I doubt that my response will be helpful to you, however, I hope are able to appreciate my perspective.
At the moment I am earning my second masters degree in Diabetes Education and Management and am certified through the ACSM as a Registered Clinical Exercise Physiologist. For my first graduate degree I studied exercise science and health promotion.I
Professionally, I believe it is a good idea to refer her to someone who truly understands the pathophysiology of both chronic conditions and is better prepared to design an exercise program for that client.
I say this as there is so much to take into consideration such as the medication she is taking and how the medication affects her exercise response.
I encourage you to do as much research as possible on both conditions should you decide to take on this client. This way you won’t have to ask the forum for ideas.
I wish you the best!
I agree with getting medical clearance and working with a dietitian on her diet. I would imagine that she would have some reimbursement through her insurance to see a dietitian if she has type 2 diabetes.
Resistance training and pool training would be great. I would just start light and progress slowly.
1. Reduce inflammation through Zone-type diet (40% veg/fruit carbs, 30% protein, 30% fat)
2. Include 8+ grams of distilled high-potency fish oil to further reduce inflammation (See the Anti-Inflammation Zone, by Barry Sears)
3. Avoid starchy carbs, including grains, to reduce acidity.
4. Supplement with a good multi 2-3 X/day, 2,000+ I.U. D3, and a liquid trace mineral supplement.
5. Depending on discomfort level in joints, lift light to medium but very slowly to increase muscular effort at low joint stress level.
6. Encourage moderate cardio to lower sugar levels and raise HDL level.
Hello Lindsey Wold,
To add, I would also add light to moderate strength training and discourage the running, for now, to save the joints. I am sure you already know to spend more time with the warm up, cool down and stretching.
Maybe you could get the client to trade the running for swimming, which is a great workout without the stressors on the body.
Good luck to you both. I am glad that she knows exercise is medicine.
I assume that the doctor has cleared her to exercise, both on grounds of RA AND her diabetes.
If it was my client, I would impress weight loss as a top priority and would recommend that she see a dietitian to assist with it so that she will eat optimally to manage any problems with diabetes.
She will be in the difficult situation that she has to balance the limitations that RA may inflict upon her with those to control her diabetes. RA progression can be unpredictable but excess weight will only make matters worse.
You say that she likes running and biking. While these are not ideal exercises for RA (many RA sufferers do much better with aquatic and very low impact exercises), they could help her with weight loss. I would check with the RA doctor whether it would be considered advisable to maintain those (at least biking) or whether she should go to lower intensities.
Light resistance training is certainly a good additional option as tolerated with RA.
This is a tricky situation, and I suggest you work very closely with her healthcare provider.