the foot or Aircast Boot. Biking is safe aerobic exercise for people with Charcot Foot to improve endurance and diabetes control.)

Because repetitive exercise on insensitive feet can lead to ulceration and fractures, you should limit your choice of exercise to low impact or non-weight bearing activities.

Lower extremity exercises that involve strength and balance are helpful for individuals with peripheral neuropathy. Long-term aerobic exercise has been shown to prevent the onset or modify the natural history of peripheral neuropathy.

Strength training can be very beneficial for people with peripheral neuropathy. Contraction of muscles, especially of lower extremities increase muscle tone, decrease sensation of tingling and weakness in the area, which lead to increase energy level to continue performing more exercise.

Avoid high impact activities that involve jumping or may result in loss of balance. Low-impact activities such as walking and stationary cycling are good options.

Other suggestions for exercises that won’t put a lot of stress on your feet include:

  • Those done in the pool. Make sure to dry your feet well when you get out of the pool, and look into buying a pair of pool shoes to protect your feet in the water.
  • Indoor or outdoor cycling
  • Hatha (stretching) yoga

As always, ask your doctor before you begin any new exercise regimen. Your exercise program should be individualized, so ask your healthcare professional to tailor a program to your particular interests and considerations.

And pay close attention not only to your feet but also your blood-glucose (“blood sugar”) levels.  Be sure to read our blog on Setting Blood Glucose Targets for Exercise.

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5 Responses to Exercising with diabetes & peripheral neuropathy

  1. Dennis Frappier says:

    This is an excellent article that should be require reading for everyone whether they have foot problems or not. Possibly many would not have adult onset diabetes if they had been following this advice. It is staggering that there are over 60,000 amputations every year in the US costing society billions of dollars and the numbers are growing. One of my friends has used a magnetic iinnersole that has turned his blackish colored feet and lower legs pink again when he thought all hope was gone. There are many natural ways of helping the body. It is too bad that our medical intervention system cannot insist that the common sense self care approaches be required prior to drastic interventions like amputations of limbs. Keep up the good work. Dennis

  2. Dianne shean says:

    Hi,I have many problems including diabetes,rheumatoid arthritis,neuropathy which has left no feeling in my feet up to my knees and now is in my hands.I was told I have charcot foot,can this make my feet shrink,I have dropped 2 shoe sizes?

  3. My brother having peripheral neuropathy disease he is survive with this problem from a long time but can’t any good treatment. Please anyone suggest me some best treatment for this disease.

  4. Barbara says:

    I have had chronic nerve pain in my R inner ear for over 7 years which is so intense it is disabling. I also have pain in my R arch of my foot. That nerve pain was at appoximately a level 3 until about 2 months ago. NOw it is at a level 10. I had starting taking Zoomba classes 7 months ago and doing some weight lifting for about 3 months. I believe these Zoomba classes and/or the weight lifting exacerbated the pain in my foot. The symptoms are very intense: extreme burning, tingling, electric shock sensations. I just started on neurontin but so far it isn’t doing anything to help me. Between my ear, head and foot nerve pain I’m at “my wits end”. I keep getting worse. I am afraid to resume exercise classes at this point even though I miss them.
    I had this pain in my foot for 7 years and it was tolerable but after I started taking these classes and doing weights it became intolerable. Any ideas, anyone?

  5. My uncle, who is now a diabetic patient, would be very happy if I will inform him this information I have got.

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