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.
Banishing aches and pains
If chronic aches and pains are robbing you of your ability to perform daily activities, a couple of strategies can help you stay active.
“Warm muscles are happy muscles,” says Shahar. “They feel better. Use a heating pack for 10 to 15 minutes. Put a towel or sheet between the skin and the heating pack.” You may be able to improve your performance by using a heating pack before a workout.
Choosing your exercises strategically can also help.
“Identify those ‘safe’ exercises that reduce the risk of joint pain and the chance for discomfort during and after exercise,” Shahar says. She recommends a recumbent stationery bike, aquatic exercise to decrease weight and pressure on the joints, and resistance training.
“Exercises that help increase the strength of the muscles around the joint will decrease joint pain,” she says. “If the knees feel weak and wobbly with exercises and have pain, exercises to strengthen the quads and hamstrings will help, not trigger more pain.”
If you lose flexibility, you lose the complete range of motion in your joints. To increase your flexibility for everyday movements, incorporate stretching and strengthening exercises that mimic activities you find difficult. For example, if bending at the waist to pick up a pencil from the floor is hard, try exercises that work the hamstrings, such as slowly reaching for your toes while seated on the ground with your legs extended. Hold for several seconds, relax, and then repeat. Practicing yoga or tai chi is also a good way to maintain, and often increase, your flexibility.
“Some people teach tai chi specifically for people with diabetes,” says Sheri Colberg-Ochs, professor of exercise science at Old Dominion University and a member of the American Diabetes Association’s Prevention Committee. “When you have neuropathy or reduced function this can help.”
Increasing your flexibility won’t happen overnight — and you shouldn’t try to make that happen.
“The most critical thing is to not start out too intensely if you’re new to exercise,” says Colberg-Ochs. “There is no right or wrong way to progress unless you do it too quickly.”
The American Society for Exercise Physiology and the American Diabetes Association have released new exercise guidelines recommending that most people with diabetes not only get 150 minutes of moderate aerobic exercise per week, but also perform resistance training on two or three days per week.
“It’s important to at least maintain your current level of muscle mass,” says Andrew S. Rhinehart, MD, medical director of the Johnston Memorial Diabetes Care Center in Abingdon, Virginia. “Age in and of itself will steal [strength] from us. If you can get stronger, that’s even better.”
You don’t have to buy a weight bench or dumbbell set to get stronger. Using inexpensive resistance bands, small hand weights, or even soup cans to exercise your muscles can make a dramatic difference.
“Hit the whole body from head to toe in order to maintain that muscle mass,” Rhinehart advises. “Resistance training helps [preserve] muscle mass in men and women and prevent osteoporosis.”
He cautions people with diabetic retinopathy (eye disease) to avoid lifting very heavy weights because of the risk of breaking blood vessels in the eyes.
“If you’re overly straining and you bear down, you’re lifting too much,” says Rhinehart.
Instead, lift light weights and do a high number of repetitions — 15 to 30 — in a set. Perform two to three sets per muscle group.
Calisthenics — those old gym-class standards that include squats, calf raises, and push-ups — can also help you build strength. However, as Rhinehart advises, go “low and slow” when beginning. Start with a low number of repetitions, and consider using modified poses, since calisthenics involve lifting your own body weight. At first, you may only be able to do knee-assisted push-ups. “But in six months, maybe you can do 10 push-ups from your toes,” Rhinehart notes.
“There is no reason to hurt yourself,” he adds. “Be careful.”
Calf raises appear simple but can be difficult. Stand near a sturdy chair (or something else you can hold on to) in case you have any difficulties with balance. Rise up onto the balls of your feet, hold this position for a few seconds, and then slowly return your heels to the floor. At first, you may not be able to raise yourself up completely, but that’s OK. Go as high as you can and work up to a full calf raise.
Squats work the entire leg and trunk area. Stand with your back against a wall and your feet shoulder-width apart and about 1 1/2 to 2 feet from the wall. With your abdominal muscles engaged, slide downward by bending your knees. Make sure your knees are behind or directly above your ankle joints. Hold for a few moments and then go back up. Over time, you will find that you can hold the squat longer, but when you’re just starting out, don’t push yourself too hard.
(For resources that show how to do exercises and stretches correctly, click here.)
In addition to its muscle-building benefits, resistance training — along with some forms of aerobic exercise — can also increase bone strength.
“Muscle pulling on bone builds bone, so any weight-bearing exercise will help build bone,” says Preethi Srikanthan, MD, an assistant clinical professor at the David Geffen School of Medicine at UCLA. This includes all activities that “require your muscles to work against gravity, including jogging, hiking, stair climbing, and dancing.”
One reason many people give up on exercising is that they feel bored while doing it. But the truth is that these people simply have not found the fitness activity that is right for them. If you like what you’re doing, you will stick with it and incorporate it into your routine instead of finding excuses to avoid it.
Joining a class or club that revolves around a physical activity can help keep you motivated, since the others participating will expect you to show up. And most people won’t quit halfway through an exercise session if others are watching.
For some people, though, exercise is more enjoyable as a solitary way to unwind. They find it relaxing to listen to music on a stationary bike, hike nature trails alone, or watch TV while pedaling on an elliptical machine.
Regularly engaging in a few different types of exercise can help keep things fresh and let you adapt easily in case traveling prevents you from attending your fitness class, bad weather keeps you indoors, or you get involved with a seasonal activity. For example, if you briskly walk around the neighborhood a couple of times each week, you could work out with resistance bands or an exercise video on alternate days — and whenever heat, cold, or rain keeps you indoors.
Variety will also help ensure that you are working different parts of your body. Walking can be great for working the lower body, but it does not do much for the upper body. Swimming provides a good overall workout, but it is not a weight-bearing exercise and so won’t do much to strengthen your bones.
If you are not sure what type of exercise activity you would like, recall what you did for fun during your childhood. If you enjoyed playing kick the can and tag with other children, you might enjoy an informal group-based activity such as walking with friends. If you loved gym class and other structured group environments, joining a fitness class or taking physically active lessons may be a good option. If you preferred competitive sports as a youngster, try joining a community league that caters to your fitness level and age.
Remember that there are many different reasons to exercise. If an activity or exercise helps relieve pain, improves your mobility, or gives you joy, then count it as a success. By focusing on the areas of fitness in which you’d most like to see yourself improve, you can choose activities that fit your goals, your life-style, and your unique personality.