Diabetes introduces a host of medical issues that can be minimized or avoided with good control of blood sugars, leading to longer life and less complications. While metabolism is the primary focus for living with and treating diabetes, there is also a host of other complaints that involve the musculoskeletal system of people with diabetes.

Generally, the skin and soft tissues can take longer to heal in people with diabetes. This is important with sports injuries, abrasions to the skin, tendon, and ligament injuries. Cuts and bruises may become infected more easily so extra care is important. Also, scarring is often more prominent.

Extra scarring can lead to decreased range of motion, especially seen in the shoulder with patients who subsequently develop a frozen shoulder (adhesive capsulitis). Earlier attention to this possible diagnosis as well as more aggressive treatment is needed for the diabetic as it takes much longer to regain the motion of this shoulder once it is lost. Decreased range of motion can also be seen in other joints that are injured in the patient with diabetes. It becomes necessary to address these injuries early, begin rehabilitation early so that general loss of motion does not occur as frequently as it potentially can in those patients with diabetes.

The use of corticosteroids in the treatment of sports injuries, like bursitis, tendonitis, and some acute disc herniations, is often helpful for the general population. However they present increased risks in the diabetes patient, as blood sugars will more easily increase for at least one week following the administration of these medications. Strict attention to this and adjusting glucose maintenance appropriately is necessary when using corticosteroids. Careful coordination with the primary care physician is very important when treating sports and musculoskeletal injuries.

The casual use of NSAIDs like Aleve, Advil, Motrin, etc., is very common in the general population, but could have a harmful effect in the diabetes population as sometimes their kidney function is not as good as in the general public. Diabetes can have many hidden effects on the body which are important to be aware of for preservation of function and improving quality of life.

The simple application of an ankle brace for a patient with diabetes who has an ankle sprain, which would seem fairly common and safe, can surprisingly lead to complications. As mentioned earlier, skin issues do appear more commonly in people with diabetes, so careful attention to skin care to prevent breakdown and possible infection with the application with any type of braces for sports injuries is very important. This applies not only to the ankle but also to the knee, elbow, shoulder, etc.

Even the application of ice for too long, potentially leading to possible frostbite injury because the diabetes patient cannot feel the skin as well, has potential damaging effects. Once again, it becomes wise to be diligent in your understanding of how diabetes can affect your body and moving towards a productive, active, and enjoyable life.


NOTE: Consult your doctor first to make sure my recommendations fit your special health needs.

Brian Halpern, MD

Dr. Brian Halpern, MD, is the first non-surgical Fellowship Trained and Board-Certified Sports Medicine Physician at Hospital for Special Surgery.
Dr. Halpern pioneered the non-operative approach to acute and chronic musculoskeletal problems - including the hip, knee, ankle, foot, shoulder, elbow, hand, and the spine. Dr. Halpern is a founder of the American Medical Society for Sports Medicine where he received the society's first Humanitarian Award. Dr. Halpern was the president of the American Medical Society for Sports Medicine Foundation, and past Associate Team Physician for the New York Mets. He has been on the Board of Directors of Face of America, working with disabled athletes worldwide.
In 1998, Dr. Halpern won an Emmy Award for the documentary Vietnam: Long Time Coming. He authored The Knee Crisis Handbook, which was published by Rodale Books in October, 2003, as well as the Men's Health Sports Injury Handbook, in 2005. His articles on sports-related injuries have been published in Men's Health magazine and other sports magazines. More information about Dr. Halpern.

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