It doesn’t matter how old you are, what you do for a living, or what health conditions you may (or may not have).

Everyone—everyone—needs to make healthy stretching and exercise a part of their everyday routine.

Yes, that’s true even if you have nerve pain or peripheral neuropathy. Actually, you might even say it’s especially true if you have a lower extremity nerve condition.

Physical activity gets the blood flowing, increases cellular metabolism, allows your cells to use oxygen and nutrition more efficiently, and reduces swelling—among other things.

For starters, that means painful symptoms are less frequent and less intense. But it can also mean that progression of nerve damage over time slows or even stops. And nerve cells that have only been damaged (not killed) may even regenerate to a degree.

But, here’s the kicker.

While exercise is essentially for healthy management of nerve pain, it’s also riskier. That’s because, without proper nerve function, you might not notice if you accidentally go too far and sustain an injury. In other words, you don’t hurt when you hurt yourself.

It sounds like a real dilemma. But the good news is, it’s a manageable one. You just need to have a plan, and a list of safe exercises to incorporate into your program.

(But before you start, hold up: always check in with your doctor before starting an exercise program for real if you have any concerns about your foot and ankle health and safety. You’re going to want some additional guidelines, restrictions, and suggestions based on your specific condition that can’t be covered in just a blog.)

With that caveat aside, let’s get to the list! We’ve separated it out into four categories of exercise you should consider: cardiovascular, flexibility, strength training, and balance.

Cardiovascular (Aerobic) Exercise

You should work to improve your general fitness level through cardiovascular exercise. This goes a long way toward keeping your nerves as healthy as possible.

Concentrate on exercises that keep your heart rate up while minimize risk to your feet from impact forces.

For example:

• Brisk walking. This simplest of exercises is also one of the best for neuropathy and nerve pain. It’s like jogging, but with way less impact on your feet. You can do laps around the mall, explore the neighborhood, or hit the treadmill.
• Swimming. Swimming is awesome cardio with minimal impact on feet and joints.
• Bicycling. Generally speaking, you’d want to stick with a stationary bicycle since there’s less risk of a fall or crash. But going out on a “real” bicycle may be appropriate if your neuropathy is less severe, and you have a safe, relatively flat, and well paved trail to use.

Flexibility

Stretches help keep your joints flexible, which improves your mobility and allows you to be more active without sustaining an injury. We recommend stretching as a warm-up before aerobic exercises, and on your own throughout the day.

Stretches to try include:

• Standing calf stretch. Stand a few feet in front of a wall (close enough to place your hands on the wall for balance). Step back with one leg so that the knee is straight, and the entire foot is firmly on the floor. (You will need to bend your front knee slightly). Hold for about 20 seconds, completing 3 reps for each leg.
• Plantar fascia stretch. Remember that wall? Now you’re going to place your heel on the ground as close to the wall as possible—with your toes as high up the wall as possible. (It may help to do this with the inside of a doorframe rather than the middle of the wall. Slowly lean forward and feel the stretch in your Achilles and the bottom of the feet. Again, do 3 reps per leg, 20 seconds each.
• Seated hamstring stretch. Good news—you get to sit for this one! Sit up straight at the edge of a hard chair. Put one leg straight out front, knee straight, heel on the floor, toes pointing up. With the other leg, you’re going to bend your knee as much as you can while keeping your foot flat on the floor. Place your chest over the straight leg and straighten your back until you feel the stretch. Do the same duration and number of reps as before.

Strength Training

Building muscle is another important way to counteract the effects of nerve damage to reduce pain and injury risk. Strength training requires some form of resistance, whether that comes from resistance bands or from your own body weight.

For example:

• Chair squats. Stand in front of a chair. Your feet, knees, and hips should all be in line, directly overtop one another. Slowly lower your rear until it’s just barely touching the chair, while keeping knees and ankles directly over the feet. (You can reach back for the chair for stability.) Keep your weight on your heels and knees and ankles directly over the feet. Then, lift back up again, without resting. Do 10-15 reps.
• Calf raises. Brace yourself against something sturdy (wall, table, countertop, etc.) with your hands, then slowly lift your heels and stand on your tip toes. Then, just as slowly, lower yourself back to the floor. If you do this on a stairway using the edge of step, you can also lower your heels below vertical in the same fashion.

Balance

Loss of sensation in your legs and feet can greatly contribute to trips, falls, and general instability. If you can’t tell where your feet are in space, you’re more likely to lose your footing. But balance is something you can train and improve.

Calf raises and squats, mentioned in the above section, also double as good balance training. You can also try:

• Side leg raise. Stand with a nearby source of support should you need it (chair, counter, wall, etc.). Slowly lift one leg to the side and hold for 10 seconds, then slowly lower it again. Switch legs and repeat. As you improve, you can take your hand off the support, or even try standing on a pillow or balance board.
• Take yoga or tai chi. This isn’t really an “exercise” per se, but we’re going to cheat and count it. These disciplines are filled with good exercises and stretches that work your balance and your flexibility within a safe, controlled environment.

We hope this gives you a good idea and good start! Again, we do want you to check in with either us or your general practitioner before beginning any exercise program. This is a good basic sample of the kinds of stretching and exercise that can often be beneficial, but there are lots more, too! A doctor or trainer can help you develop a program that’s not only helpful, but fun to do!

Of course, stretching and exercise is only one aspect of comprehensive care for neuropathy. It’s also important to visit Dr. Birnbaum and the Brook Valley Podiatry team to determine what additional medical therapies and options may be necessary. To schedule your appointment with us at our Spring Valley, NY location, please call (845) 352-7507.