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Strength at home

Exercises for peripheral neuropathy: balance and leg strength in shoes

Our editorial home version of a programme tested in a supervised trial in people with diabetic neuropathy, where standing and walking exercise improved walking distance and daily steps. Check both feet before you start, and keep well-fitting shoes and socks on for the whole session. Keep a kitchen counter or the back of a sturdy chair within reach. If you have an open sore, an ulcer, or a red, hot or swollen foot, do only the seated moves and contact your GP or foot team straight away. Three times a week, not on back-to-back days.

35 minBeginner13 movesA bench or box · Something with weight · A wall · A step · Cardio machineHip flexors · Calves · Quads · Glutes · Shins · Hip abductors
Follow along: a timer, a cue and the next move, one step at a time.

Warm-up, seated (about 3 minutes)

  1. Seated march1 min
    Beginner · Hip flexors, Quads, Abs · 3D demoShoes on, sitting tall on a firm chairHarder: Standing march
  2. Ankle circles10 each way, each foot
    Beginner · Calves, Shins · 3D demoSlow, full circlesHarder: Ankle CARs (controlled articular rotations)

Seated strength (about 3 minutes)

  1. Seated bent-knee calf raise (soleus raise)2 sets of 12
    Beginner · Calves · 3D demoLift both heels, pause, lower slowlyHarder: Slow calf raise
  2. Seated knee extension (chair)10 each leg
    Beginner · Quads · 3D demoStraighten the knee, hold for a second, lower slowlyEasier: Quad set (static quads)Harder: Leg extension

Strength at the counter (about 10 minutes)

2 rounds · Rest 60 s between rounds

  1. Sit to stand from a chair3 to 5, building to 15 over the weeks
    Beginner · Quads, Glutes, Hamstrings · 3D demoA firm chair against a wall; push on your thighs at first if you need toHarder: Bodyweight squat
  2. Slow calf raise5, building to 20
    Beginner · Calves · 3D demoBoth hands on the counter. Skip these if you have hard skin, a sore or a past ulcer under the ball of your footEasier: Seated bent-knee calf raise (soleus raise)Harder: Standing dumbbell calf raise
  3. Tibialis raise5, building to 20
    Beginner · Shins · 3D demoBack against a wall: lift the fronts of both feetHarder: Single-leg tibialis raise
  4. Low step-up10 each leg
    Beginner · Quads, Glutes, Hamstrings · 3D demoThe bottom stair, both hands on the rail at first, then oneHarder: Step-up

Balance at the counter (about 5 minutes)

  1. Single-leg stand2 holds of up to 30 s each leg
    Beginner · Hip abductors, Calves, Glutes · 3D demoBoth hands on the counter at first, then one, then fingertipsEasier: Tandem stance and heel-to-toe walkHarder: Single-leg reach matrix
  2. Side-stepping (sideways walking)10 steps, twice
    Beginner · Hip abductors, Glutes, Adductors · 3D demoOne hand on the counterHarder: Lateral band walk
  3. Backward walking10 steps, twice
    Beginner · 3D demoOne hand on the counter; short stepsHarder: Backward sled drag

Walk (10 to 20 minutes)

  1. Treadmill walking10 to 20 min
    Beginner · Quads, Calves, Glutes · 3D demoOn even ground in good shoes. Every 2 weeks, add about 10% to your usual daily stepsHarder: Treadmill jogging

Cool-down

  1. Wall calf stretch (gastrocnemius)30 s each leg
    Beginner · Calves · 3D demoHands on the wallEasier: Seated calf stretch with a towelHarder: Toes-tucked kneeling (toe squat)

Tips

  • Check both feet before and after, including the soles, heels and between the toes, using a mirror or a helper. A new blister, cut, red patch or swelling means no standing exercise until it's been seen: contact your GP or foot team within 24 hours.
  • Keep well-fitting shoes and socks on for the whole session, and never walk barefoot, even at home. Check inside your shoes before you put them on.
  • This is our editorial home version of a trial programme that physiotherapists supervised 3 times a week for 12 weeks. Move up one step at a time, and stay at a level until it feels steady.
  • If you've had a foot ulcer, an amputation or Charcot foot, plan exercise with your foot team first.
  • On other days, cycling, a rowing machine or swimming (if your skin is intact) gives your feet a rest from weight-bearing.
  • If you take insulin or another medicine that can cause a hypo, our type 2 diabetes guide explains how to exercise safely.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

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Questions people ask

How long does the exercises for peripheral neuropathy: balance and leg strength in shoes take?

About 35 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: A bench or box, Something with weight, A wall, A step, Cardio machine. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 4 of its 13 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.