If you have not exercised in a while, getting moving again can seem intimidating, especially if you equate working out with performing a punishing routine in a gym full of super-fit people. “I’m not one of them,” you may think; “I’m too weak, too old, too heavy, or simply not obsessed with my body image the way ‘they’ are. Why bust myself to lose just a bit of weight, which I might gain back anyway?”
In reality, though, there are many different reasons to exercise other than weight loss, and countless ways to do it without setting foot in a gym. Many relatively simple activities can improve your balance, flexibility, energy level, and general feeling of well-being, helping you to accomplish tasks in your daily life more easily. These activities can be done at home or in a neighborhood park, and many can be done either alone or with an activity partner or group.
Once you have received your doctor’s go-ahead to start exercising or to increase the intensity of what you’ve already been doing, try a few of the exercises described here to help you meet specific fitness goals, such as increasing your strength or reducing pain. You may be surprised by how much better you feel.
Improving your balance
It’s hard to feel comfortable doing any type of exercise when you feel wobbly doing it. This means that improving your balance can help you get fit in other ways, as well. To boost your balance, Karen Kemmis, a physical therapist and certified diabetes educator who works at the Diabetes Center of the State University of New York’s University Hospital, recommends trying to balance on one foot while standing near the kitchen counter, so that you can hold on if you feel unstable. Build up to holding this pose for 10–20 seconds on each foot. It can help to focus your eyes on an object in the distance while you try to balance.
Kemmis also recommends walking as if you were on a tightrope, putting one foot directly in front of the other. At first, take steps with your feet a comfortable distance apart. As your balance improves, place your feet closer and closer together until eventually, each step is only the length of your foot. Try doing this across a room. If you need to, extend your arms out like a tightrope-walker to help keep your balance.
One excellent way to improve your balance is to practice tai chi, the ancient Chinese system of exercises that has been called “meditation in motion” because of its gentle movements. Most communities have tai chi classes, or you can follow a tai chi video at home.
“Tai chi has been shown to improve balance, and it’s quite safe for almost everyone,” Kemmis says. “Even if someone has joint pain because of knee arthritis, or hip or back pain, they can do tai chi quite well.”
Kemmis recommends leg-strengthening exercises to address balance issues, too. Good options include climbing stairs or repeatedly standing up from a chair without using your hands to push yourself up.
“Try to work up to three sets of about 10 repetitions,” says Kemmis.
For best results, perform these exercises two to three days per week.
Having more energy
It’s tough to get in shape – or to do much of anything – if you feel like you have no zip left. The key to feeling more energetic is maintaining muscle tone. Assess what activities fatigue your body, and use those activities for exercise. If you tire from climbing stairs or walking out to the mailbox, do each more often to build up your leg muscles.
“As people get tired, they do less, so we have to make an effort to push ourselves a bit,” says Kemmis. “It makes things easier, so it’s worth it in the end.
“People often think it has to be a 30-minute walk all at once. But even 5 or 10 minutes at a time that total 30 minutes at the end of the day will help. Don’t get discouraged. Just try to build up.”
Stiffness can hamper both regular daily activities and attempts at exercising. The best way to decrease stiffness is to stretch properly. While many people have been taught that stretching should precede exercise, that’s not so.
“The most important thing is to do stretches when the muscles are warm,” says Jackie Shahar, manager of the exercise physiology department at the Joslin Diabetes Center in Boston. “That will most likely happen after someone has done some aerobic activity or resistance training.”
Don’t try to stretch immediately after getting out of bed or after sitting still for a while, because your muscles will be cold. A few minutes of walking with your arms pumping will do the trick to warm them up. Then stop to stretch before continuing your walk or whatever activity you have planned. You can also perform stretches at the end of your workout if you prefer.
While stretching, don’t bounce, bob, or jerk. Slowly and gently move into a position that puts gentle pressure on the muscle and hold the position for 20 seconds. Then relax and repeat; you may be able to stretch a little farther the second time, but don’t force it. Stretch each muscle group or whatever body parts feel like they need to be stretched.
If your calves habitually cramp, try a stretch that Shahar recommends: Lean your palms against a wall at shoulder height with one leg under you and one leg extended behind you. Bend the “front” leg. Keep your “back” heel flat on the floor. Bend your elbows so that your nose gets closer to the wall. Hold the position for 20 seconds and then switch legs and repeat.
For the lower back, Shahar advises lying on your back on a bed or on the floor with your knees bent. Slowly and gently lower both knees to one side, twisting at your waist. Hold the position for 20 seconds, then lower your knees to the other side.
If your quadriceps (thigh muscles) are tight, try another move from Shahar: Place one hand on the wall, and bend the knee of opposite leg so that you can grasp your ankle behind you with the other hand. Gently pull your heel toward your buttock. You can also perform this stretch using a chair back (or seat, if you are shorter) as a support for the foot that’s behind you.
With summer just around the corner, now’s the time to start planning how to take advantage of the longer days and warmer temperatures. In particular, it’s time to start thinking about how you will stay active this summer and how you might take your physical activity program to new heights by exercising outdoors, scheduling active weekend outings, and perhaps even planning an activity-oriented summer vacation such as a bike tour or walking tour.
Outdoor activities can be a lot of fun, and they’re also good for your health. Working regular physical activity into your lifestyle can help reduce your risk of heart disease and high blood pressure, as well as help you manage your blood sugar. Important data from a study published in the journal Diabetes Care showed that stationary biking three days a week for 45 minutes improved insulin sensitivity by 46%.
Regular physical activity can also help prevent diabetes, so if your friends or family members need a little extra encouragement to join you in your physical activities, let them know what a great thing they’re doing for their health. The Diabetes Prevention Program, a major three-year clinical trial conducted by the National Institutes of Health, showed that in 3,234 people with impaired glucose tolerance (often called prediabetes), those who walked or exercised five times a week for 30 minutes (150 minutes total per week) lost 5% to 7% of their body weight (approximately 12–15 pounds) and reduced their risk of diabetes by 58%. For people over the age of 60, the reduction in diabetes risk was a whopping 71%.
If you’ve made physical activity a priority this year and have improved your conditioning, what better way to put all that fitness to good use than to take an active holiday or enjoy an active weekend? For those of you who haven’t quite reached the get-up-and-go stage, the prospect of an active summer weekend or vacation might be just the motivation you need to lace up your sneakers and start exercising.
Before you call your travel agent, take a few moments to think about the type of activity you’d like to do and what you’re capable of doing. Would you enjoy a guided nature walk or group bird-watching outing on gentle paths? Or would you prefer a rugged hike in the woods or mountains? Are you fit enough for a bike tour through the vineyards of northern California? Or would a historic walking tour through the villages of Vermont suit you better? There are dozens of activities to choose from in your own hometown, across the United States, and throughout the world.
Perhaps the simplest, safest, least expensive, and most convenient form of physical activity is walking. You can do it anywhere, anytime, with just a pair of sturdy shoes. You can do it alone, with a partner, or with a group in structured or informal walking activities. Here are some of the many choices.
Urban parks. City parks are wonderful places to walk and enjoy nature close to home. Urban park rangers in most city parks lead theme tours throughout the year, and many are free of charge. Call your local recreation department or park headquarters for details.
Walking and biking clubs. Clubs offer the chance to meet new people and to try new walking or biking routes. All major cities and some smaller ones have them. Most clubs sponsor events (walking clubs sometimes team up with local running events), and many offer instruction for free or for a small charge. Contact your local running, biking, or sporting goods store, or attend a local walking, running, or biking event to find out about clubs in your area. Clubs and stores are also great resources to find out about biking vacations and walking tours.
Volkssport. Volkssport clubs in every state organize noncompetitive walk, bicycle, swim, and cross-country ski events for people of all ages. They are not contests of speed or endurance, but rather family-oriented activities that promote participation in recreational activities for fun, fitness, and friendship. Participants can walk, jog, run, or use a wheelchair. Each event is given a trail rating, and routes are set out so that you finish at the starting point. The most common distances are 5, 10, and 20 kilometers (3.1, 6.2, and 12.4 miles).
Bird-watching. In 1991, more than 24 million Americans took field trips for the express purpose of watching wild birds. In general, bird-watching is not too vigorous, although the equipment — binoculars, cameras, tripods, zoom lenses, etc. — can get heavy after hours of walking. The amount of walking depends on the group and its goals, but almost all trips involve a fair amount of standing in one place to watch (or look for) birds.
The American Birding Association is the largest bird-watching organization in North America. Although they don’t run field trips themselves, they endorse tours run by operators who have a proven record of competence and quality. There are many tours to choose from, both nationally and internationally.
The National Audubon Society, an organization with over 600,000 members, 508 chapters in the Americas, and 100 Audubon Sanctuaries and nature centers nationwide, organizes field trips through local chapters — many of which are open to nonmembers for a nominal charge — and guided bird-watching vacations through local chapters and the national organization. Call or visit their website to find a chapter near you.
Mall walking. Not ready for walking outdoors? Many of America’s shopping malls have organized walking clubs, and many open their doors early for walkers. It’s a great way to get out of the weather and away from traffic, and restrooms and water are never far away. Membership is usually free. You can find out more by stopping by the mall office or contacting them by phone.
Whether you’re a seasoned traveler or a casual one, living with diabetes can create some quandaries before you hit the road. This doesn’t mean you should be discouraged from travel adventures. Your passport to success for traveling with diabetes is obtained by planning the trip, preparing for situations, packing wisely, and focusing on positive solutions when challenges arise.
Give yourself plenty of time to plan your trip. This will give you a better opportunity to get an adequate stock of your daily diabetes medications and other medications and testing supplies. In particular, check the refill timing on your prescriptions so that you don’t run out.
You’ll probably be eating at different times and taking part in different activities on your vacation, so keep a sharp eye on your blood glucose levels so you can feel your best and enjoy your trip. In fact, pack extra testing strips to monitor responses to new experiences and foods. Review your itinerary and adjust your meal schedule to avoid hypoglycemia (low blood sugar), or plan how to fit in some walking to help avoid hyperglycemia (high blood sugar). If you’re working with a travel agent, tell him or her that you have diabetes so you can develop a workable itinerary for your journey based on your usual routine. Ask about the meal service on planes; nowadays, meals are the exception, not the norm, so carry items with you.
Furthermore, if you take insulin, talk to your doctor about developing a correction scale and having some fast-acting insulin with you in case you need it, such as Apidra, NovoLog, or Humalog. An insulin correction scale — or sliding scale, as it is sometimes called — is a written plan to help you address hypo- and hyperglycemic events as they occur, and it can be extremely valuable on the road, when you’re away from your usual health-care team. The correction scale, written by your physician or health-care provider, has various ranges of blood glucose values and the corresponding insulin doses you would need to take for each range of blood glucose. It’s tailor-made instruction from your provider on how to deal with excursions with your blood glucose levels while you’re traveling.
If you take any prescription medications, ask your pharmacist to print out two copies of your current medications. Put one copy in your suitcase and keep the other with you at all times.
The Internet is a great resource as you prepare for some of the decisions you will need to make. You can look up guidelines from the FAA, the airlines, and train and bus lines regarding baggage, carry-on rules, and ordering special meals or services. If you’re traveling by car, you can use online mapping sites to plot a route. You can also explore your restaurant choices, plan stops for bathroom breaks and stretching, and locate chain pharmacies or health-care facilities. (Click herefor a list of websites that offer helpful travel tips for people with diabetes.)
An important part of preparation is learning the baggage rules you’ll encounter, including guidelines for transporting medications, devices, gel cooler packs, and food. For example, if you wear an insulin pump (or other diabetes-related device) and you’re at an airline security checkpoint, inform them of your device; they’ll probably have you step aside and simply use the scanner wand so that you can keep your insulin delivery uninterrupted. Check the manufacturer’s guidelines of your device for additional advice about going through security scanning, water-resistance parameters for those hours by the pool, and temperature limitations. Plan to take extra pump or insulin device supplies, write down help-line numbers, and take along user tip sheets.
If you take insulin with syringes, think about how you’ll carry and dispose of your syringes or pen needles en route. Padded insulin travel packs — which include handy straps for organizing your supplies, cool pack inserts, and pockets for alcohol pads and other items — are available. Portable sharps containers and needle clips also can be found online. Some airports, hotels, and public restrooms have sharp containers, but many do not.
When you’re traveling by car, fill a small plastic food container or thermos with cotton balls to nestle your insulin vials in, secure the top, and then place it in a small cooler; do not freeze or place on ice. Follow the manufacturer’s guidelines to store insulin pens or vials and avoid spoilage or trips to a local ER for help. (Spoiled insulin often has visible clumps or crystals and should be discarded.)
Always carry your medical insurance card, pharmacy card, and physician/health-care provider phone numbers with you. Consider wearing a medical ID, since you could become separated from your purse or wallet.