A strong outside strengthens the...
Transcript of A strong outside strengthens the...
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
A strong outside
strengthens the inside
Exercise
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Table of Contents
Activity pyramid …………………………………………………………………………2
Benefits …………………………………………………………………………………..3
Safety …………………………………………………………………………………….4
Common barriers ………………………………………………………………………...6
What to do if your have complications ………………………………………………….10
Target heart rate …………………………………………………………………………11
Beginning Exercise ……………………………………………………………………...13
Understanding your muscles …………………………………………………………….14
Stretching exercises……………………………………………………………………...15
Strength training exercises……………………………………………………………….19
Aerobic exercises…...……………………………………………………………………23
Walking guidelines...…………………………………………………………………….26
Sources ..………………………………………………………………………………...27
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Why should I be physically active?
Being physically active is important in the prevention and treatment of diabetes… that’s
right, TREATMENT. Regular physical activity can actually prevent and delay the onset
of diabetic complications.
Do you know the benefits of exercise? They include the following:
Keep and improve your strength
Increase your energy levels
Improve balance which will help prevent falls
Prevent or delay diseases such as heart disease and cancer
Perk up your mood which will reduce depression
Improve diabetes as well as heart disease, high blood pressure, stroke, and colon
cancer
Reduce body fat
Help you lose weight
Improve your body’s ability to use insulin
Lower bad cholesterol and increase good cholesterol
Now that we know the benefits of exercise, let’s stop and go over a few definitions.
Physical activity- anything that gets your body moving
Exercise- planned, structured and repetitive bodily movements done to improve or
maintain one or more components of physical activity
Aerobic activity- also called “cardio” gets you breathing harder and your heart beating
faster
Intensity- how hard your body is working during aerobic activity
Moderate intensity- means you are working hard enough to break a sweat and increase
your heart rate. If you are working this hard you will be able to talk, but not sing the
words to a song
Vigorous intensity- means you are breathing hard and fast and your heart rate is up. If
you are working this hard, you will not be able to say more than a few words with out
pausing for a breath
Cardiovascular- includes the heart and blood vessels, which carry nutrients and oxygen to
the tissues of the body
Cardiovascular disease- includes diseases such as coronary artery disease, heart attack,
heart failure, high blood pressure and stroke
Range of motion- the normal amount your joints can be moved in certain directions
Weight bearing activities- includes doing aerobic exercise on your feet with your bones
supporting your weight
Repetitions- or reps, is the number of times you repeat an exercise
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Safety
When to check with your doctor:
If you have any complications of diabetes (numbness or tingling of limbs, kidney
problems or eye problems)
If you are a man over 40, or a over woman over 50, and have never tried exercise
or have a chronic health problem (you do not have to check with your doctor for
walking)
Any new symptom that has come up and you have not discussed with your doctor
Dizziness or shortness of breath
Chest pain or irregular heart beats
Blood clots
An infection or fever with muscle aches
Unplanned weight loss
Sores that will not heal on the feet or legs
Joint swelling
A hernia
Recent hip surgery
Safety Tips
Start slowly
Increase your activity level each time you exercise
Don’t hold your breath during exercise, this will increase blood pressure
Proper foot wear should be worn
If you are not on any fluid restriction, be sure to drink plenty of fluids even if you
don’t feel thirsty
Always bend forward from the hips not at the waist, to make sure you are bending
right see if your back is straight when you bend forward, if it humps your are
bending wrong
Always stretch to prevent injuries
Wear some form of diabetes and personal identification
Avoid vigorous activity in extremely hot, humid, smoggy, or cold environments
Exercise should not make you feel really tired or keep you in pain. If these symptoms
occur, discontinue exercise and talk with your doctor.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Shoes
When exercising, it is important to wear proper shoes. People with diabetes sometimes
lose feeling in their feet and legs. Wrong fitting shoes can pinch or rub your feet causing
sores.
What to look for in shoes
Breathable
No interior seams or covered inseams
Plenty of room in the front of the shoe so the toes can move
Elastic or an adjustable fit to prevent the shoe from sliding around
It is a good investment to have custom insoles made or go to a shoe store that specializes
in diabetic shoes. There are also diabetic socks.
Taking care of your blood sugar
It is a good idea to check your blood sugar before and after exercise. Do not
exercise if your blood sugar is less than 70 or more than 300.
Carry a snack (carbohydrate) in case your blood sugar gets low during exercise
Examples of snacks include:
1/2 peanut butter sandwich
Juice box and string cheese
Peanut butter and small apple
Banana and peanut butter
Crackers and cheese
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Common barriers to exercise
What is a barrier?
The dictionary defines a barrier as, “a structure such as a fence that is
intended to prevent access or keep one place separate from another.”
We all experience personal barriers to things. A personal barrier to
exercise is something that personally prevents you from exercising. So how are you going
to jump that imaginary fence in your way?
Barrier: Between work, family, and other demands; I am too busy to exercise!
Solution: Make it a priority the same way you make other things a priority. Carve time
out in your day or certain days of the week. Write it on a calendar and write the time to
keep yourself accountable. Wake up 30 minutes earlier to go on a walk. Take an evening
exercise class to keep you accountable. Try to schedule a walk during your lunch hour.
Additionally, you can try to build physical activity into your routine chores. Rake the
yard, shovel snow, wash your car, or vacuum at a fast pace.
Barrier: By the end of a long day, I am too tired to work out!
Solution: Spread your work out through out the day. Break it into three 10-minute
increments. Walk in the working, mid-day, and evening. Figure out what works best for
you. Trick yourself into exercise; take the stairs, park at the back of the parking lot, or
walk in place while watching TV.
Barrier: Getting on a treadmill or stationary bike is boring!
Solution: Meet a friend for workouts; this will keep you motivated and accountable.
Watch TV while on a bike or treadmill, or read a book or magazine. Listen to a book on
tape, or music that inspires you. You can check out books, books on tape, or music from
the library. Change your scenery and go outside and ride your bike, or go on a walk.
Barrier: I am afraid I will hurt myself!
Solution: Start slow and increase the length of time you exercise by one or two minutes
every time. Start with moderate intensity workouts first and then progress to harder
exercises. Take an exercise class, the instructor will show you the safest ways to perform
exercise and watch you do the exercises to ensure you are properly performing them.
Water workouts are the best if you are worried about your joints or muscle aches.
Swimming laps or doing water aerobics is a fun way to do water workouts.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Barrier: I do not want to spend a lot of money to join a gym or buy workout gear!
Solution: Choose free activities. Dance, garden, take your children or grandchildren to
the park, go on walks, walk around a local mall or store, such as Wal-Mart. Find out if
your job offers any discounts at fitness clubs, some companies will pay for half of the
membership. Some fitness clubs offer discounts or scholarships based on income. Use
canned food, or fill milk jugs filled with water or sand and use them as weights.
Barrier: I don’t have anyone to watch my kids while I exercise!
Solution: Do something physically active with your kids. Remember your children need
exercise too, so involve them. Dance to music, walk while they ride their bike, run
around at the park with your kids, or play games such as soccer, basketball, or tennis.
Take turns with your spouse while one of you exercises. Hire a babysitter. Try to find
fitness clubs that offer childcare.
Barrier: I would be embarrassed if my neighbors or friends saw me exercising!
Solution: This can be a common fear that people face, but does it really matter? You are
doing something positive for your health and you should be really proud of it. If someone
sees you exercising you may inspire him or her to start exercising, and they may even
want to join you. Ask someone to exercise with you. Having someone to exercise with
will make you feel less self-conscious, be accountable, and make it fun. If you do not
want to exercise in your neighborhood go to a local park, nature trail, or fitness or
community center to be active.
Barrier: The winter is too cold and the summer is too hot to be active!
Solution: Walk around the mall or a store such as Wal-Mart. Join a fitness or community
center that allows you to pay for the months and classes you want instead of a whole
year. Work out at home; check out exercise videos from the library every week or share
videos with friends to switch up your work out.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Now that you have heard common barriers, what are the barriers that stop you from
exercising?????
Take a few minutes and write down 2-3 barriers you have.
My barrier: ________________________________________
My barrier: ________________________________________
My barrier: ________________________________________
Now from the discussion above what can you do as a solution to these barriers?
Solution: __________________________________________
Solution: __________________________________________
Solution: __________________________________________
Now that you have critically thought through barriers and solutions, take the next step.
Know your goals: Short-term goals like walking 10 minutes 3 times a week are good to
start out with. Write on a calendar the days and times you want to try to exercise. Then,
track your exercise on the spreadsheet that is provided.
My goals: ______________________________________________________
______________________________________________________
______________________________________________________
Have support: Think of people that can encourage you to exercise. Think of your
patients, spouse, siblings, relatives, and friends for encouragement. These people can help
keep you stay on track by providing encouraging words that motivate you, watch your
children or get them to exercise with you. Don’t forget your biggest cheerleader, your
dietitian or healthcare provider. We really want to see you succeed, because we know
how much you will improve your overall health.
Lastly, write a memorable message for yourself to motivate you to exercise.
A memorable message is a 6-10 word message for you to look at and remind yourself
why you are exercising.
My memorable message for you is, “A strong outside strengthens the inside.”
Your memorable message is ___________________________________________
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Put this message in a place that you will see everyday such as your mirror, refrigerator, or
bulletin board.
What to do if you have complications of diabetes
Cardiovascular disease
You may need to be monitored in a cardiovascular rehabilitation program.
Avoid activities that can increase your blood pressure greater than 260/125,
activities that increase blood pressure are the ones that primarily use the upper
body and arms.
Avoid activities that require heavy lifting or straining.
Avoid trying to move a heavy object while holding your breath.
Try activities that use the lower extremities such as walking, light jogging, and
cycling activities.
When doing resistance exercises, try low resistance with high repetitions.
Peripheral vascular disease- narrowing of your vessels that carry blood to your legs,
arms, stomach, or kidneys
During physical activity you may experience pain, because oxygen is not
getting to your muscles
A walking program with periods of rest may help improve circulation and
decrease pain
Everyone is different, so you will have to start slow and work up slowly,
because higher intensity requires more oxygen which will cause pain
Use conversation, music, and other elements to distract attention from the
discomfort and pain
Stop exercising when you cannot distract the pain, and the pain becomes intense
Weight bearing activities are ok (fast walking, jogging, running, jumping,
jumping jacks, step aerobics, dancing, weight lifting, hiking, stair climbing, and
push-ups)
If you have pain when you are resting or in the night, do not start a walking
program
Retinopathy- eye problems causing blurred vision
This is a very serious disease, talk with your doctor or eye doctor before starting
any exercise
Visual impairment
Swim in lanes that use lane guides
Stationary cycling
Treadmill walking
Dancing with a person that doesn’t have any vision problems
End-Stage renal disease
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Activity levels will depend on the level of kidney function, speak with your
doctor
Start at a very low level and slowly progress
Brisk walking, swimming, and cycling should be ok
Peripheral Neuropathy- numbness or tingling in arms, fingers, legs, or feet
Stretching is ok, but overstretching can occur so only hold for 10 seconds
Avoid lifting weights due to an increased chance of tissue and joint injury
Do low impact activities such as cycling and swimming. Brisk walking is ok if
balance is not impaired
Avoid jogging because it puts extreme pressure on the feet
Chair exercises are ok
Autonomic Neuropathy- affects involuntary body functions such as heart rate, blood
pressure, perspiration, and digestion
Your body may not be able to cool down or increase body temperature during
exercise, so avoid extremely hot or cold environments
Avoid high intensity physical activities
Possible low blood pressure or high blood pressure can occur after high intensity
exercises
Frequent blood sugar monitoring may be needed
Review the following 6 questions. If you answer yes to any of the following questions, do
not start exercising and speak with your doctor.
1. Are you a man over 40 or a over woman over 50 and have never tried exercise or
have a chronic health problem?
2. Do you have any new symptom come up and that you have not discussed with
your doctor?
3. Do you experience dizziness, shortness of breath, chest pain or irregular
heartbeats?
4. Do you have blood clots, a hernia, unplanned weight loss, joint swelling or an
infection or fever with muscle aches?
5. Do you have a sore that will not heal on the foot or leg area?
6. Have you had recent hip surgery?
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Target heart rate
Everyone should determine his or her target heart rate. When doing aerobic exercise,
your target heart rate will give you an estimate of how hard you are working.
How to determine your target heart rate
Taking your pulse is the first step to determining your target heart rate
Press the tips of your index and middle fingers on the inside of the opposite wrist just
below the base of the thumb. Count the number of beats over a minute (60 seconds).
Do it when you have been sitting for a few minutes.
When taking your pulse after exercise, count the number of beats over a 10 second
period and multiply this by 6. Don’t count your pulse for an entire minute. During the
minute your heart rate will slow down and you won’t get an accurate reading.
You want your exercise intensity to be in the rage of 50-80% of oxygen uptake reserve
(VO2R) or heart rate reserve (HHR). So what does that mean?
Let’s do an example of a 50-year-old male.
First we estimate the heart rate maximum.
Estimated HR max = 220-age
Now we estimate the target heart rate range with 50% as the lower estimated range and
80% as the higher estimated range.
Lower range = [(220 – Age) x .50%]
Lower range = [(220-50) x .50]
= [170 x .50]
= 85 beats per minute
Higher range = [(220- Age) x .80%]
Higher range = [(220-50) x .80]
= [170 x .80]
= 136 beats per minute
This person would want to keep their heart rate between 85 to 136 beats per minute
during exercise.
This is just an estimation of heart rate, don’t use this method to determine your maximum
heart rate if:
You are on medication that will change your heart rate such as beta-blockers.
Beta-blockers alter your heart rate response to physical activity and mask
hypoglycemia. Some examples of beta-blockers include: Propranolol, Sotalol,
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Atenolol, Metoprolol, Lopressor, and Coreg. Ask your dietitian or your healthcare
provider if you are on any beta-blockers.
You have a pacemaker or have an irregular heart rhythm called “atrial fibrillation”
You have other conditions that affect your pulse rate
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Beginning exercise Your exercise routine should consist of a warm up and cool down .
Warm up
5-10 minutes of low intensity aerobic exercise
Why do you need to warm up?
It prepares muscles, heart and lungs for the activity
It helps reduce muscle injury
It helps you safely transition from resting to exercise by increasing blood flow,
elevating body temperature, increasing oxygen availability, and increasing
metabolic rate
Stretching should be part of your warm up
An easy warm up is to walk in place for 5 minutes, then stretch for 5 minutes
Cool Down
5-10 minutes of low intensity activity
It is a good idea to include stretching in your cool down
Why do you need to cool down?
It helps the body to safely transition to the resting state
It prevents blood pooling in the arms and legs
It removes metabolic by products
It may reduce risks for cardiovascular complications immediately after exercise
Extra tips for exercise
Make sure when you exercise to breathe continually and avoid breath holding, exhale
during the exertion or lifting phase, and inhale while returning to starting position
Lift weights with slow controlled movements
Try to use complete range of motion
Try to keep your body straight while performing exercises
STOP exercising if you feel dizzy, light headed, unusual shortness
of breath, or chest pain
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Understanding your muscles
As you read through this book, you will see the names of the muscles used. Refer back to
this picture to understand the muscles you are exercising. You want to make sure you do
the recommended repetitions, so you don’t overwork your muscles.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Stretching Hold each stretch for 15 to 30 seconds.
Complete 2 to 4 repetitions.
Try to stretch at least 2 to 3 days per week.
Breath in and out normally when stretching
Neck stretch
With your hands behind your head, push your head back into your
hands focusing on the force coming from your neck. Do not push too
hard otherwise you may strain your neck. Hold stretch for 10-15
seconds and repeat once.
Neck stretch
Gently grasp side of head while reaching behind back with other
hand. Tilt head away until a gentle stretch is felt. Repeat to
other side. Hold stretch for 30 - 60 seconds. You can repeat 2 to
3 times as desired.
Shoulder stretch
Bring your arm across your body and hold it with your other arm, either
above or below your elbow. Hold the stretch for 30-60 seconds and switch
to your other arm.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Triceps extension
Extend your arm up, and bend at the elbow, so that you are reaching
down the center of your back. Hold that arm down at the elbow with
your other hand.
Hold each side for 30-60 seconds.
Arm circles
Extend your arms out to the side forming a “t” with your body. Make small circular
motions for 10 seconds; slowly enlarge your circles for another 20 seconds.
Wrist Stretches
Extend your arm straight in front of you, flex your palm up, and point your fingers down.
Use your other hand to gently pull your hand back. Hold this stretch for 20 seconds. This
exercise can also be done
with your fingers pointed
up.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Runners Stretch
Excessive tightness of the calf muscles can contribute to many foot
problems and some knee problems. This exercise is very important
for diabetics to prevent leg and feet problems
Lean forward against the wall with the legs in a position as if you
were walking, straighten your back leg and keep the front leg bent.
Lean into the wall until the stretch is felt in the calf, try to hold the
stretch for 20 seconds and then switch legs. Repeat this for a total
of 3 times on each leg. This totals 1 minute per leg. It is best to do
6 minutes total a day, which is 3 minutes per leg. This exercise
distributes your weight evenly.
Hip stretch
Sit in a chair, cross your leg so your ankle is on the
opposite leg, push down on the leg that is crossed, and lean
forward until the stretch is felt in the hip. Hold for 20
seconds and repeat on the opposite leg.
Hamstring Stretch
Sit upright and tuck foot near groin with the opposite leg
straight. Reach forward from the hips and grab your ankle
until the stretch is felt in the back of the thigh. Hold for 20
seconds and repeat with the opposite leg.
Hamstring Stretch
Slowly bend forward from the waist with your knees slightly bent and
reach for the floor keeping your head up. Only go as far as you can, the
stretch will be felt in your lower back and hamstrings. Hold for 20
seconds.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Quadriceps Stretch
Find something to hold on to in order to keep your balance.
Stand in an upright position and slowly bring one leg behind
your back and grab your foot. Hold for 20 seconds and
switch legs.
Seated straddle
Sit in an upright position with your legs as far apart as possible, bend forward at the hips
keeping your head up and reaching toward your feet. Hold for 20 seconds in the middle,
hold for 20 seconds when trying to reach to one side, and then switch to other side.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Strength Training
What is strength training?
Strength training includes weight lifting, weight machines, and resistance bands.
It is best to exercise large muscle groups before you exercise small muscle
groups. This means doing back and chest exercises before arm exercises.
Frequency: 2 to 3 times per week with 48 hours of rest between sessions.
Start with one set of 10 to 15 repetitions for each area, and then increase to 2 sets
of 10 to 15 repetitions.
When you feel comfortable with those repetitions, increase to 3 sets of 8 to 10
repetitions.
Rest is very important, a minimum of 15 seconds to 1 minute; with higher
intensity training 2 minutes rest may be needed.
If this is too much for you, try 1 set for each area starting with 10 t o15 repetitions and
progressing to 15 to 20 repetitions.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Bench Press
Grab a pair of hand weights and lay flat on your back. A weight
bench is ideal, but if you don’t have one just lie on the floor.
Position your hands wider than shoulder width apart with your
elbows pointing away from you. Weights should be in line with
your arms. Lift your arms up over your chest and bring them down
until they nearly touch your chest, and repeat. Do this 10-12 times
and take a break, then do another 10-12, and another 10-12. This
will work your chest muscles.
To change this exercise tuck your elbows into your side and keep your elbows tucked as
you lift. You can use a prop for your feet, or if you are on the floor curl your legs up.
Squat
If you are a beginner, start with this squat. Start with your feet
shoulder width apart, push your butt back, bend your knees, and keep
your arms straight out in front of you. Once you are in this position,
push your butt towards the floor as if you were to sit in a chair. Keep
your torso straight, and don’t strain your back. Slowly rise and return
to your starting position. Do 3 to 5 reps as desired.
The blue
shows the
modification
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Dumbbell squat
Grab a pair of hand weights (8-10 pound hand weights will show the best
results). Stand with your feet hip width apart and arms to your sides. Squat so
your thighs are parallel to the floor and return to standing. Do this 10-12
times; take a break, repeat 10-12 times, rest, and repeat. This works your
quads.
To change this exercise, position the dumbbells in front of your
thighs with your palms facing your body. Let the dumbbells drop
straight toward the floor as you squat. This works your glutes and
hamstrings.
Pushup
Get in a plank position with your feet together and hands wider than
shoulder width apart. Bend your arms, lower your chest toward the floor,
and press back up. Do this 6-12 times, rest, and repeat 2 more times.
To change this exercise, place your feet on a six to eight inch high
step. This works your shoulders.
The blue
shows the
modification
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Lateral Bend and reach
Grab a pair of 5 to 10 pound dumbbells and stand
with your feet about four feet apart. Turn your left
foot out 90 degrees. Raise your right arm straight
up above your shoulder, palm facing in (A). Brace
your abs, and bend to the left, lowering the left
dumbbell to your left ankle (B). Rise up keeping
your right arm overhead. Do 12 to 15 reps and
repeat on the other side. Do three sets, resting for
up to 30 seconds between each set.
This is an example of a strenght training workout.
Lunge twist
Stand with your feet hip width apart knees slightly bent, elbows bent 90 degrees by hips.
Lunge forward with right leg and rotate torso and arms to the right. Rotate back to center
as you quickly push off right foot to return return to start. Do 16 reps aleternating sides.
This will target your abs, obliques,gluteus, and quads.
Step hop Stand with feet hip width, knees slightly bent, hands on hips. Step forward with right
foot, then lift left knee to hip level as you hop straight up on right leg. Land with feet
together. Do 16 reps alternating sides. This will target your abs,
gluteus and legs.
Shot put
Stand with right elbo bent with hand by ear, left arm out at shoulder level. Lunge to right
with right leg: rotate torso to right. Push off right foot to stand, pivoting to left. Extend
right diagonally (as if throwing a shot). Do 16 reps alternating sides.
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Aerobic
Aerobic activity can also be called “cardio”. This exercise really gets you moving, your
heart beating, and your blood flowing. Aerobic activity can be broken down into two
categories, moderate intensity and vigorous intensity. Benefits of aerobic exercise include
blood glucose control and improved cardiovascular status.
Guidelines: 20 to 60 minutes (can be divided into three 10-minute sessions 3 to 5
days of the week preferably every other day
Moderate intensity workouts include increasing your heart rate and breaking a sweat.
Walking fast
Riding a bike on a flat surface or with a few hills
Playing doubles’ tennis
Pushing a lawn mower
Shoveling light snow
Bowling
Water aerobics
Vigorous intensity workouts include breathing hard and fast while increasing your heart
rate
Jogging or running
Swimming laps in a pool
Riding a bike on hills or at a fast pace
Playing singles’ tennis
Playing basketball
Step aerobics
Jumping rope for extended periods of time
Shoveling heavy snow
Boxing or kick boxing
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Water aerobics can be considered moderate or vigorous intensity depending on what you
do.
Water aerobics can include running, jogging, or walking in a pool. It is best to
start in the shallow end, move in thigh deep, and then move in chest deep.
A typical aerobic routine lasts 30-45 minutes and involves warm-up, cool down,
and stretching exercises.
Each exercise should be held for 20-60 seconds.
Remember even in water you can hurt your feet, so it is best to wear a good pair
of water shoes.
Here is an example of a water aerobics workout:
Warm up: Run or walk easy for 10-15 minutes, slowly increasing your speed and
intensity. Do a few stretches to loosen up your muscles and finish the warm up with a few
short fast sprints.
Main set: Alternate between running and cross-country skiing. First two minutes easy,
next 2 minutes moderate intensity, next 2 minutes hard, next 2 minutes moderate
intensity, last 2 minutes easy. Repeat if you like, 2-4 times as the maximum.
Cool down: Run at an easy pace for 10 minutes gradually decreasing intensity. Finish
with a good stretch.
Other things you can do in water:
Water squats - stand in the water with your feet apart, bend your knees, and push
your hips back like you were to sit in a chair. Do this about 5 times. This will
work the front of your thighs and buttocks (hamstrings and gluteus).
Do laps walking forward and backward.
Kick - use a kick board or the side of the pool. This will work your thighs and
buttocks (hamstrings and gluteus).
Pull ups - grab the side of the pool and pull your self up as far as you can keeping
your knees bent, exhale as you pull yourself up. This will work your back,
shoulders and arms.
Arm motions- stand in water up to your neck and reach your hands out to each
side, elbows straight, palms forward, slowly bring them forward and clap your
hands, return to starting position. This will work your chest muscles.
Arm motions- stand in water a little above your waistline with your palms down
on the surface of the water. Keep your elbows locked at your side as if they were
glued to you rib cage, exhale and push your hands down until you are at your
hips, turn your hands and bring them to starting position. This will work you arm
muscles (triceps).
Arm motions- stand in water a little above your waistline with your arms at your
hips, palms forward, exhale as you bend at the elbow to bring your hands toward
your shoulders. This will work your arm muscles (biceps).
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Pool crunches- stand with your back to the wall holding into the rim of the pool
with your elbows, keep your knees bent, bring both legs into a sitting position and
hold it for 10 seconds. Bend at the knee to bring the legs down. Remember to
keep your back straight and breathe slowly through out this exercise. This will
work your stomach muscles (abdominals).
Jumping rope
Start out doing the recommended amount of repetitions and increase the amount and
speed the more you become familiar and comfortable with these exercises. You can
combine the different jump rope exercises to fit your preferences.
Basic jump - grabbing the handles on the rope with the middle of the rope behind
your calves and swinging it forward. Start out by doing this 10 times and rest.
Reverse basic jump - is the same as the basic jump except you start with the rope
in front of you by your ankles and swing it over your head in a backwards motion.
Start out by doing this 10 times and rest.
The twister - when doing the basic jump keep your feet together and twist your
lower body, to the left on one jump and then to the right on the next jump,
alternate sides for 10 jumps and rest.
Jogging step - when doing the basic jump, walk or jog over the rope 10 times at
the speed you are comfortable with and increase at your own rate.
Double under - when doing the basic jump keep your feet together and jump up
once but swing the rope under you twice. Do this up to 5 times and rest. To add a
challenge to the double under swing the rope under you 3 times, 4 times, or 5
times in one jump. Increase the number of jumps at your own pace.
Criss Cross - start in the basic jump position when the rope is at the top of your
head cross your arms by putting your left arm on your right side and your right
arm on your left side. Open your arms when you have jumped over the rope. Do
this 10 times and rest.
This is just an example of how to turn jumping rope into a 30-minute exercise routine.
Basic jump - 3 minutes
Rest - 2 minutes
Basic jump - 3 minutes
Rest - 2 minutes
Reverse basic jump - 3 minutes
Rest - 2 minutes
Jogging step - 2 minutes
Basic jump - 2 minutes
Rest - 1 minute
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
Criss Cross - 2 minutes
Basic jump - 2 minutes
Rest - 1 minute
Twister - 2 minutes
Basic jump - 2 minutes
Rest - 1 minute
If you like walking but find it to be boring or feel like it is not working your muscles
enough try this routine below.
MINUTES WHAT TO DO RPE*
0:00–3:00 Warm up slowly 2–3
3:00–5:00 Increase to a moderate pace 4–5
5:00–8:00 Speed up and lengthen your stride;
your breathing should be faster 5–6
8:00–10:00 Do walking lunges 7–8
10:00–12:00 Walk at a moderate pace 4–5
12:00–17:00 Alternate 30 seconds fast; with 30
seconds moderate 6–8;
4–5
17:00–18:00 Repeat walking lunges 7–8
18:00–20:00 Recover 4–5
20:00–26:00 Alternate 1 minute fast; with 1
minute moderate 6–8; 4–
5
26:00–30:00 Slow pace to cool down 2–3
*Rate of Perceived Exertion (RPE) is based on a
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
scale from 0 to 10, 10 being the most challenging.
How many steps do you walk a day?
The new guideline for steps taken per day is 10,000 steps. An easy way to count steps is
to wear a pedometer. Most pedometers are made to be worn on your waste line. People
with bigger waste lines may have trouble keeping the pedometer on; in this case there are
pedometers made to wear around your neck or very slim pedometers that fit in your
pocket. Some pedometers include a radio and will talk telling you how far you have gone
and how far you need to go. Some watches now have pedometers on them. You can also
buy pedometers that measure heart rate. Pedometers are a simple way to track how far
you have walked through out the day to see if you are meeting the steps taken guideline.
Sources and picture sources
This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self
Management of Diabetes Program, funded by the Missouri Foundation for Health.
U.S. Department of Health and Human Services, National Institute of Health. (2007). Exercise: A
Guide from the National Institute on Aging. NIH Publication No. 01-4258.
Mensing. C. (2006). The Art and Science of Diabetes Self-Management Education: A Desk
reference for healthcare professionals. Chicago, IL: American Association of Diabetes
Educators.
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