By Sheri R. Colberg, PhD, FACSM
You need properly functioning joints to be able to bend, flex, or move your body. That’s why taking care of your joints and preventing injury is important.
A joint is wherever two bones come together, such as your hips, knees, and multiple places in your hands. They’re made up of tendons that cross each joint and attach muscles to a bone on the other side, along with ligaments that attach to bones on both sides of joints to stabilize them. Other important things to know are that the ends of bones are covered with cartilage and that tendons and ligaments are also made primarily of collagen.
If you damage your joints, moving them can get a lot more difficult or painful. You can acutely injure your joint cartilage (examples are sprains and tears of tendons or ligaments) or you can develop an overuse injury related to repetitive joint movements and wear-and-tear over time. The bad news is that damage to cartilage and collagen is not repaired by the body easily or well, mainly because cartilage lacks its own blood supply. Bone breaks heal faster in most cases.
Aging alone can cause you to lose some of the cartilage layer you have in your knee, hip, and other joints—leading to osteoarthritis and joint pain—but having diabetes also potentially speeds up damage to joint surfaces.
Although everyone gets stiffer joints with aging, diabetes accelerates the usual loss of flexibility over time by changing the structure of the collagen matrix in the joints, tendons, and ligaments. Basically, glucose “sticking” to joint surfaces and collagen makes you more prone to overuse injuries like tendinitis and frozen shoulder (1; 2).
It may also take longer for your joint injuries to heal properly, especially if your blood glucose is running higher. What’s more, losing movement around your joints makes you more likely to get injured by falling, and fear of falling can make people choose to be more inactive.
Losing your joint flexibility through aging, diabetes and being inactive only further increases your risk of injuries and joint-related problems often associated with diabetes, such as diabetic frozen shoulder, tendinitis, trigger finger, and carpal tunnel syndrome. These joint issues can come on with no warning and for no apparent reason, even if you exercise regularly and moderately, and they may recur more easily as well (3).
It is not always just due to diabetes, though, since older adults without diabetes get inflamed joints more readily than younger people.
So, what can you do to keep your joints mobile and healthy if you’re aging (as we all are) and have diabetes? Regular stretching to keep full motion around joints can help prevent some of these problems, but you should also include specific resistance exercises that strengthen the muscles surrounding affected joints.
It’s also helpful to vary the activities that you do so that you stress joints differently each day. Overuse injuries are more likely to occur if you do the same activity daily for weeks or months, or you can get them from doing too much too soon.
Doing moderate aerobic activity that is weight-bearing (like walking) will actually improve arthritis pain in hips and knees (4). You can also try non-weight-bearing activities, such as aquatic activities that allow your joints to be moved more fluidly. Swimming and aquatic classes (like water aerobics) in either shallow or deep water are both appropriate and challenging activities to improve joint mobility, overall strength, and aerobic fitness.
Walking in a pool (with or without a flotation belt around the waist), recumbent stationary cycling, upper-body exercises, seated aerobic workouts, and resistance activities will give you additional options to try.
Finally, managing blood glucose levels effectively is also important to limit changes to collagen structures that can happen when levels stay elevated. What’s more, losing excess weight and keeping your body weight lower will lower stress on joints like hips and knees that can lead to osteoarthritis (5).
Simply staying as active as possible is also critical to allow your joints to age well, but remember to rest inflamed joints properly to give them a chance to heal. You may have to try some new activities as you age to work around your joint limitations, but a side benefit is that you may find some of them to be enjoyable!
- Abate M, Schiavone C, Pelotti P, Salini V: Limited joint mobility in diabetes and aging: Recent advances in pathogenesis and therapy. Int J Immunopathol Pharmacol 2011;23:997-1003
- Ranger TA, Wong AM, Cook JL, Gaida JE: Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis. Br J Sports Med 2015;
- Rozental TD, Zurakowski D, Blazar PE: Trigger finger: Prognostic indicators of recurrence following corticosteroid injection. J Bone Joint Surg Am 2008;90:1665-1672
- Rogers LQ, Macera CA, Hootman JM, Ainsworth BE, Blairi SN: The association between joint stress from physical activity and self-reported osteoarthritis: An analysis of the Cooper Clinic data. Osteoarthritis Cartilage 2002;10:617-622
- Magrans-Courtney T, Wilborn C, Rasmussen C, Ferreira M, Greenwood L, Campbell B, Kerksick CM, Nassar E, Li R, Iosia M, Cooke M, Dugan K, Willoughby D, Soliah L, Kreider RB: Effects of diet type and supplementation of glucosamine, chondroitin, and msm on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program. J Int Soc Sports Nutr 2011;8:8
In addition to my educational website, Diabetes Motion (www.diabetesmotion.com), I also recently founded an academy for fitness and other professionals seeking continuing education enabling them to effectively work with people with diabetes and exercise: Diabetes Motion Academy, accessible at www.dmacademy.com. Please visit those sites and my personal one (www.shericolberg.com) for more useful information about being active with diabetes.
Join the Newsletter
Never miss a post! Subscribe to my newsletter.