Blog , Physical Therapy , Health & Wellness , Aches & Pains

Returning to Activity After a Pandemic

(Used with permission from The American Physical Therapy Association, July 2021)

During the COVID-19 pandemic, activity levels dropped for a lot of people. Between stay at
home orders, gym closures and working from home, people became more sedentary. On top of
that, there were shortages of equipment like dumbbells and bicycles, making staying active at
home difficult even if you wanted to.

But this summer, things look different; vaccines are widely available, restrictions are loosening
and people are looking to get active and enjoy the warm weather. That’s all good news, but if
you had a long break from activity, your body might not be ready to jump right back in. Here
are a few tips to help you get more active without getting hurt:

Start Slow

● If you’re a runner, think about a walk to run program
● If you’re a weight lifter, start with lighter weights and less reps.
● Whatever your activity of choice is, start with short periods of activity and gradually
work your way back up.

Warm Up and Cool Down

Warming up gets your heart and lungs ramped up and prepares your muscles and tendons for
the increase in activity about to come. Include some light cardio like jogging, calisthenics, or
cycling, followed by active stretching like butt kicks, high knees, or yoga.

Cooling down transitions your body back to a lower state of stress – it brings your heart rate and
breathing down, decreases blood flow to your muscles and back to places like your digestive
system, and helps you relax. It’s also a great place for static stretches if you need some work on
your flexibility.

Take A Day Off

Rest days let your body recover and keep you from getting burned out. Not enough exercise
isn’t good for you, but too much of a good thing can cause problems too.

Watch for early signs of injury

Some soreness for a few days after activity is normal, especially if you’ve had a long break. But
there are a few common issues to watch out for as you return to activity:
● Swelling or bruising
● Joint pain, especially in the knees or shoulders
● Foot pain, which could be a sign of plantar fasciitis
● Muscle strains – particularly common in the hamstrings
● Sprains – most common in the ankle

Any of these issues justifies a call to your physical therapist. Getting checked out early can
prevent an injury that derails your attempt to return to activity. PTs see all of the issues just
mentioned on a regular basis and can help safely guide you back into a more active lifestyle.

Physical Therapy , Health & Wellness , Aches & Pains , Blog

Use It and Improve it!

Written by Anne Kruse, PT, DPT, Therapeutic Pain Specialist, Cert. MDT

As I reflect on my own physical fitness over the years I am amazed at how true what I learned years ago in school really is. One of the phrases I have heard and now use is:

“If you don’t use it, you lose it.”

I distinctly recall the first time I found this phrase applied to me. During my first year of PT school I had settled into a routine of little to no exercise. The following summer a friend asked me to run the Bix 7 Road Race with her. I thought, “Sure, I was on the track team in high school and ran some in college, this will be fun.”

Little did I realize how completely out of shape I had become and the seven mile race was absolutely brutal. I must confess I walked the majority of it. That was a wake up call and I began to make a concerted effort to exercise a few times a week; walking with friends after class, playing an occasional game of racquetball, lifting weights, etc.

Why Not Me?

Fast forward to the spring of 2018. As my husband and I sat in the stands of Drake stadium watching our sons compete in the Drake Relays, I had another awakening. I was amazed as I watched an elderly gentleman take to the track and compete in the Masters 800. While his time didn’t break any records, he was out there doing it and clearly having fun. Yet again I had become too busy in my own life to exercise regularly, and yet this is what I teach people every day. With the support of my family and friends, I returned to running, ugly as it was. I found it challenging to even run a half mile initially, but have grown to really appreciate running as a means of exercising, relaxing, and spending time with my family and friends.

Why do I share this tale?

Because we are all human and have times in our lives when our own wellness plans get derailed. But fortunately, as humans, we also have an amazing ability to improve our wellness. In recent years I have learned the phrase, “Use it and improve it” and this holds true with all of our bodily systems.

What Does the Research Say?

In 1966, the Dallas Bed Rest and Training Study was conducted in which five healthy 20 year old male volunteers were recruited to spend the summer in bed. The cardiovascular fitness levels of the participants was measured before beginning the study.

After just three weeks in bed, without any weight bearing activity, the participants were found to have had such significant declines in their cardiovascular fitness that the bed rest was stopped.

On average the participants had a:

27% decline in their ability to absorb and use oxygen
26% decline in the amount of blood their hearts could pump through their bodies in a minute
35 point increase in heart rate during a submaximal workout

To complete the study, the participants were taken through an eight week workout program.

45% increase in their ability to use oxygen
40% increase in the amount of blood their hearts pumped through their bodies in a minute
49 point decrease in heart rate with a submaximal workout

Hmm, working out improved their heart and vascular system function to better than they were before the study.

But wait, there is more!

The same five participants were studied 30 years later (1996). Only two had continued to exercise and all had gained weight and body fat. At baseline it was found they on average had only declined 12% in their ability to absorb and use oxygen.

Thus, three weeks of bed rest at age 20 was more detrimental to their cardiovascular fitness than 30 years of aging.

Compared to the original study, there was no bed rest, but a training program was begun. In 1996 the training was less intense and involved walking, jogging and cycling over a period of six months instead of eight weeks based on the age of the participants and to reduce the risk of injury. After the training program, the participants had improved their ability to absorb and use oxygen by 14% to similar levels attained in the 1966 study.

Wow! Ok, but why do I care?

So, the take home point is this: no matter where you find yourself in life, it is important to your health to move. Whatever you choose to do, be it walk, jog, bike, or swim, have fun and realize you are helping to reverse the effects of inactivity and aging and are improving your cardiovascular fitness. If you find yourself needing some guidance, consult your physician, PT or personal trainer.

Now get out there and “Use it and improve it!”

Health & Wellness , Blog , Physical Therapy

The Importance of A Good Night’s Sleep

Written by Ashley Wood, PT, MPT

It is probably not news to many of you that sleep dysfunction has become a major problem in our country. The CDC has reported that 70 million Americans have extreme sleep problems while almost 50% of Americans feel sleepy during the day, at least three days out of the week. But, why is this such a big deal?

Why is sleep important?

Sleep is restorative and important for the function of all of our body systems. We all know that when we do not get enough sleep it is harder to:

concentrate,
process information,
remember things,
and just overall makes us feel crabby.

But sleep affects many other areas of our bodies as well

The rise of chronic conditions in our country such as diabetes, obesity, IBS and other digestive problems, anxiety, depression, dementia, and Alzheimer’s disease have been linked to several lifestyle influences, including lack of good quality sleep.

The lack of sleep is also a driver of pain. Of course being in pain can cause us to have difficulty with sleeping, but the reverse is also true. Lack of sleep can:

increase our pain sensitivity,
decrease pain threshold,
and decrease our body’s natural endorphins that help with modulating pain.

This is why we as physical therapists often educate our patients on sleep and ask questions to determine if there may be an undiagnosed sleep disorder present. Getting a proper amount of sleep not only helps with the healing of your tissues after an injury, but also can affect the pain that you are experiencing related to that injury.

How much sleep should you get?

It is recommended that the average adult get at least seven hours of sleep per night.

But, the quality of your sleep is just as important as the quantity of your sleep.

If you find yourself waking up several times per night or not feeling rested after getting the quantity of sleep needed, you are likely not getting good quality sleep. If this is the case, it is important to speak with your health care provider to determine if there is an underlying cause for not getting good quality sleep or if there are things that need to be adapted with your sleep behavior to assist with getting a better night’s sleep.

How do we change our sleep patterns to ensure a better night’s sleep, both in quantity and quality?

Sleep hygiene is the term used to describe establishing good sleep habits. Here are a list of tips for helping to establish good sleep hygiene:

1. Go to bed and wake up at the same time every day. This establishes a good circadian rhythm for your body and makes it more natural for your body (and brain) to relax and fall asleep. Also, try not to nap during the day as this makes it more difficult to go to bed at a consistent time and to fall asleep at night.

2. The bed should only be for sleep and sex. We should not watch TV in bed, use our phones in bed, or work/do homework in bed. If we are only using our beds for sleep and sex then when we get into bed, our bodies and brains become accustomed to relaxing in preparation for falling asleep. Many experts also recommend that the bedroom itself be off limits for working and watching TV and only be a place for sleeping.

3. Decrease the amount you are stimulated prior to going to bed. Try to use the last hour before going to bed as a time for relaxation. Put your phone away and turn off the TV. You can read a book or practice mindfulness or other relaxation techniques.

4. What if I wake up at night? If you wake up during the night, try some relaxation techniques such as progressive muscle relaxation, deep breathing exercises, or mindfulness to settle your body and brain. If you are unable to fall back asleep, get out of bed and do something that is relaxing until you are feeling tired again.

As you can see, sleep is an important part of our daily lives, not just so we feel good but so our bodies can function properly. The lack of sleep has increasingly become a problem in our country and has been linked to many chronic illnesses.

If you are having difficulty falling asleep or staying asleep, or just don’t feel rested after getting a proper amount of sleep, talk with your health care provider to see if there may be underlying issues contributing to poor sleep quality. Changing sleep patterns can be difficult and takes time, but your body will thank you for it!