Mayo Clinic Minute: 5 steps to diabetic foot care
Foot Care and Exercise With Diabetes
Exercise is at the top of the to-do list for managing diabetes. But while staying active is important, so is paying attention to your feet, as diabetes complications can make your feet more susceptible to injury.
Diabetes requires extra foot care because the condition affects your blood flow and your nerves, explains foot health expert Robert Thompson, a certified pedorthist and executive director of the Institute for Preventive Foot Health in Birmingham, Ala. “Many people understand that diabetes can affect their hearts, but they don’t understand why their feet — the farthest point from the heart — are involved,” he says.
For about 40 percent of people with diabetes, complications will include peripheral diabetic neuropathy, nerve damage that affects the feet. With neuropathy, you might not feel when you develop a sore, blister, or even burn. To complicate matters, diabetes complications also include reduced blood flow, which means your body can’t heal as easily as someone without diabetes. That sets up a dangerous situation in which a tiny cut or irritation can lead to infection and even amputation.
How Exercise Can Affect Foot Care
Exercise that involves being upright and putting pressure on your feet, called weight-bearing exercise, can increase the chance of injury to your feet.
“Walking counts as a weight-bearing activity because you have the weight of the body on the soles of the feet,” explains Sheri Colberg-Ochs, PhD, a professor of exercise science in the human movement studies department at Old Dominion University in Norfolk, Va., and the co-author of a statement on exercise and diabetes for the American Diabetes Association (ADA) and the American College of Sports Medicine (ACSM).
Yet despite possible foot problems with diabetes, you don't want to give up weight-bearing activities, as there are many benefits from aerobic activities like walking, including improved heart health and weight management, as well as improved blood sugar control.
The Essentials of Foot Care and Exercise With Diabetes
The 2010 joint statement from the ADA and the ACSM, co-authored by Colberg-Ochs, formally recommended that people with neuropathy who do not currently have any sores (or lesions) on their feet engage in moderate physical activity. Walking is one of the safest and lowest-cost activities around, but you can engage in any activity you enjoy as long as you take the proper precautions to protect your feet. These precautions are especially important if you have neuropathy, but everyone with diabetes should follow them, says Thompson.
Here's a foot-care checklist:
Check your feet before exercise.If you find a sore on your feet, skip your workout and focus on caring for the sore.
Wear padded, polyester-blend socks.Cotton socks hold moisture and lose their cushioning, creating a wet layer around your foot. Look for low-friction athletic socks designed to help wick moisture away from your feet.
Wear supportive athletic shoes.Find shoes with arch support that are fully enclosed. Wear shoes like these even during activities that don’t obviously call for it, such as a walk on the beach. If you have diabetic neuropathy, it can be hard to tell if shoes fit right, so ask for help from a professional shoe fitter at an athletic shoe store. And remember not to tie your shoes too tightly.
Acknowledge your changing movements.Lost sensation in your feet can lead to changes in gait, such as walking with a wider stance or taking smaller steps. Good shoes can help protect your feet from the changing pressure.
Consider an orthotic insert.Talk to your doctor about prescribed shoe inserts that can reduce the risk for pressure sores or calluses.
Vary your exercise routine.Both weight-bearing and non-weight-bearing exercise (like swimming) will benefit your body. “I can’t really stress enough rotating the activities you are doing so you aren’t putting stress on your feet and joints in the same way,” says Colberg-Ochs.
Check for sores after every workout.Always check feet after exercise. Use a small hand mirror with a handle to help you look at hidden parts of your feet. If you have an amputation or partial amputation, check the skin of the stump to make sure it is healthy and not discolored or developing sores.
When to Call your Doctor
If a foot sore isn't healing well after a day or two, call your doctor. If you aren’t sure how to handle a sore, don’t wait to call your doctor — seek immediate care. Infections can take hold very quickly.
The good news, says Colberg-Ochs, is that people with neuropathy do not seem to have a greater risk for developing another sore after the first one has healed. So, after you take time off from weight-bearing activity to heal, start working out again.
Be mindful of your feet, and you’ll be able to get exercise with diabetes on a regular basis — and enjoy it more.
Video: Diabetic Foot Strengthening Exercises
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