T Nation

Training without a foot


#1

Hey all,

This post actually has to do with a client of mine. Recently this gentleman (age:59, just started training) had part of his foot removed due to diabetes. He came to me in an effort to drop bodyfat and possibly prevent further advancement of the disease through exercise and healthy eating.

Unfortunately, the problem wasn't resolved and he has had almost his whole foot removed as of a couple weeks ago. Currently he can't walk on it and has trouble making it to the training studio.

Here's my imagination at work:
As of now I've recommended that he purchase an inexpensive arm ergometer (arm bicycle) for home to get some cardio in. I've also suggested that he rent a wheelchair from a local pharmacy and wheel around his neighbourhood. His other option is to go to the mall (chairs free at customer service) and do a couple laps daily.

Does anyone have suggestions for other methods to get activity in his state? He probably doesn't have anything more than 5lbs dumbbells at home.


#2

How about swimming?


#3

I guess it would be a possibility. I wonder if he could cover up the wound (it's still not fully healed) and go swimming.

Cool thought. Thanks. Any more would be appreciated.


#4

What a dilemma. On the one hand your client would benefit mentally from doing something, anything PROactive. But on the other hand, he needs as much of his nutritional and energetic resources for healing as possible.

After he's feeling better, when he's chomping at the bit, I don't see why he couldn't do mostly upper body exercises, not to mention leg extensions and leg curls. There are your military presses, pullups and dips on a Gravitron. Bench presses, too; all varieties. It's just going to be a case of getting out of his wheel chair and onto a bench or the equipment. I even like the Hammer Strength machines; Hi and Low Rows, incline, decline and flat bench (although there isn't any reason he couldn't be doing it with a regular bench).

Am I missing something, Kinetix? Does he have access to a gym? Is what I'm suggesting feasible?

As far as nutritionally, make sure he's getting a good 3-a-day multivitamin, flaxseed oil @ 1T per 50 pounds of BW. For bones, he needs to supplement with silica, boron and a good calcium supplement with cofactors. MSM (sulfur) is huge for pain management, and joint integrity; work up to 5g x 2. For inflammation and protein turnover, I'd recommend Wobenzyme and bromelain. Get aggressive on the dosing of the last 2.

I hope -- assume -- you're helping him with diet and carb management; choices, timing, etc. Please take full advantage of r-ALA with all carb-containing meals.

Any questions, anything I can do, please ask, Kinetix.


#5

Terry,

Thanks for your thoughts. The problem with my client is that because his circulation is so bad (NOTE: eat well and don't get diabetes) his foot can't heal. This is his second surgery and they keep taking more of his foot. It's a possibility that they'll eventually have to take his whole leg. Despite this AND being 59 he really wants to make an effort. Unfortunately, with his foot as it is he can't really make it to my training studio (We're on the second floor of a building). In the future you are correct, upper body work will be the focus and I'll toss in some leg extensions and curls. What I guess I'm searching for are ideas as to how he can stay active in the meantime. I need some innovative ideas.

With regards to supplements I'd especially appreciate your advice. As my research tends to center more on training and nutrition (mostly protein) I'm not so strong in this area. If you have time could you review the supplements you've listed and give me some background on what they're supposed to do? I and my client, would really appreciate it.

Thanks in advance.

What a dilemma. On the one hand your client would benefit mentally from doing something, anything PROactive. But on the other hand, he needs as much of his nutritional and energetic resources for healing as possible.

After he's feeling better, when he's chomping at the bit, I don't see why he couldn't do mostly upper body exercises, not to mention leg extensions and leg curls. There are your military presses, pullups and dips on a Gravitron. Bench presses, too; all varieties. It's just going to be a case of getting out of his wheel chair and onto a bench or the equipment. I even like the Hammer Strength machines; Hi and Low Rows, incline, decline and flat bench (although there isn't any reason he couldn't be doing it with a regular bench).

Am I missing something, Kinetix? Does he have access to a gym? Is what I'm suggesting feasible?

As far as nutritionally, make sure he's getting a good 3-a-day multivitamin, flaxseed oil @ 1T per 50 pounds of BW. For bones, he needs to supplement with silica, boron and a good calcium supplement with cofactors. MSM (sulfur) is huge for pain management, and joint integrity; work up to 5g x 2. For inflammation and protein turnover, I'd recommend Wobenzyme and bromelain. Get aggressive on the dosing of the last 2.

I hope -- assume -- you're helping him with diet and carb management; choices, timing, etc. Please take full advantage of r-ALA with all carb-containing meals.

Any questions, anything I can do, please ask, Kinetix.


#6

Kinetix, why the fuck are you pasting Tampa's reply if you're not commenting on it?

Hm?


#7

I'm sorry, that wasnt helpful.

Was it?

Accept my apologies.


#8

Sorry for the hijack

Yet again Diesel proves He's a dork

End Hijack


#9

Kinetix, the more that I think about it, the more that I feel you should get your client to a clinical nutritionist. His diabetes is a complicating factor, especially the fact that it's so advanced. There may be absorption issues and nutrient delivery issues. I have no doubt his cardiovascular system needs support. He needs the multivitamin I told you about, and he would definitely benefit from antioxidant support and trace minerals that ameliorate glucose metabolic abnormalities, along with some of the nutrients I recommended that support bone matrix remodeling.

Kinetix, the list goes on and on. Supplement recommendations for someone who has suffered a bone fracture are different than your client's issues and a lot more complicated . . . and with much greater chance for repercussions. Your client needs bloodwork done to identify deficiencies (vitamins and minerals, both) and identify exactly what dosage brings him into the normal/optimal range. The dosage required to correct a deficiency can vary widely from individual to individual, so follow-up bloodwork is typically required.

As far as exercise goes, for right now I think 20-minute cardio sessions would be ideal. Not only would it improve insulin sensitivity, it would impove nutrient delivery (due to a more extensive capillary network) and strengthen the heart. You may have to work up to those 20-minute sessions, though.

Kinetix, I wish your client all the best. If you have any questions, don't hesitate to ask.


#10

It certainly appears that circulation is paramount. Having said that perhaps a heated pool would be better than a cold environment.


#11

Diesel, chew my nuts you uneducated monkey turd. Oh...that wasn't helpful. Please accept my apologies.

Terry and Others,

Thanks for the advice. I'll possibly get him to speak with a nutritionist and get some bloodwork done. Thanks again.


#12

Kinetix, UBE is great for cardio. I have used it many times w/ my clients. Another thing you can do is grab focus mitts and have him throw punches. work on the jab, hook, and uppercut combinations. Also when you do find a nuristionist make sure he or she specialize in someone that has diabetes.

Hope this helps.

In Health,

Silas C.


#13

fogot to add sitting down of course.


#14

Thank you fitone, yet another great idea from the people at T-mag. I think punching some mitts might help him blow off his frustrations.


#15

If the dudes got use of one leg why couldn't he use crutches for a 10 min. walk? My Dad had one leg and used crutches for 75% of his mobility. Anyone who's had to use them know that they kick your ass. I don't know if this'll help, just wondering.

Billy


#16

Billy,

Unfortunately diabetes tends to effect the extremities most so circulation in his other foot isn't what it should be either. In the event that he puts to much pressue and damages it his other foot won't heal either. Not the nicest condition to be in. Kinda makes me remember to eat clean.


#17

"heated pool..."

Individuals with complications from diabetes have to be careful with heated pools (or saunas, for that matter). The poor circulation does not allow the body to regulate temperatures of the extremities very well.