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Step 2: Get Up and Get Moving (Part 6)

Sheri

Now that the New Year is here, all your patients will make resolutions to lose weight. Sheri Colberg, Ph.D., FACSM has some great ideas on Exercising with Excess Body Weight or Arthritis for your patients.

Step 2: Get Up and Get Moving (Part 6)
Choosing Planned Activities—Strength and Flexibility

By Sheri Colberg, Ph.D., FACSM

Exercising with excess body weight.

Carrying around extra body fat can pose a formidable challenge to being physically active. Excess weight alone can often keep you from wanting or being able to participate in sports or other physical pursuits, thus potentially creating a catch-22 for weight management and self-care. For example, choosing not to participate in physical activities due to your excessive body size lowers your daily calorie expenditure, which causes you to potentially gain more weight. At the same time, being sedentary makes you lose muscle mass, making you weaker and robbing you of any incentive to become more active.

Start out slowly, so that you neither injure yourself nor cause yourself to lose motivation. Walking more is a great way to start, but it is not for everyone, so don’t hesitate to try out different low-intensity activities until you find the ones that are most enjoyable for you.

You can choose to get moving simply by doing non-weight-bearing exercises, such as any swimming pool—based activity, stationary cycling, and other activities done off your feet. Many exercises can be done seated, and there are countless articles, books, videos, and DVDs on the subject. Many of the stretches and resistance activities given in the next fitness step can also be modified slightly to work from a sitting or lying position, if that makes them easier for you to do.

Exercise Videos and DVDs for Everyone

A wide selection of videotapes and DVDs demonstrating various physical activities, including exercise routines to be done in a chair or wheelchair, are available from a variety of sources. You can find materials for aerobic workouts, strength training, flexibility moves, yoga, and more. In addition to finding them at local sporting-goods stores and national chains, some online sources to peruse for workout videos are the following: Stronger Seniors (www.strongerseniors.com), Active Videos (www.activevideos.com), Just About Fitness (www.justaboutfitness.com), and Collage Video (www.collagevideo.com). In addition, three workouts highly recommended by About.com include: (1) Jodi Stolove–Chair Dancing through the Decades (2004) and Chair Dancing around the World (2004); (2) Tai-Chi Exercises for Seniors (1998); and (3) Doctor’s Senior Exercise (1998). Try out various ones to see which works best for you.

Exercising with orthopedic problems and arthritis.

Simply by having diabetes, you already have a high risk of both joint-related injuries and overuse problems like tendonitis. You may therefore find that adopting a more moderate exercise like walking rather than a more vigorous one like running makes more sense, since you’ll have less potential for joint trauma with the former. Diabetic frozen shoulder, “trigger finger,” and other acute joint problems can also come on with no warning and for no readily apparent reason. The best defense is to prevent all of these injuries with good BG control, in addition to doing flexibility exercises that help emphasize and maintain a full range of motion around all your joints.

Arthritis is also more common in people with type 2 diabetes due to the extra body weight most of them are carrying around. Lower extremity joints (the hip, knee, and ankle) are most often affected, and, when present, osteoarthritis can severely limit your ability to exercise. However, research has clearly shown that exercise is an effective means of managing arthritis, even the more severe rheumatoid type. Get started with some basic range-of-motion exercises to increase your joint mobility, and then move on to specific resistance work. You will derive immense benefit from both improving joint flexibility and increasing the strength of your muscles surrounding any affected joints.

If you have arthritic knees or hips, walking may be too uncomfortable or painful. Your best option is to try non-weight-bearing activities, such as “walking” in a pool (with or without a flotation belt around your waist), aqua aerobics, lap swimming, recumbent stationary cycling, upper-body exercises, seated aerobic workouts, and resistance activities.

No matter what physical activity you choose to do, start out slowly and progress gradually–using pain as your guide. If you have extremely arthritic joints or flare-ups of pain, concentrate on non-weight-bearing activities. After exercising, you may want to apply ice to your arthritic joints (particularly your knees) for 15 to 20 minutes to reduce swelling and help prevent soreness, and you may additionally benefit from taking nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen to temporarily lessen any discomfort related to the exercise.

Another strategy that can help prevent and treat all orthopedic problems (both increased arthritic pain and more general injuries) is the concept of cross training, in which stressing different muscles and using varying joints from day to day can prevent problems with overuse and keep all of your joints moving more freely.

In two weeks, I will share more tips and ideas from my latest book, The 7 Step Diabetes Fitness Plan: Living Well and Being Fit with Diabetes, No Matter Your Weight (2006). Information about all of my books, my many articles, my research, and more is available on my web site: www.SheriColberg.com.

Tip for the day: First try doing activities that don’t require you to carry around your full body weight, such as swimming, other aquatic activities or classes in a swimming pool, seated exercises, stretching, and light resistance training. As your fitness level gradually increases, you may find yourself able to try new activities that you were previously incapable of doing.

Learn more about the Steps to Health Program at STEPS TO HEALTH

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