Top 10 Strengthening Exercises for Frozen Shoulder in Diabetic Patients

The global prevalence of diabetes has risen dramatically in the last few decades, and currently affects millions of people around the world. Diabetics require to control the blood sugar level in their body otherwise, it can lead to long-term complications, like heart problems, muscle cramps, arteriosclerosis (blocked arteries), etc. Regular exercises help to keep the heart healthy and maintain the cholesterol level in the body. Diabetics have high glucose levels in their blood because, either their body doesn't produce enough insulin to process glucose, or their body doesn't use insulin properly. This leads to the development of various joint disorders associated with diabetes, and among them, shoulder issues like the frozen shoulder are observed quite commonly in diabetic patients. Frozen shoulder is characterized by pain, thick adhesions, and significant loss of its range of motion in all directions. And exercises are generally helpful in restoring shoulder joint movement. In this blog, we have mentioned a few exercises for frozen shoulder.

 

Frozen shoulder

Frozen shoulder or adhesive capsulitis, is painful with loss of shoulder motion, which typically occurs in phases. It starts with pain and stiffness, that lasts for 2-6 months. Then it evolves into a less painful, but stiff with complete loss of certain movements. Usually, after months to years of the onset, there is spontaneous improvement in the range of motion. Physiotherapy treatment focuses on decreasing pain, inflammation, and increasing the range of motion.

 

Exercise for Frozen Shoulder

Before doing these exercises do warm up by taking a warm shower or bath for 10 -15 minutes.

Flexion Extension Exercises:

• Sit or stand and use an exercise rod or band.
• Gently bend the arm and shoulder muscles.
• Lift the rod or band over the head and behind the back.

 Pendulum Stretch:

• Relax the shoulders.
• Stand and lean slightly forward, so that the affected arm hangs down,
• Swing the arm in a small circle in clockwise and anti-clockwise directions about a foot in diameter.

 Towel Stretch:

• Hold one end of a towel behind the back and grab the opposite end with the other hand.
• Hold the towel in a horizontal position. Use the unaffected arm to pull the affected arm upward so that stretch is felt.

 Finger Walk:

• Face a wall at arm's length.
• Reach the wall at waist level with the fingertips of the affected arm. Bend the elbow slightly, slowly walk the fingers up the wall, till the arm is raised as far as comfortable.
• Do not involve the shoulder muscles.

 Cross-body Reach:

• Sit or stand and use the good arm to lift the affected arm at the elbow, and bring it up and across the body, exerting gentle pressure to stretch the shoulder.
• Hold the stretch for 20 seconds.

 Armpit Stretch:

• Use the unaffected arm to lift the affected arm onto a shelf about breast height.
• Slowly bend the knees and open up the armpit.
• Deepen the knee bend slightly, gently stretch the armpit, and then straighten.
• Stretch a little further with each knee bend, without forcing it.

 Outward Rotation:

• Hold an exercise band between the hands with the elbows at a 90-degree angle close to the sides.
• Rotate the lower part of the affected arm outward two or three inches and hold for 5 secs.

 Inward Rotation:

• Stand next to a closed door, and hook one end of an exercise band around the doorknob.
• Hold the other end with the hand of the affected arm, while holding the elbow at a 90-degree angle.
• Pull the band toward the body 2-3 inches and hold for 5 seconds.

 Hand-behind-back Stretch

• Stand and place the affected arm behind the back.
• Use the opposite hand to take hold of this wrist.
• Stretch the affected arm by moving it towards the opposite buttock.
• Slowly move it as far up as possible.
• Hold this position for a few seconds.

 Umbrella Push

• Sit in a chair with the elbows alongside the body.
• To hold an umbrella in front, use an overhand grip.
• Use the unaffected arm to push the affected arm over to the side.
• Keep the elbow of the affected arm drawn in at the side.
• Return to the starting position.

While performing these exercises, do them gradually and hold the arm at the endpoint of the range of motion for a few seconds. Slowly release the stretch and repeat. Do not perform forceful movements because they can elicit pain.

 

Diabetes and Exercises: How to Manage blood sugar levels with Physiotherapy?

Diabetes is one of the most prevalent diseases in the modern world but if treated early can reduce the risks of progression to diabetic neuropathy or autonomic neuropathy. People with pre-diabetes, have impaired fasting glucose and also impaired glucose tolerance, thus are prone to diabetes and can fall victim to cardiovascular disease. Regardless of the type of diabetes the person has, it is important to do exercises. Physiotherapy is one suitable option that focuses on encouraging preventative care and helps to manage the symptoms of diabetes. This blog describes the benefits of exercises for diabetic patients and a few of them are mentioned below.

 

Diabetes

Diabetes is of 2 Types, Type1 diabetes (insulin-dependent), caused by cell destruction in the pancreas, has deficient insulin secretion, and is often associated with pancreatic antibodies. They are typically exogenous insulin-dependent and at greater risk of ketosis, coma, and death. Type 2 diabetes (noninsulin-dependent), related to genetic and lifestyle, is insulin resistant and has insulin deficiency.

 

Benefits of Exercising:

Physiotherapy is an important part of diabetes management. Physiotherapist recommends exercises that cause muscles to use sugar for energy. With the help of regular exercises, the body uses insulin more efficiently. Lack of activity and being obese are the most significant environmental factors related to Type 2 diabetes. Increased activity and increasing exercise levels promote weight loss. It increases the body's sensitivity to insulin and enhances the utilization of glucose. It helps to lower blood sugar levels and maintain overall diabetic control. Exercising regularly and losing weight are beneficial in glycemic control in Type 1 and Type 2 diabetes and also help prevent the development of diabetes in people who have prediabetes.

 

Exercises for Diabetic Patients:

The physiotherapist designs a structured exercise program according to the patient's needs. Structured Exercise programs consist of resistance training and aerobic exercises. Top of Form

The 3 main types of exercise for diabetic patients are aerobic, strength, and flexibility exercises. A diabetic person should start with aerobic exercises, then slowly progress to strengthening exercises and then progress to flexibility exercises, with two sessions of strength training per week.

 

Walking:  Brisk walk of 30 minutes, 5 days a week is recommended. It is a simple and safe exercise and just requires a good pair of shoes and a safe place to walk.

 

Cycling:  Cycling is a low-impact exercise for lower joint pain, a good exercise for diabetes.

 

Swimming: Aquatic exercise like swimming helps reduce the blood sugar level, also is a low-impact exercise for diabetes and it helps to relax the whole body and is a good workout for the heart, lungs, and muscles.

 

Aerobic exercises: Aerobic exercises like aerobic dance can also be done as a workout.

 

Weight training: Weight lifting and other strengthening activities help to build up muscle mass, and burn down calories. Strength training can also improve blood sugar control, thus suitable exercise for diabetes.

Resistance band exercise: Resistance band exercises can also be done by diabetic patients. With the help of simple weights or resistance bands, strengthening exercises can be done.

 

Calisthenics: Calisthenics is a type of strengthening exercise, where the patient's own body weight is used to increase strength e.g squats, pushups, pull-ups lunges, and abdominal crunches.

 

Pilates: Pilates is a fitness program, recommended to improve core strength, coordination, and balance.

 

HIIT: High-intensity interval training (HIIT) is a suitable exercise for diabetic patients.  By performing High-intensity interval training, leads to rapid improvement in glucose levels in diabetic patients.

Other exercises are like playing tennis, basketball, running, jogging, and these exercises engage all the muscles of the body and also help maintain blood sugar levels.

Note: Check your blood sugar level before and also after the exercises, keep a snack handy in case your blood sugar drops down, drink plenty of water before, during, and after the exercises and wear proper shoes and socks.