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The Conundrum Arising from Being Active and Getting Injured

by Dr. Sheri Colberg, Ph.D., FACSM

You finally decide to get active to help manage your diabetes better or to prevent type 2 altogether, and once you’ve hit your stride, you get an injury that puts you back on the couch! Getting injured from being active happens often enough that you need to know how to prevent and treat injuries so you can stay on track. The best medicine is prevention, so trying to prevent injuries before they happen is the best way to avoid having to take time off from exercising and sidetracking your fitness program. Here are some things you need to know:

The incidence of activity-related injuries, such as inflamed tendons (tendinitis) and stress fractures in bones, rises dramatically when people do more than 60 to 90 minutes of moderate or hard exercise daily. These types of overuse injury are nagging and persistently uncomfortable. Overuse injuries occur following excessive use the same joints and muscle in a similar way over an extended period of weeks or months. If you develop an overuse injury, it’s likely to be the result of excessive training, or doing too much too soon. In my own experience (since I’ve been regularly active for decades), they can also arise from doing something unusual, such as putting down a paver driveway, beating the yard into submission, or cleaning excessively prior to putting the house on the market.

Overuse injuries are more common in anyone with diabetes because elevated blood glucose can affect the health of your joints. Although everyone gets stiffer with age, diabetes accelerates the usual loss of flexibility, especially when blood glucose is higher. Glucose “sticking” to joint surfaces makes people with diabetes more prone to overuse injuries like tendinitis and frozen shoulder (1; 2). It may also take longer for joint injuries to heal properly. The bones themselves can be thinned by exposure to elevated blood glucose levels, making fractures more common in people with any type of diabetes (3). The best prevention of any of these issues is optimal blood glucose control and regular stretching to maintain motion around joints.

You’ll likely benefit from doing a variety of activities on a weekly basis, an approach known as cross-training. Changing up your workouts is really the key to avoiding overuse injuries, keeping exercise fresh and fun, and getting more fit. Each activity a person does stresses muscles and joints differently, which lowers the risk of injury. It adds variety to an exercise program when you include activities like walking, cycling, rowing, swimming, arm biking, weight training, aerobic classes, and yoga, and it gives you flexibility to choose different options based on your time constraints, the weather, and other factors. It also allows you to rest some muscles and joints without stopping exercising entirely. Alternating hard and easy days to lower the constant stress on muscles and joints is also a great idea.

To prevent overuse injuries, progress your exercise slowly (particularly the intensity), choose safe activities for you personally, always warm up and cool down, and make sure that you stretch your muscles regularly to stay more limber. For ongoing problems, treat affected areas with R.I.C.E. (rest, ice, compression, and elevation), combined with anti-inflammatory medications like ibuprofen (Advil or Nuprin) or naproxen sodium (found in Aleve), and avoid going back to normal activities or aggravating joints further until your symptoms resolve.

Finally, taking at least one day a week off from planned activities to rest allows your body time to recuperate and may prevent overuse injuries like tendinitis and stress fractures. It doesn’t mean that you have to stop moving, though, so keep your bodies in motion even on your days off for optimal blood glucose control.

References cited:

  1. Abate M, Schiavone C, Pelotti P, Salini V: Limited joint mobility in diabetes and ageing: recent advances in pathogenesis and therapy. Int J Immunopathol Pharmacol 2011;23:997-1003
  2. Ranger TA, Wong AM, Cook JL, Gaida JE: Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis. Br J Sports Med 2015;
  3. McCabe L, Zhang J, Raehtz S: Understanding the skeletal pathology of type 1 and 2 diabetes mellitus. Crit Rev Eukaryot Gene Expr 2011;21:187-206

 

As a leading expert on diabetes and exercise, I recently put my extensive knowledge to use in founding a new information web site called Diabetes Motion (www.diabetesmotion.com), the mission of which is to provide practical guidance about blood glucose management to anyone who wants or needs to be active with diabetes as an added variable. Please visit that site and my own (www.shericolberg.com) for more useful information about being active with diabetes.