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Exercise for Polyneuropathy
Every polyneuropathy patient wants to be able to walk without being afraid of falling. Exercises to help you be able to do that can be found on this page. You want to increase your own quality of life, reduce symptoms, improve your sense of balance and performance in everyday life - and all this should be possible without pills and medication with a few simple exercises? Even at home? Balance Training can help - you will find exercises you can immediately follow along at home, in the office, anywhere.
A German version of this article is available at bitzer-sporttherapie.de/uebungen-bei-polyneuropathie/
To achieve real results you need to understand why training works. In this video you will learn all about how Balance Training can help you. After watching this video you will better understand how the exercises work.
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Why you need to know how to exercise by yourself.
We would all think that for something as complicated as polyneuropathy, you should get help from healthcare professionals instead of taking care of it yourself. But the problem with polyneuropathy is that there are hardly any medications that help. Also, while physical therapy is important and helpful for polyneuropathy, there simply isn't enough time in therapy sessions to accomplish much.
Therefore, every serious therapist will confirm that you have to practice yourself in order to achieve something. Because the exercises should trigger a training effect. However, this can only occur if you practice often enough. You do not have to train for a long time, nor does the training have to be physically demanding. The most important thing is that you train the nervous system regularly! And that is only possible if you do it yourself.
Simple Exercises can help you walk better and reduce your pain
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Special Exercises can increase mobility and reduce the negative effects of Polyneuropathy
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Exercise should target your brain instead of your muscles
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These exercises are easy to do and are short in duration
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They can be done at home by yourself
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They require no physical exhaustion
Feelings and sensations are made in your brain
Common misconception: Nerve damage in your hands and feet cause all the symptoms
The common misconception is that the nerve damage in your hands and feet exclusively cause the symptoms of polyneuropathy because it is here that symptoms are felt the most.
However, research conducted by the University of Freiburg, Germany has shown that the reflexes of Polyneuropathy patients functioned very differently to the reflexes of people without Polyneuropathy. These tests were undergone with the use of electric stimuli that were sent through the patient's legs and therefore their nerves.
As a result, we found out that the central nervous system was working differently in people that suffer from polyneuropathy.
THE GOOD NEWS!!!
The central nervous system is the brain and the spinal cord and these are the most trainable organs we have.
In fact, It requires much less time an effort to train these organs than, for example, training your muscles. This gives us a great opportunity to help with polyneuropathy.
As the central nervous system works differently in patients with Polyneuropathy, we can conclude that the condition does not just change the way your nerves in your hands and feet work. It changes the signal processing in your brain, which interprets these signals.
Polyneuropathy changes signal processing in your brain
When your brain receives the signals from your hands and feet and then processes them. This can be trained and improved.
Consequently, is it possible to train your brain to process the signals differently and, with practice, potentially eliminate pain be able to move more freely and fluidly.
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With practice you can move more precisely, even with damaged nerves!!!
How can you train this?
One mayor study tested the effect of strenuous exercise on polyneuropathy patients and although there was a positive effect, it was minimal and required a great deal amount of training.
A much easier option is: Balance Training.
Balance TrAINING
Balance Training is very simple, all you need to do is stand in a position where it is hard to keep your balance and try to remain as stable as possible. (See exercises below).
As far as we know this is the best way to train your brain to alter the way it processes signals coming from the nerves. It increases how well you can feel your body, and therefore, how well you can move it.
Balance training helps everybody: athletes, the elderly and people recovering from injuries
Numerous studies on Balance Training have shown positive effects in which athletes improved their performance as it helps to both activate and sense of your muscles better.
This is why balance training is used by most high performing athletes to prevent injuries and improve their performance.
This is also true for elderly people. With Balance Training they fall a lot less frequently. And consequently suffer from fewer injuries.
Furthermore, in sports such as Basketball or volleyball, Balance Training has even been shown to prevent some 60% of ankle injuries and 50% of knee injuries.
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Specifically for people suffering from polyneuropathy, studies have demonstrated that balance training improves mobility, balance and reduces both pain and numbness. One of the most extraordinary things about this method is the minimal duration of the training. Some studies have investigated only 8 minutes of training twice a week and were still proven to show significant improvements in patients.
Here are some examples of studies:
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Streckmann et al. (2014)
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Bland et al. (2019)
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Vollmers et al. (2018)
Example exercises
So now I'll show you a selection of exercises to try.
Start with the first and easiest exercise and slowly work your way up to the harder variations.
If you have trouble keeping your balance on an exercise but can just about manage it, this is the right difficulty level for you. Practice until it is easier for you and then choose the next more difficult exercise.
The exercises are chosen so that there is something for everyone, from the very weak patient to the very able. Therefore, do not expect too much from yourself. The exercises are intentionally chosen so that the difficult variations are almost impossible to do without practice.
Be patient, the exercises have a real effect only if you do them for a few minutes every day for a long time.
Translated with www.DeepL.com/Translator (free version)
Safety first
To avoid the risk of falling during practice, you should always practice in a safe manner. Therefore, stand between a table and a sturdy chair or armchair to practice. If you lose your balance, simply sit down or hold on to the table.
Exercises for standing more stable
First, stand up normally. If you can do this well, close your eyes. Closing your eyes causes you to rely on information from your body instead of sight. This will train your body awareness in a more targeted way.
If the first exercise was easy for you, now place one foot forward so that the ball of the rear foot and the heel of the front foot touch.
However, offset the feet slightly to the side of each other.
Should this also be possible without any problems, close your eyes.
The next more difficult variation is to place the feet directly in front of each other, i.e. no longer offset them sideways. You can also try this with your eyes closed.
If you don't manage this exercise, that's perfectly fine. It is already quite demanding and often not easy even for people without polyneuropathy.
If you didn't start to lose your balance during the last exercise, now stand on one leg.
To make it more difficult, close your eyes again.
The last and most difficult exercise is to stand on your toes with one leg.
If you can do even this with your eyes closed, your balance will be better than most healthy recreational athletes.
Exercises for better walking
Whether you're walking from room to room at home, outside on the street or hurriedly crossing the hallway at work - walking safely and without fear of falling is super important. The following exercises can help with that.
If you suffer from polyneuropathy, you will probably not be able to do all the exercises without practice.
Therefore, start with the easiest variation and then work your way up to the more difficult exercises.
For your safety:
If you do these exercises for walking, make sure you have something to hold on to in case you lose your balance or trip. It is a very good idea to have a friend stand next to you and catch you if you fall, especially the first time you try the exercises.
Start by simply walking in slow motion. The slower you walk, the longer you have to stand on one leg. This will train nervous system for better control of your balance and gait.
If that is very easy for you. Try the same with your eyes closed.
If this works well move on to the next level of difficulty: lift your knee with each step. This will make it a little harder to keep your balance and your nerves will have to work even harder.
If you feel like this is too easy for you, try doing the same exercise with your eyes closed.
The last and hardest exercise is to try walking on your tippy toes. Not only will this make the exercise more demanding for your nervous system, it will also strengthen your calf muscles.
Another good exercise for walking with polyneuropathy is to walk and take very long steps. Many patients tend to take very short steps with their feet close to each other. However, this is a very unstable way of walking and also slower and more energy consuming than normal walking.
That's why you should exercise your stride length. Find a route in your home that you have to walk frequently, such as the hallway. Now count how many steps you need to do this. In the future, try to make yuor steps as big as possible and cover the distance with fewer steps. If you can only walk with a walker, you can still do this in order to improve your gait.
Exercises for your hands
In order to reach the hands more specifically, further coordination exercises are useful. As with all the previous exercises, it is important to train your perception of your own body, this time specifically in the hands. As with the exercises shown so far, it is not important to make a great physical effort, but rather to perform the movements as controlled as possible in order to stimulate the nervous system.
1. Balance a bottle on your hands
Something like balance training can also be done with the hands to improve movement control and body awareness despite polyneuropathy. To do this, take an empty plastic bottle, ideally 1.5 l. Place it on your palm and balance it there. If this is too easy for you, place the bottle on the lid.
If this is easy for you as well, you can combine the exercise with one of the exercises for stable standing (see above).
2. Bend or stretch your fingers one at a time
Try alternately bending or stretching your fingers one at a time. For example, bend or stretch only the index finger or only the ring finger. To make it harder, you can try to move two fingers at the same time, for example only the index finger and the ring finger or only the middle finger and the little finger, while the other fingers remain immobile.
3. opening and closing buttons
Very many people with polyneuropathy report that they get problems with opening and closing buttons. Therefore, it is useful to practice doing just that. For this purpose, take a shirt or blouse on which you can still open and close the buttons easily. Practice opening and closing the buttons again and again.
To train more efficiently, try to do this is while you stand in a position where you can also train your stance as in the exercises for stable standing above. For example, stand on one leg and then start opening and closing the buttons. The more often you practice this, the longer you will still be able to open and close the buttons, even if the polyneuropathy continues to worsen.
4. writing nicely
This is an exercise that is especially useful if you have polyneuropathy and are starting to have trouble when writing. Try to write especially nice and precisely. At first glance, this seems like an everyday thing and is certainly not a spectacular exercise. However, the better you can control the pen, the better the signal processing in your brain will be, which can help against the symptoms of polyneuropathy. In addition, should the polyneuropathy worsen, you will not have problems with writing as soon, if you practice writing nicely early on.
In addition, all activities in which you train fine motor skills are useful. For example, drawing, needlework or even building models. These activities improve the perception and movement control of your hands, so you can at least in part compensate for the worsening due to polyneuropathy.
Of course, such things are more difficult and may be less enjoyable if you are limited in your motor skills. But still, it is very important to practice them anyway. Not only does this help to remain able to do all these things. It is also very likely that such training will help against pain and numbness of your hands.
Short training FAST improvements
My personal experience is, that this type of exercise can bring improvements within a very short time. I have balance tests before and after training with a lot of patients and during seminars. Within 1-2 hours of training virtually everybody improves his or her balance at least to some extent.
A lot of people improve greatly though. These are usually the people who felt very weak before training. Just starting to train a little bit makes them notice that they are actually more capable then they thought.
Obviously there are limits to the improvements that training can bring about. However if you keep trying you will definitely be better off and slow down the process of deteriorating balance and mobility that polyneuropathy causes.
Since the exercises are so easy to do and require no extra equipment, you can do them at home by yourself.
All you need is to know how to do the exercises.
This is why I wrote a book that gives you all you need to know about how to exercise safely. It contains 24 exercises for every skill level so no matter how fit or weak you are, you can start at your level and progress at your pace.
The book also contains a self-test for your balance.
I would be happy if you ordered the book in my online store for £12.
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All you need to know about safety
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24 different exercises for every skill level
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Self test for your balance
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All for £12
Age and physical weakness should not stop you from training
So how big of an effect can you expect through this training and does age or physical fitness stop you from exercising?
Let's take a look at a Case study:
Patient A was 92 and had severe trouble to walk when he first started exercising. He suffered from severe Polyneuropathy that made it impossible for him to feel anything below the knees. His feet, calves, and lower leg were completely numb and he could not use any of the muscles in his feet. He had been the victim of a bomb blast in 1944 which had heavily injured his left leg and had trouble moving that leg since then. Because of his age, he felt he could no longer improve his condition.
I did a balance test with him (that is also included in my book exercise for polyneuropathy), to see how good his balance was and if there would be improvements.
As we can see from his test result above, he initially scored 22 points which means he had trouble just standing up because his balance was not good enough.
However, after just one week he had quadrupled his test result. 100 points means you can stand normally and even do some more difficult movements and exercises. Its the difference between walking only on a walker or walking normally without any help.
In the next segment, the results get worse. This is because he, unfortunately, suffered a stroke, and the Balance Test taken in the second week was done in the hospital.
However, even after the stroke, he still had a better balance test result than before he started to train. He later went back to training and began to improve again.
This is not a miracle cure!
The man is still suffering from Polyneuropathy and still has not got the greatest balance but it is much better than before exercising. Although you can never tell exactly what a person's results are going to be, my personal expierence is that literally every patient I personally did balance training with has made improvements.
DO STRETCHING EXERCISES HELP WITH POLYNEUROPATHY?
When you think of exercises for health, many people think of stretching exercises first. This is also the case with polyneuropathy. That is why if you search the internet for exercises for polyneuropathy, you will quickly find stretching exercises.
CAN STRETCHING EXERCISES HELP THE NERVES IN POLYNEUROPATHY?
It is not clear though, if stretching can help with nerve damage. Stretching actually only means pulling on a structure. Classic stretching exercises, as we all know them are intended to pull muscles and tendons and put them under tension. Since the nerves are not the structure that is being pulled, this would probably not have a big effect on them.
There are ways to stretch nerves however This happens in particular when during a classical stretch, e.g. of the calf, you also move your head in a certain position. Because the nerves form a string from the ends of the limbs to the brain, they are then moved along by the head movement and put under tension. It is questionable though, how pulling on a nerve should heal it.
The EFFECTIVENESS of stretching on NERVES IS NOT SCIENTIFICALLY PROVEN
There is no scientific evidence that specific stretching for the nerves can help with polyneuropathy. It is true that there have been animal experiments in which poor laboratory animals were given poisons that damaged the nerves and thereby causing polyneuropathy.
If the nerves were stretched during this procedure, the polyneuropathy was actually less severe. However, I doubt that this also works in humans who's polyneuropathy comes from completely different causes.
stretching has no EFFECT ON THE NERVES but ON THE MUSCLES
I have tried nerve stretches with some patients in my own practice. Unfortunately I could not find any improvement in nerve function.
But there is one positive effect of stretching in polyneuropathy:
Stretching exercises can prevent and alleviate muscle tightness. This is because the muscles relax after stretching.
Tight muscles are VERY COMMON IN POLYNEUROPATHY
Muscle tightness, especially of the calf muscles, is a very common problem that I observe almost without exception in patients with polyneuropathy. Because of the nerve damage, the movements no longer work as they would in a healthy person, and this very often leads to the tightness of muscles.
This can cause problems in several ways - in addition to polyneuropathy:
1. tight MUSCLES ARE WEAKER THAN RELAXED MUSCLES
A hardened, tight muscle is weaker than a relaxed muscle. Therefore, if you have muscles that are already weakened by polyneuropathy, the tightness of the muscles will of course make this problem worse.
2. HARDENED MUSCLES CAN CAUSE TREMENDOUS PAIN
The most common cause of pain in the musculoskeletal system are tight muscles. This is called 'myofascial pain syndrome'. This is why massages, for example, can help with pain because they loosen tight muscles, which reduces the pain.
If you have pain because of polyneuropathy and you have tight muscles adding up to it, the pain will get worse. If the muscles are relaxed, the pain will also improve. I have even had patients with polyneuropathy whose pain disappeared completely after their tight muscles were treated.
Furthermore, it is almost impossible to tell whether the pain is caused by nerve damage and polyneuropathy or by a tense muscle. In many cases, both contribute to the pain. It is impossible to know, which cause is more important - the tight muscles or the nerve damage - before you treated the muscles. Therefore every patient has to try and find out individually.
3. constantly contracted muscles can compress nerves
There are areas where muscles and nerves share a relatively narrow space. When the muscle contracts, it changes it's shape. This means that it becomes thicker in certain places.
This can cause the muscle to press on the nerve at these narrow points, further impairing the function of the nerve that has already been damaged by polyneuropathy.
Examples of this are in the cervical spine and the lower legs. The Scaleni muscle and the nerves that supply the fingers run parallel along the cervical spine. When these muscles tighten, they can cause problems in the entire arm, right down to the fingertips. The same applies to the lower leg, where the long fibular muscle can compress the nerves that supply the toes.
When such nerve compression is present, the treatment of the muscles can produce impressive improvements. This possibility is often overlooked in people with polyneuropathy because all the symptoms are blamed on polyneuropathy and no additional causes are considered.
STRETCHING EXERCISES HELP by relaxing muscles
Regular stretching exercises can prevent all these problems. It can therefore be said that stretching has no direct effect on the nerves in polyneuropathy, but it can still have a positive effect on your well-being.
This is why I recommend stretching exercises if you suffer from polyneuropathy, even if they do not directly help the nerves themselves. It is particularly useful to stretch the muscles of the calves and neck extensively.
You should make sure that you stretch long enough. Short stretches of just a few seconds, as is often seen in popular sports, are not enough to reduce the tightening of muscles. The stretch should be held for at least 30 seconds to one minute.
It is not necessary to hold an intense, painful stretch . It is better to hold a medium tension that still feels comfortable for a longer period of time.