Best activities/exercise to avoid feet and leg problems
July 6, 2017 10:52 AM   Subscribe

I am overweight and sedentary and hate exercise, but I'm scared of continuing this way.

I am in my late 50s and quite sedentary and overweight. I had knee surgery last January followed by 8 weeks of PT, and my knee is almost completely healed, but I still feel weakness in it, especially when walking down stairs. I can also feel some weakness in my hip on the same side, which feels related to the knee weakness. I have diabetes type 2 (well controlled, no daily testing), which is causing some problems with my feet, such as extreme sensitivity, pretty severe foot tiredness and soreness when standing or walking for just a little while, and feelings of uncomfortably hot feet. For several years I've had some swelling in my feet and ankles, and since the knee surgery the ankle on that leg is always fairly swollen and tight feeling. And when I get up from sitting it's a real haul, and takes me a bit to work out the stiffness in my hips, knees, and ankles. I find myself really putting off having to stand up because it's just so hard! My poor cats get ignored and not let out because I'm too lazy to get up and do it.

I absolutely hate exercise, hate feeling sweaty or hot, and get really, really red-faced. I just want to sit. But I'm feeling really scared of becoming limited in what I can do and becoming someone who no longer has a choice and must sit because she's unable to walk.

I have 2 questions: 1) what are the best activities or exercises to deal with my foot discomfort/pain, swollen feet and ankles, and weak knee, and 2) how on earth do I keep up a modicum of motivation when all I want to do is throw myself into my chair after work and watch TV until bedtime?
posted by primate moon to Health & Fitness (22 answers total) 14 users marked this as a favorite
 
Actually, something you can do which should help and will also feel good, is to put your feet up when you get home. this counteracts sitting/standing all day and should also help relieve swelling, and will also feel good.

What I like to do is lie on my back on the floor and put my feet on the edge of the bed, sometimes on top of pillows. But if that position is uncomfortable for you, you put your legs on top of pillows on the floor- any elevation should help.

Also, lying flat on your back on the floor for awhile is good as well.

You may want to go to an exercise center and look into restorative yoga, or chair yoga. This should be of great help and won't make you feel sweaty or hot.

Also, how about something in the pool? many exercise center offer classes in the pool- no sweat there either, and much easier on your joints and limbs.
posted by bearette at 11:00 AM on July 6, 2017 [4 favorites]


I love love Pilates, if you can find a good instructor and afford private lessons. It is not cheap but will give you a new relationship with your body. And you get to lay/sit down a LOT. It feels amazing.
posted by bookworm4125 at 11:07 AM on July 6, 2017 [3 favorites]


Walking. It sounds counterintuitive but it's been reproduced as an intervention better than lots of things for lots of conditions, including knee problems and metabolic syndrome.

Here's a little animated YouTube video that discusses the benefits and what you might try.
posted by bilabial at 11:11 AM on July 6, 2017 [11 favorites]


Seconding exercise in the pool, especially if you can find a class that's specifically aquatherapy or geared towards people with physical issues. My local Y has a very popular water therapy program and it's fantastic to be able to move comfortably in the water when you can't on land.
posted by camyram at 11:14 AM on July 6, 2017 [10 favorites]


Tai chi doesn't involve getting sweaty. I find it a lot easier than yoga because it doesn't involve getting up and down off the floor. (I haven't tried chair yoga.)

Also, agree that walking can really be good. Even moving a little bit is better than not moving at all. So you don't have to walk fast or for great distances. If it seems overwhelming to you, start with 5 minutes.
posted by FencingGal at 11:15 AM on July 6, 2017 [1 favorite]


Seconding Pilates...it changed my whole attitude about exercise. And the water aerobics idea is great. The YMCA by my house offers several classes and they're really fun! Lots of laughing and fun music, all while getting a good workout. The other bonus is that the classes tend to be filled with women in their 50's and over, in all shapes and sizes.

Good luck!
posted by Gusaroo at 11:18 AM on July 6, 2017 [2 favorites]


Walking, in any place with lots of air conditioning to avoid sweating. My local Y has an indoor walking/jogging track, for example. Even a little walking will improve circulation in your legs and feet tenfold. And, once you're up and walking, you're up until you sit down again, unlike some other forms of exercise which might require a lot of tiring up/down.

Good luck.
posted by Crystal Fox at 11:25 AM on July 6, 2017 [1 favorite]


Walking somewhere air conditioned, like a mall. At first, give yourself permission to stop and rest frequently and then walk a little more. Obtain comfortable, supportive shoes.

You may want to ask your doctor about compression stockings to help with the swelling as well.

If you can get access to a pool, you don't necessarily have to swim or do water aerobics - you can also walk in the shallow part of the pool. It will give you resistance but you won't get hot or have to put a lot of weight on your knee.

Also think about finding audio books, podcasts, awesome music, or other cool stuff to listen to while you walk. That will help make it more entertaining to do.

Even a small amount more activity than you get now will help you, if you do it consistently. Worry about making it longer/harder after you start being able to tell that you feel stronger or get out of breath less easily.

One of the first things I did when I was in a similar position was go window shopping in a mall. I gave myself permission to amble along and to stop frequently to look at items or rest on a bench, but it got me on my feet and moving and that was the first step in rebuilding my stamina.

Good luck, we are all rooting for you!
posted by oblique red at 11:32 AM on July 6, 2017 [10 favorites]


Basing my answer off my recent experience with knee surgery, and advice from surgeon and PT:

Your instinct is correct - any sustained period of decreased activity after joint injuries or surgery can have long term to permanent consequences to functioning. But the good news is that it's quite achievable to improve your long term prospects with a relatively modest investment in your activity levels.

The best exercise for your knees is any exercise that you can do regularly. Swimming is great, and improves strength and fitness without putting stress on your joints. Walking is even better, and can be done in an air conditioned mall for comfort. Take up any sort of active hobby - golf, or cycling, for example and have some fun instead of 'exercising'.
posted by mikek at 11:38 AM on July 6, 2017 [4 favorites]


Came here to 2nd Tai Chi. Sounds like it might be a bit of a challenge for you at first but could greatly help your strength, balance and stability. And no real sweating involved.
posted by gnutron at 11:39 AM on July 6, 2017


Agreed with the suggestions for Pilates! If you can't afford a studio or don't have one near you, you can also find lots of videos on YouTube (I especially like Robin Long's videos -- if you scroll down a bit she has a "Pilates for Beginners" series that walks you through all the basic moves in short videos of about 10-15 minutes each.) I find it makes me a lot less sweaty than other types of workouts but definitely makes me feels stronger/healthier too.

Walking in air conditioning is also great in the summer -- if you cannot afford a Y/gym membership, you could also consider an indoor mall, or if there's a college campus near you walking around a big building (every university I have ever worked at keeps their buildings chilled to near meat-locker temperatures for unknown torture reasons -- but it could work to your benefit!). Swimming is great too if you have access to a pool.

For motivation, it depends on the activity. For walking-type exercising, I like to have fun podcasts to listen to (maybe that you only listen to when exercising?). For stuff that's not conducive to that (for example, you obviously can't be listening to a Pilates video while also listening to a podcast), maybe try to think about a way you reward yourself -- like a favorite TV show that you only get to watch if you've done your 15 minutes of Pilates or gone to the pool? Also consider whether it's possible to do anything over your lunch hour (i.e. if there's a pool/gym nearby) -- I find that's a lot easier to motivate and I have more energy than after work, although of course everyone is different with that. Another option for motivation is having an accountability partner you check in with.
posted by rainbowbrite at 11:40 AM on July 6, 2017 [6 favorites]


do you have access to a pool? (maybe a local Y?) its zero-impact, and easy on joints since you are buoyed by the water. no need to worry about getting dirty or sweaty and you can start out very gently and work your way up to a more vigorous level as is appropriate.
posted by supermedusa at 12:33 PM on July 6, 2017 [1 favorite]


If going to the pool is intimidating, please know that many people feel the same way, especially if they are overweight or have body image issues. I answered a question in this thread that might be helpful if you feel that way too--there are a lot of good ideas for how to get over pool anxiety!

I'd also mention that my mom has a hard time getting into traditional swimsuits with her mobility issues and if you do, too, something like swim shirts and swim shorts can help with the difficulty of putting on a one-piece, and still give you coverage and ease of movement.
posted by stellaluna at 12:51 PM on July 6, 2017 [6 favorites]


The motivation thing is so hard, you're not alone! I had knee surgery a year and a half ago (ACL replacement) and I still have a weak knee - I suspect because it's hard to motivate to do my at-home PT exercises and I stopped doing them sooner than I should have. When you finished up the 8 weeks of PT, did they give you any exercise instructions to do at home? While I agree with everyone about walking, pool workouts, and other ideas, the PT specific to recovery from your surgery is important. I bike to work most days and run at least a couple miles 2+ times a week, yet it's *only* my PT exercises that really make my knee feel more stable and secure. (Mine includes lots of hip strengthening, so you're not wrong about that being connected to the knee.)

I've recently re-committed to my at-home PT because I'm tired of my knee popping and being stiff every time I get up, and for me the commitment is: every day, I choose one: bike to work, go for a run, do my PT, or do 15-20 minutes of good stretching/yoga/foam rolling. I'm not perfect about it, but that's the goal.

For someone starting out from a less active lifestyle, your commitment might be: I will do every prescribed exercise at least once per week. (BTW, this is what my PT told me: I could split them up so I'm doing only 10-15 mins per day, or bunch them up so I'm doing 40 minutes twice a week, or whatever fits my schedule best, as long as I'm doing them all every week.) Or, you might promise yourself every Tuesday and Thursday I will do something, no matter what it is. Give yourself the option to be flexible about what you're doing. On lazier days, maybe it's 15 minutes of stretching and yoga/pilates-ish stuff. On days where you're more motivated, maybe you go for a walk or do some pool exercises. As you get stronger, you can extend the length of time you're doing things or how many days a week you're doing them. The important thing is starting to incorporate some kind of activity into your routine.

(Side note: The only thing that motivates me to keep up with running is being signed up for a 5K or similar; that's just how my brain works. If you're externally motivated as well, maybe signing up for a class or a charity walk or something would help you get over that but-the-couch-is-so-comfy hurdle. Or get a step counter and set some step goals.)

If stiffness and mild pain are bothering you, don't be afraid to take some Advil/Aleve/etc., if it doesn't conflict with other meds, so you can be more active. Good luck!
posted by misskaz at 1:40 PM on July 6, 2017 [1 favorite]


Another suggestion for gentle movement with less sweat and is something you can do with a more sedentary lifestyle: purchase a foot bike/pedal exerciser. Likely, you may have seen one such device when you received PT post-surgery. This will give you gentle range of motion exercise for the entire lower body and assist in keeping your stiff joints from getting too tight. Daily exercise with a foot bike starting at 5 minutes as a first goal and bumping up in 5 minute increments as tolerated would go a long way in getting you eased into appropriate joint exercise.

Also, since you've noticed some edema in your knees and ankles, it might be a good time to revisit your doctor OR contact your PT that you worked with for a re-evaluation and possible continuation of PT. The exercises you performed in PT are also not through once you are discharged from the PTs care - it's more like you are shown what to continue once you are discharged to have the most optimal benefit of your recovery.

As far as something dietary that I have seen help people in my family with swollen knees and ankles: dropping sodium intake to the 2300mg daily value... which is equivalent to 1 teaspoon of salt. It is compliant with a diabetic diet (and is a precursor to a renal diet... is anyone keeping an eyeball on your liver function with labs? if not, please harass your doctor about that.)
posted by missh at 1:43 PM on July 6, 2017


I know you have hot feet, but I'm going to recommend trying a pair of pressure socks/stockings anyway. I'm overweight and the pain and ache of just standing is so terrible. I started wearing pressure socks to deal with a large burn on my shin, and behold the miracle, I can walk so much better now, and I am in so much less pain. Get a pair that come in measured sizes (ankle and calf circumference). It might change your life, like it did mine. You can even get them in toeless styles, which might make your hot feet more comfortable.

Other things that have helped me: deep water aerobics (no one can see you sweat) and a stationary recumbent bicycle. Both are things you can do without weight bearing, and at your own intensity.
posted by k8oglyph at 3:00 PM on July 6, 2017


Apologies in advance if this is way off the mark for you but: sometimes motivation issues are also shame/avoidance issues.

There's certainly no reason to feel shame in this situation but many people do, and many people -- without realizing it -- will direct all kinds of incredibly cruel thoughts at themselves, without even really registering them or hearing them. Things they'd never say to anybody else. Things that are incredibly, tremendously de-motivating.

It also sounds like you're experiencing some fear around this situation -- that if you dont act now, you wont be able to act later. Fear is another tremendously de-motivating, avoidaince-making emotion.

Ideally, in childhood, when we experience fear we have some sort of parental figure nearby who stands there calmly and expresses sympathy for our fear and reassures us that we will live through it and we learn the lesson that fear is tolerable and life goes on. But that doesnt happen for all of us. Some of us get yelled at when we're afraid, and told to suck it up and stop sniveling. So as adults that's what we tell ourselves when we're afraid, which can be counterproductive. It pisses us off, and we shut down and don't listen: avoidance.

So for me, when I am avoiding something, letting myself experience just a few minutes of really sincere sympathy for how hard and scary the situation is -- and I have to feel it as kindly as I would for someone else -- does wonders for my ability to deal with the situation.

Also maybe if you can find a friend to meet up with a few times a week for whatever activity you determine makes sense you can basically remove motivation from the equation. Like, if your friend is coming over to do 10 minutes of [walking around the neighborhood/trying a pilates video/2 pound weightlifting for beginners], whether you are motivated or not doesn't matter because she is coming over so you have to do it.
posted by mrmurbles at 3:03 PM on July 6, 2017 [2 favorites]


Nthing swimming. My poor diabetic feet hate every kind of exercise, but swimming actually feels GOOD. It's easy on the joints, you don't get too hot or sweaty, and flapping your feet around in the water feels really nice. You don't even have to be able to swim all that well as long as you can keep yourself afloat, kick your feet and pull yourself forward with your arms. I don't ever put my head or face under the water. You can even hold on to a kickboard to make it so your face stays out, and propel yourself around by kicking your legs.

I also do a lot of stretching in the pool, and when I'm done exercising often I will just float around with a pool noodle and let my whole body relax for awhile.

The Y is a good suggestion for finding an indoor pool, but also if you have any hotels nearby you might be able to go swim there for cheap. I have my gym membership at a nearby hotel which maintains the gym for guests but also sells memberships to the public for a decent price.

I seriously adore swimming. I have gone regularly for years, and I have never in my life kept up with any other kind of exercise long-term.
posted by Serene Empress Dork at 6:28 PM on July 6, 2017


Pilates is great, I do it twice a week. It won't do anything to mitigate the cardiovascular risks associated with diabetes (and if you have diabetic foot complications, you have macrovascular complications).

Swimming is excellent. So are recumbent bikes in the gym (you can sit, you can read/watch TV), you can get your heart rate up for the recommended 30mins 3xweek). Or the cross-trainer is a bit like running but without the jarring on your joints.
posted by tinkletown at 3:46 AM on July 7, 2017


The best exercise is the one that you do. It doesn't matter so much what it is. Try many things and find one that you enjoy and will do often. That's the key. There is no magic bullet.

That said, the thing that gives the best benefit for the least amount of time is probably weightlifting. As you age, you lose muscle mass. Muscle burns calories 24/7 and adding even a pound of muscle has a huge calorie-burning impact. Also, it's something you can do sitting down or in a machine, though free weights are better for building stabilizing muscle. Stability is a huge issue as we age, as well. Something to think about.
posted by domo at 6:47 AM on July 7, 2017


I had allowed myself to get very sedentary and overweight--ended up with Type 2 diabetes. I've been controlling my blood sugar with diet (gave up grains, sugar, most fruit, starchy veggies, etc.). I was completely out of shape, everything hurt, neuropathy in my feet, etc. I hate exercise, and couldn't stick with anything--plus almost impossible to get up/down off the floor because of arthritis in my knees and hips. I lost about 40 pounds from the modified diet and then starting Pilates with a private teacher a little over a year ago. The studio I go to has machines that are raised off the floor higher than normal and I bought an exercise table from Amazon so I could do my "homework" without having to get down on the floor. Paying for the coach made me keep going to the classes since my resolve would weaken a half an hour or so before heading out the door, and my coach has a 24-hour ahead cancellation policy.

I also bought a recumbant exercycle. It is a great cardio workout that doesn't hurt and doesn't make me sweat too much. I like having it in my home because I really can't stand the gym. I love swimming, but don't like everything around getting to the gym and getting into the pool. (some day I would love to get a swim spa for home).

Recently, I taped a bunch of "Functional Fitness" videos off one of the local PBS stations--all her exercises can be modified to do while sitting (she has people next to her doing two levels of modified moves). Her focus is on building core strength (like Pilates) and helping you to be able to continue to do life activities (like getting in and out of a chair, reaching things in a cabinet, etc.) They are designed to address various ailments including diabetes.
She's a little over the top--but I find it just the right level of challenging. She doesn't use many "props" and is good at showing household items you can use to replace specialized equipment. If you can't find the shows to tape, I've linked to her website for the DVDs.

I'm much more mobile now and can do about 4500 steps a day (I was literally down at around 1500 which is crazy low). I'm hoping this year I can get it up to 10,000 (I have a fit bit now that I got for Christmas). I am also much stronger, don't get winded as quickly, etc. It has taken a long time (as Suzanne says, "You didn't get out of shape quickly, give yourself time to get back in shape."

Also I've continue to lose weight (I jump-started my weight loss by going on Optifast through my medical plan). 26 weeks fasting and now about 5 months back on food and I'm down 80+ pounds. I am able to put off the hip operation that was in my future--now it is a little farther out in my future.

Give yourself credit for any additional steps, exercise, etc. that you do. Take baby steps and you'll surprise yourself. If you can get a coach, I highly recommend it.
posted by agatha_magatha at 10:45 AM on July 7, 2017 [1 favorite]


I got a stationary bike that fits under my desk. I have a ceiling fan in our home office, which helps a lot with the sweat. I can game while exercising, I don't have to go to a gym, and I don't have to exercise outside in bad weather. I think playing computer games during exercise is about the closest I'm likely to get to enjoying exercise.
posted by Anne Neville at 4:20 PM on July 8, 2017


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