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Exercise For Diabetes

Balance Exercise

Three people, none of whom know the others, happened to mention balance exercise to me on three consecutive days. I’ve learned to listen to coincidences like this, because the last time it happened like that, I listened and changed my life for the better.

That was another story that happened more than 30 years ago. The new story happened a couple of weeks ago. And again I listened.

First, I listened to my favorite Certified Diabetes Educator. She was concerned that this summer I slipped and fell several times while hiking in the mountains. While I eventually realized that much of the blame should go to my old hiking boots that needed (and got) new soles, I know that I’m not as steady on my feet as I was when I was younger.

I don’t have any of the diabetic neuropathy that plagues about half of those of us with diabetes. But simply having diabetes, as I do, can weaken sensory nerves.

Then, the next day I listened to a professional photographer who took me to the mountains for a photo shoot for an exhibition that will include my mug. I slipped and fell on the trail. While it was pitch black, freezing cold, and icy, I fell and he didn’t. The photographer told me that following his knee surgery his doctor recommended that he do balance exercises.

Finally, I listened to my podiatrist on the following day. He told me about the balance exercises that he recommends to his patients.

The coincidences continue. When I went to a hotel in Denver to attend the “Diabetes Conversation Map” training last week, I picked up a copy of The Wall Street Journal, which I subscribed to until Rupert Murdoch added that paper to his media empire.

The Journal that day reported how sports medicine has begun to focus on senior athletes. “Balance, in particular, is emerging as an important element for older people,” the article says. “Older muscles are smaller and slower and respond less efficiently when we need to brace ourselves, making us more vulnerable to falls.”

To compensate for these changes we can focus more on balance and flexibility than the traditional focuses of exercise, aerobic and resistance training. The American College of Sports Medicine and the American Heart Association now recommends that anyone age 65 or more have a physical activity plan that includes all four of these types of exercises.

And it’s not just the senior set that can benefit from balance training. “All people who are at least 50 with clinically significant chronic conditions or functional limitations” need it too, according to the Journal, quoting those organizations. And if anyone has a “clinically significant chronic condition,” it is of course those of us with diabetes. You can find the recommendations of these two organizations online.

The final coincidence – a fine example of synchronicity – is The Cochrane Collaboration’s release this week of a review of research on exercise. To appear in The Cochrane Library (but as I write not free online), “Exercise for improving balance in older people” concludes that doing tai chi and standing on one leg can help us to regain lost balance.

I know from my experience that tai chi works. I studied it and practiced it years ago, when I didn’t know what it could do for my balance. But I wasn’t patient enough to continue doing it.

My favorite CDE was the first person to show me how simple and effective that standing on one leg could be to help me regain my balance. All I had to do was to stand on one leg and then the other for 30 seconds each. When I could master that, the next step was to do it with my eyes closed. Finally, she said to do that on a pillow.

My photographer completed agreed. He does the same exercises.

My podiatrist told me very much the same thing. “Balance is important for everyone,” says Dr. John Jachimiak, “but we tend to lose it as we age. We can get it back and improve it with this simple exercise.” He is a board certified surgeon who specializes in sports medicine and diabetic foot reconstruction.

This works with our proprioceptor sense, a “distinct sensory modality that provides feedback solely on the status of the body internally,” Wikipedia says. Dr. Jachimiak says that this is where a joint is in a spacial relationship to fire the appropriate muscles to stand erect.

The biggest difference from what my favorite CDE told me is that for Dr. Jachimiak the final step is literally onto a folded towel instead of a pillow. Essentially the same.

What else, I asked? Do these exercises on once or twice a day, he says.

That’s all? Just a couple of minutes and no special equipment?

“Right,” Dr. Jachimiak replied. “Think of it as a long learning curve and not as a sprint.”

That’s what I have been doing since I had the good fortune to hear about balance training from three great people. I still can’t go for 30 seconds on one leg with my eyes closed, proving once again how much of a visual person I am.

But I do these simple exercises regularly now, including every time I need to wait. I did these exercises beside a mountain lake as I waited for first light so I could photograph it. Likewise on a mountain top.

Even in a busy waiting room I practice standing on one leg. It might seem strange to the other people waiting there. But to me it seems strange that they were wasting their time instead of doing balance exercises.

For more information, see exercise’s affect on diabetes, and exercise’s affect on bones and muscles.

This article is based on an earlier version of my article published by HealthCentral.

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  • laura at

    Last summer I took a bad fall, breaking a toe and my wrist as I took a header down the garden steps. In the course of doing PT, I learned that my chronic stumbling and “listing to the right” were probably due to surgeries to my right foot and insensitivities due to diabetes. In addition to standing on one foot (for a minute rather than 30 seconds), I also stand with one foot lined up directly in front of the other, then alternate to the other in front. But I was told to do these exercises near a chair or wall, in order to prevent falls. Consistency as well as upping the difficulty area key to success.