I have a female client who has just been diagnosed with osteoarthritis in her cervical, lumbar and sacral spine. Her doctor is limiting her activity level, which is now causing some added stress, both physically and emotionally. She also has adult onset diabetes and is struggling with her weight. She has been on a consistent exercise program including cardiovascular, strength and flexibility. Do you have any recommendations for her program with regards to her arthritis? And her diabetes?
First, what made your client go see her physician? Did one or both of her problems suddenly appear? If they have, then the diseases may be rapidly advancing. If they have not, and one or both of the diseases are slow, then the following suggestions are appropriate. Most of the research on osteoarthritis promotes exercise, heat and ice therapy and proper use of medications to control pain and inflammation. Type 2 diabetes is well documented. Exercise is one of the key elements for controlling elevated blood glucose levels.
Aerobic type exercise (i.e., stairmaster, bike, treadmill, swimming, etc) is important for both types of diseases. One way to train your client is to ask how she is feeling each training day. If it is a good joint wellness day, then training could be a little more vigorous then when her joints are hurting. Gunnar Borg (Borg's Scale of Exertion) developed his scale this way. Borg's Scale is used in every exercise lab and cardiologists office I have ever been in and is a staple in cardiac rehab. I use this approach with all the people I work with, athlete or rehab client. When using the scale, keep her efforts between 5-7 (1= very easy, 10=max.).
Strength training is recommended for both diseases. Spend time on the exercise ball, use dumbbells and exercise bands to allow for free range of motion. Look at the PTN Exericse Library for some ideas on exercise ball work. Keep the intensity light, using three to six reps. The number of sets is where you adjust her loads. Again, when she feels well, go up to six to 10 sets. When she feels poor, perform maybe one to two sets.
Before training, your client may benefit from a hot bath or shower, a light dose of anti-inflammatory medication and an analgesic sports cream. Now, she is ready to train.
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