Diabetic neuropathy — foot and balance exercises

If you have diabetic neuropathy, it is worth checking your feet every day, wearing comfortable, closed shoes and regularly doing simple foot and balance exercises, e.g. ankle circles, heel raises holding a chair and standing heel-to-toe. Exercise 2–3 times a week, with support. Neuropathy affects up to half of people with diabetes, and the diabetes itself is treated by a doctor.

Below: warning symptoms, foot checks, choosing footwear and 6 safe exercises with dosage.

Can you exercise with diabetic neuropathy?

Yes, and regular movement is recommended. Neuropathy reduces sensation in the feet, the strength of the small foot muscles and ankle mobility, which worsens balance and increases the risk of falls. Foot and balance exercises help maintain function, and the 2023 diabetic foot guidelines recommend them for people without active foot wounds.

A physiotherapist does not treat diabetes – medicines and insulin are always chosen by your doctor.

How should you check your feet every day?

Once a day, ideally in the evening, look at both feet: the top, the soles, the heel and the spaces between the toes. Look for wounds, blisters, abrasions, calluses, redness and changes in colour. Use a mirror or ask someone close to you for help. With reduced sensation, a small cut may not hurt at all, so your eyes have to do the job of feeling.

Wash your feet in lukewarm water, checking its temperature with your elbow or a thermometer, and dry carefully between the toes. Do not warm your feet with a hot-water bottle. Cut your nails straight across and do not remove calluses yourself – a podiatrist or a doctor will deal with them.

What shoes should you choose with neuropathy?

Choose closed shoes that are soft inside, without seams pressing on the toes, with a wide and deep toe box, a stable heel and Velcro or lace fastening. Buy them in the afternoon, when your feet are slightly swollen. Before putting them on each time, feel inside the shoe with your hand, because a small stone or a folded insole can injure your foot without you noticing.

Do not walk barefoot, even at home. Wear socks without tight cuffs and change them every day. If your feet are deformed, a doctor may prescribe custom-made footwear or insoles.

Which foot and balance exercises can you do at home?

A safe set includes ankle circles, curling and straightening the toes, scrunching a towel with your toes, heel raises holding a chair, standing up from a chair and standing heel-to-toe at a worktop. Exercise in shoes or non-slip socks, 2–3 times a week, always with support within reach, and check your feet afterwards.

1. Ankle circles. Sitting on a chair, lift your foot slightly and draw circles with it. 10 in each direction, with each foot.
2. Toes up and down. Sitting, feet flat on the floor: lift all your toes, then press them down into the floor. 2 sets of 10.
3. Towel scrunches. Sitting, use your toes to pull a towel lying under your foot towards you. 2 sets of 10 scrunches.
4. Heel raises. Standing facing a stable chair or worktop and holding on with both hands, lift your heels and slowly lower them. 2 sets of 8–10.
5. Standing up from a chair. From a chair with a backrest, stand up and slowly sit down, using your hands to help at first. 2 sets of 5–8.
6. Heel-to-toe standing. At the kitchen worktop, place one foot directly in front of the other and hold the position for up to 10 seconds, holding on to the worktop. 3–5 repetitions, then switch legs.

If the pain gets worse or spreads, stop the exercise and consult a physiotherapist. Also stop if you feel dizzy, shaky, sweaty or weak, as these may be signs of low blood sugar. You will find more exercises in our post balance exercises for older adults.

How does a physiotherapist help?

A physiotherapist assesses sensation, strength and mobility in your feet, your balance and the way you walk, and then chooses exercises and their dosage to suit your abilities. They teach you how to stand up and walk safely and advise on footwear and walking aids. A consultation in Rydułtowy costs 180 PLN, and the number of visits is decided individually.

You can read more about rehabilitation in diseases of the nervous system on the page rehabilitation in neurological conditions.

Prices valid from 08.2026. The physiotherapist decides on the number of visits individually after the consultation.

Summary

With diabetic neuropathy, the basics are daily foot checks, closed, well-fitting shoes and 6 simple foot and balance exercises done 2–3 times a week with support. A wound, a blister or a hot, swollen foot require a visit to a doctor first.

Frequently asked questions

Sources

• van Netten J.J. et al., Prevention of foot ulcers in persons with diabetes at risk of ulceration: IWGDF 2023 guidelines, Diabetes/Metabolism Research and Reviews, 2023.
• Pop-Busui R. et al., Diabetic Neuropathy: A Position Statement by the American Diabetes Association, Diabetes Care, 2017.
• Polish Diabetes Association (Polskie Towarzystwo Diabetologiczne), Zalecenia kliniczne dotyczące postępowania u osób z cukrzycą (clinical recommendations for the management of people with diabetes), 2024.
• Monteiro R.L. et al., Foot-ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: a randomized controlled trial, Scientific Reports, 2022.
• Colberg S.R. et al., Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association, Diabetes Care, 2016.