Taking Care of Your Feet: How to Exercise Safely With Peripheral Artery Disease

This content originally appeared on Diatribe. It was reissued with permission.

by John Kerr

Lifestyle changes, such as diet and exercise, are key to preventing and managing diabetes-related complications, such as foot disease. In addition to being proactive in foot care, here are some tips for safely exercising in peripheral arterial disease:

It is becoming increasingly clear that diabetes exerts much of its devastation in blood vessels, both large and small. Larger arterial damage is often a dramatic process with severe health complications, such as heart attacks, strokes, and renal failure.

Many years before these major catastrophic events, the smallest vascular walls where nutrition and waste exchange take place are quiet, smoldering inflammatory storms. This injury is the worst in the small blood vessels that are farthest from the heart and lungs: feet.

The benefits of physical activity have been extensively established. And this is not as true as diabetic people. However, foot problems can disappoint and prevent the exercise. There are several strategies to exercise safely and protect your feet, especially if you have neuropathy or peripheral arterial disease from diabetes.

How does diabetes hurt your feet?

In people with diabetes, foot problems arise from increased glucose levels. High circulating glucose levels compromise oxygen delivery, disrupt nutritional exchange, collect toxic waste, and cause inflammation. This can occur anywhere in the body, but the nerves in the feet are particularly sensitive.

Fifty percent of diabetic patients live with some form of diabetic neuropathy. The nerve can be damaged in two ways, due to hyperglycemia levels and poor circulation. The nerves slowly break down, the muscles are lost, and the structure of the feet changes eventually. This can lead to joint pain, impaired function, ulcers from unnoticed or infectious small injuries.

Foot problems from diabetes can overlap with larger vascular diseases such as peripheral arterial disease (PAD). Signs of foot trouble are often seen several years ago when the major arteries get clogged. Symptoms include:

• Changes in skin texture and color
• Nail bacteria
• Numbness or tingling
• Loss of sensation
• Painful burning toes
• Loss of muscle mass
• Lower strength

What is Peripheral Artery Disease?

Pads are large blood vessel blockages and share many risk factors with diabetes-related foot disease. These obstructions can also occur in people without diabetes. This is because they often inherit cholesterol problems. The signs and symptoms of PAD are as follows:

• Cold feet
• hair
• Skin changes (thicker and less elastic)
• Red, shiny toe
• Discoloration of toenails and fungal infections
• Calf pain and cramps while walking and climbing stairs

Together, foot disease and padding are typical problems in people with diabetes. Approximately 50% of people with diabetes who develop foot ulcers also have PAD. Furthermore, living with pads complicates the healing of ulcers and is more likely to cause them to occur.

Reduce disease progression due to exercise

While it can be difficult to keep up with exercise if you have ulcer-like padding or foot issues, Dr. Tom Biernacki, a board certified foot and ankle surgeon, has strengthened the importance of physical activity. One study conducted over 20 years showed that people who lifted weights or participated in resistance training (such as weightless bands and squats) had a 20% reduction in mortality.

“We’ve got some form of aerobic exercise, like walking or jogging, and we’ve got an additional 20% reduction,” Biernacki explained. “Imagine just adding resistance training and aerobic training together and you’re 40% less likely to die.”

Recent studies also show that people who exercised demonstrated greater reductions in wounds. Importantly, there were no negative outcomes for participants’ movement.

Another study examined people with foot ulcers who had just been healed. One group performed foot uncle flexibility and resistance exercises at home three times a week, while the other group received normal care. Only four participants who exercised needed additional care, but 64% of those who did not exercise had ulcers returned.

Studies that demonstrate benefits for glucose control, A1C, quality of life, and other measures of fitness follow these two general principles.

1. Weight, band resistance, and free weight: 8-10 repetitions of 2-3 sessions per week at medium intensity and 2-3 sets.
2. Walking, jogging, cycling or equivalent: Medium intensity, 3-5 times a week for 15-45 minutes (excluding warm-up and cool-down sessions).

Remember that exercise is better than no exercise. Walking at least 30 minutes a week has been shown to be effective in reducing the risk of major vascular events, but this is truly a minimal amount. Professional organizations like the American Heart Association recommend a minimum of five days a week, if not every day.

If you don’t have access to the gym or treadmill, there are plenty of home-based exercise programs. Some, including outdoor walking, have shown better results than treadmill exercise. It is important to remember that exercise is dose dependent. This means that the more you get, the more benefits you will see.

Protects your feet during exercise

Chronic conditions like foot injuries and padding can be a major barrier to exercise. The good news is that there are many steps people can take to protect their feet and safely obtain the recommended amount of physical activity.

Avoid intense or shocking exercises such as long distance runs, jump rope, and lifting heavy weights. Aim for exercise in moderate weather or indoors during extreme weather (heat or cold). Try low impact exercises like walking, swimming, cycling and more.

If you are not ulcers or injury, rest your legs and stick to back and arm training like a chair exercise. If you have ulcers or wounds, avoid lifting heavy weights. For people with neuropathy and PAD, some of the active foot care means checking your feet every day.

Before exercising, make sure your feet are clean and dry. Wear shoes that fit properly and provide support. Running Stores have great options and specialists that will help you find the right pair, even if you’re not a runner. Wear polyester or breathable socks that will keep your feet dry during physical activity. Drink plenty of water before, during and after activities to maintain hydration and balance your temperature.

Other ways to avoid foot problems

People with diabetes should start early to prevent padding and foot-related problems. This is because when symptoms such as burning toe, convulsive calves, or loss of sensation appear, the disease is already present and becomes difficult to treat.

In addition to exercise, below are steps you can take to prevent future problems and slow the progression of the disease.

Control glucose levels

The underlying problem that promotes lower extremity damage is the elevation of glucose. Excessive blood glucose (hyperglycemia) overwhelms the cells lined up in the arteries, causing a cascade of negative events. As with other major catastrophic complications of diabetes, such as vision loss and kidney failure, better control of blood glucose and improved time for range is the starting point.

Biernacki emphasizes early and active involvement in foot care and observes true improvements in neuropathic symptoms in his own practice, simply by controlling glucose levels.

“If people have very high blood sugar for a while and are reduced with treatment, their symptoms can improve significantly for about three months or more,” he said. “Some of this is reversible just by taking the medication properly and improving your diet. This includes the intake of the right nutrients, vitamins and a diet of proven anti-inflammatory foods.”

Look at cholesterol

Another important aspect of preventing poor circulation (especially in larger blood vessels) is identifying and reducing cholesterol abnormalities.

Cholesterol management often requires medication to achieve profits. Fortunately, many of these drugs have been used for a long time and have a good track record of having few side effects. Doctors may use multiple medications to reduce the risk of catastrophic events such as a heart attack or stroke. A particular medication depends on a person’s unique profile.

Monitor your blood pressure

Due to long-term rise in blood pressure, blood vessels are stiff and unresponsive. It also contributes to inflammatory storms caused by hyperglycemia and cholesterol abnormalities. This can directly damage arteries and nerves, leading to diabetes-related foot disease.

Approximately 78% of patients with type 2 diabetes have hypertension, which accelerates the progression of vascular disease. In addition to exercising and maintaining a fruit and vegetable diet, you may also need medication for treating hypertension.

Stop smoking

Smoking, especially tobacco, is very bad for the arteries and accelerates nerve damage. Smoking is the biggest cause of large arterial disease, with 80% of people with PAD, who are at an increased risk for all major catastrophic events or who are previous smokers.

Smoking also contributes to the development of diabetes, interferes with the effectiveness of insulin and increases the risk of foot disease. In people who already suffer from foot illness, smoking adds to the risk of amputation.

Stopping smoking is extremely difficult due to its addictive qualities. Few people can quit on their own, and most people need counseling and drug-inclusive assistance programs. The American Thoracic Society’s Clinical Practice Guidelines strongly recommend using Chantix (Varenicline) to stop smoking.

Eating healthy foods

There are some simple and specific changes to your diet that can make a real difference. One simple dietary change that can bring health benefits is the addition of fish rich in omega-3 fatty acids.

“Oil-based fish consumption is very clearly linked to lower risk of cardiovascular disease and mortality due to cardiovascular disease, which is particularly potent in people who already suffer from cardiovascular disease.”

Eating two or more oily fish per week can reduce your risk by 80%. An example is:

• salmon
• sardine
• Atlantic mackerel
• Tara
• herring
• Lake Trout
• Canned food, light tuna

Balance your diet with foods rich in antioxidants and nutrients, including leafy green vegetables, fruits, nuts, seeds, and lean proteins.

What if I already experience pain or numbness in my leg?

This is a real problem, and people with too many diabetics struggle.

“People are afraid to take care of their feet because they think it’s bad. It’s not gloss. I’ve always told you, it can basically save your lifetime of mobility,” says Biernacki.

“How many patients come in, they come in, they easily come, they start walking and say this is the best I’ve felt in 20 years. “The great thing is that almost every insurance in America covers foot care because they know that going to see a podiatrist saves billions of dollars.”

Diabetes-related podiatrists and pads should be avoided at any cost. That’s a step towards Quicksand. The best way to stay safe and healthy is to start from scratch. By caring for those feet, you are caring for your kidneys, eyes, brain, and mind.