Corinna: This week I have a congestion cold, so I didn’t exercise as scheduled. I didn’t think it would be a good idea to be trying to lift 5 lbs weights above my head while feeling woozy.
Ginger: Oh, bummer! Tis the season…I just got my flu shot!
Corinna: What are guidelines for exercising while feeling sick, especially for people living with diabetes?
Ginger: A really important thing to watch out for when sick, especially if you get more of a fever/flu rather than a cold, are ketones! Illness/stress-induced ketones can become very dangerous very quickly if not dealt with quickly. More fluids, and often higher insulin doses advised by your doctor…with lots of extra ketone urine tests! The moment you start vomiting, whether from ketones or the flu itself, definitely contact your doctor because things can get out of hand very quickly and getting an I.V. of fluids can be the only way you can help your body flush out those ketones.
Corinna: Yikes! I hadn’t thought about that. Thankfully I haven’t had that kind of symptoms. Just foggy-headed congestion and post nasal cough. Sugar-free Robitusin has been my friend this week—and the occasional nap.
This brings to mind one of my biggest worries when it comes to exercise…injuries.
I have a gimpy knee. Sometimes it gives me trouble and I don’t always know what sets it off. Sometimes it feels weak. Sometimes it seems to make a popping noise. Sometimes it hurts when I move it a certain way. I know, I know…Doctor says ‘don’t go like that.’ That’s a really old joke.
Here’s the thing, when my knee is being gimpy I don’t want to strain it and make it any worse. So I don’t know whether to exercise with less intensity, like limiting how deep I squat or lunge, or whether I should just skip exercise that causes any pain.
I’m sure other folks have similar kinds of problems. Maybe it’s an elbow or a hip.
What’s your advice?
Ginger: Oh, we’ve got all our aches and pains! Believe me, I have my own, too! If you know that lunging too deeply bothers your knee, but lunging half-way feels fine, then you have determined the right limit for you. For example, I know that stretching my left hamstring triggers a pain in my hip that no doctor has been able to diagnose…but regardless of a diagnosis, I know that stretch causes me pain so I avoid any exercises that put me in that position.
If you find a variety of exercises that really do bother your leg, make a list of them so you can be clear on what you should and shouldn’t do. (It’s easy to forget which ones are safe for you and which ones are not!)
Corinna: I know that pain can cause stress, and stress can play havoc with blood glucose control. Is there anything in particular a person living with diabetes should be mindful about when dealing with a painful injury?
Ginger: Well, an injury can definitely come with a great deal of inflammation. And inflammation is a stress on the body. The less inflammation in our bodies, the better! Gluten, for instance, is a food that’s proven to cause a great deal of inflammation, even in non-diabetics.
Dr. Kratz explained it well in a Diabetes Forecast article: “A chronic, low-grade inflammation appears even when there’s no underlying infection and no sickness, like a cold or flu, to prompt a typical immune response….It’s associated particularly with obesity and seems to play a role in all of the major diseases—heart disease, diabetes, and certain cancers.”
Constantly encouraging or causing inflammation in the body causes turmoil to the whole system, not just the area of the body that’s in pain. So being aware and respectful of those tender areas, and doing what you can to reduce that inflammation is important. Remember though, this doesn’t mean a little pain is an excuse to sit on the couch all day. Never stop searching for exercises that work for you. I have a nice list of exercises that I can’t do because of my left hip, but I have a nice long list of the ones I can do, too!
Corinna: It sounds like it’s best to avoid injuries, if possible, in the first place. What kind of advice do you have for avoiding injury while still exercising with enough intensity to feel the benefit?
Ginger: Intensity is the most obvious, but what’s more important, actually, is form. The most common exercises that are performed incorrectly are the squat, lunges, and push-ups. I took extra time to explain these exercises in the videos, but here are a few extra tips:
Squats: Most people bend their knees forward, putting a great deal of weight and pressure into the joint rather than utilizing the quads and glutes. Instead, try pushing your hips back and letting your chest lean forward a bit while still keeping your head up. At the bottom of your squat, your knees should NOT be over your toes. Put more weight into your heels and push your hips back!
Lunges: A pretty easy problem…most people don’t step their front foot far enough forward from the back foot. Thus, at the base of their lunge, their front knee is too far past their toes and putting a great deal of stress on the joint, rather than the muscle. Solve this problem by taking a long step forward. Your front leg should be bent at a 90-degree angle at the lowest point of the lunge.
Push-ups: This one is easy…your hands are too close together! At the lowest point of your push-up, your elbows should be directly above your wrists. Most people put unnecessary pressure on the joints in their wrists because their hands are too close together. If you’re on your knees, be sure to move your knees back so your thighs/waist are at a 120-degree angle rather than 90 degrees. This will allow you to engage your core like a full push-up would and build more overall strength.
Intensity: Well, this is hard because everyone is different, but it also relates to what we talked about last week. When you feel the muscle begin to burn, you know you’re in the working zone. Folks who are more conditioned can push this to the point of exhaustion, while newbies really should listen to their bodies and do what’s comfortable. As a personal trainer, I’ll tell ya that most people can do WAY MORE than they think they can do. I’ve never in my all my training ever met a client who was pushing themselves too much. Instead, I found myself often helping clients realize just how much more they were capable of. Don’t be afraid to go a smidge further than last time…you’ll be surprised by what you can accomplish. And always listen to your body!
Corinna: Any tips on how to avoid having your exercise routine totally go down the drain because of a sickness or injury?
Ginger: My dad has this phrase (I think he stole from Clint Eastwood): “Adapt! Improvise! Overcome!”
If you need to take a week off in order to give your body the rest it truly needs, then do so! Listen to your body, and relax. You’ll get back to your workout when you’re good and ready. Sometimes the biggest deterrent to getting back to exercise is that silly scolding and guilt-tripping we put ourselves through! Let it go. If you’re sick, and you avoid the gym (both for your body’s health and to prevent spreading your sickness to others), you’re doing the right thing!
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I’ll be trying out the SweatBetes videos and checking in with Ginger over the next few weeks on TuDiabetes. Join the conversation at http://www.tudiabetes.org/forum/topics/workout-wednesday-with-sweatbetes.