Exercise and Rehab during Covid-19 Lockdown

At the time of writing this article, the UK is 3-4 weeks into the covid-19 lockdown, restricting all unneccesary travel, increased social distancing, and recommendation of leaving your home for no more than a maximum of 1 hours exercise a day.  With many people staying at home, it is the perfect time to rest those injuries, then slowly start to exercise again.  And with limited exercise equipment to hand, or restricted areas to go for out-door activities, we have to start using our time and resources effectively.

As a podiatrist, you would probably be expecting me to be a keen runner, however, I am more at ease exercising in a gym.  The current lockdown has forced all gyms, swimming baths and leisure centres to close, which has made me change my exercise routine.  I used to try to get to the gym 2-3 times a week, where the treadmill was simply used as a warm up piece of equipment, and then I'd use the weights, then followed by going for a few lengths in the swimming pool, and on rare occaisions, I'd go straight into the pool, and skip the gym all together.

As the lockdown kicked in, I removed a few key items from my clinic to help manage during this covid-19 initial period.  Mainly, the treadmill I normally use for my biomechanics assessments when I video people walking and runnings, my blood pressure monitor and the dyson fan!  All of which are being used at my home to keep my health in the best possible shape.

It sounds obvious, but it's a key item to get right.  Make sure where ever you have your equipment, it's safe to operate, and no-one is going to have to squeeze past you to get to another room, or the family dog isn't going to try to join you.

Make sure you have good ventilation, especially if you are using a running machine or an exercise bike in a small room.  The last thing you need is for your environment to be getting too warm and stuffy, and you start to feel faint or light headed.

Also, if you are using headphones, don't have them too loud, as you may need to hear other things in the house, such as the door bell, or a member of the family shouting to get your attention.  It's better to hear them, than have someone tap you on the shoulder from behind, and make you jump out of your skin, and go flying into the wall!!!

The biggest mistake most people make when they first restarting exercise is to do too much, too soon!  This can be anything from attemping a 5-10 mile walk across the hills, hitting the gym to see how much weight you can move  through to getting on an exercise bike or treadmill and going full belt for 5 - 10 minutes.  This is the first action into gaining or reviving an injury, and setting you back even further.

The first time you exercise, especially at home with an old piece of exercise equiment, be it that fold up running machine / exercise bike which is stored in the spare room and acting as a clothes horse, or the kit you've bought from one of the many shopping channels which folds flat and stores under the bed or the back of the wardrobe, is to set it up, and use it for just a few minutes at a very gentle pace to ensure it is working correctly.  The main reason for this is you don't want to be getting to full pace, and then sustaining an injury when you fall off, or it jams etc.    This is the same case if you are dragging that old push bike out of the garage or shed to start getting some fresh air.  Your first ride should be no more than a few minutes at a very gentle pace to ensure the brakes work, and the tyre pressure is correct.

The other reason to start off gently, is to make sure your rested injuries are able to cope with the exercise.  It doesn't have to be a leg injury you are protecting either.  When you run or cycle, your whole upper body is being used / moved, and any previous neck, back or shoulder injuries have to be taken into consideration and monitored with all exercise therapies.  This especially true for neck problems if you are cycling outside and need to be looking over your shoulder before turning right.

Despite my previous occupation being a computer engineer, and working with all sorts of electronic gadgets over the years, I still think the best way to monitor progress is to keep things as simple as possible.  Unless you already own a fitbit, a garman heart rate watch, or some other monitoring gizmo, monitor the speed you are working at, and for how long.

The treadmill / running machine I have for the clinic (now at my home) displays speed, time, distance and calories burned.  And that's it.  Nothing else.  It's at a fixed angle, and has no other special features.  To be honest, I don't even know if the speed is in miles an hour or kilometers an hour, or the distance.  So when I'm using it, I set the speed to what feels comforable for me to maintain without getting too breathless too quick, and I use it for a fixed amount of time each time. 

If you are going walking or cycling outside, keep the pace steady, and try to keep to a similar time when you first start out, at least for the first week or 2.  Building up too quickly will aggravate any previous problems, and set you back even further.

As the weeks pass, you should find it takes longer to become tired, and when you've finished, your recovery time is shorter.

One of the simplest way to increase your exercise level is to build it up very slowly.  For example, most people can walk or cycle for approximately 20 minutes at a slow or steady pace, 3 - 4 times a week without any major impact to their well-being.  Once you've exercised at this level for 1-2 weeks, break the time down to blocks of 5 minutes, and then exercise for 4 minutes at the slower pace, followed by 1 minute at an increased pace.  Do 4 sets of this for your 20 minutes of exercise.

After another 2-3 weeks, exercise for 3 minutes at the lower pace, and 2 minutes at the increased pace.  Every 2-3 weeks reduce the time at the lower rate, and increase the time at the higher rate.  This method is often used for returning to running after leg injuries, and is called the walk / run method, but can be used for cycling, step-ups, skipping etc.

Following this method for most forms of exercise will allow you to slowly increase your activity levels at a safe and steady pace.

At some point, we will all be able to return to work, but in the mean time, I like to keep a good daily routine, as it provides structure and helps keep me in a good frame of mind.

The bedside alarm wakes me up at 7am, and I usually manage to get out of bed by 7:20am.  I'm usually rested sufficiently by 8:30am to do some exercise, so most mornings I go on my treadmill for aproximately 15-20 minutes at a slow to medium pace.  The machine is in the conservatory, with the door open, and some 80's rock music playing to keep me motivated.  By the time I've finished, I've worked up a sweat, but it only takes a few minutes for my breathing and heart rate to return to normal.  I'll then have a shower and get dressed into some acceptable lounging round the house clothes.

I've never been a big fan of treadmills / running machines, as I normally find them quite boring, but I'm finding myself getting quite addicted at the moment.  Listening to some music I've not heard in quite a while is bringing back memories of my youth, driving round with the music blasting from the tape deck of my 1978 Ford Cortina is making me feel quite nostalgic!

The rest of the day will be either catching up on much of the administration of running a clinic, planning some form of marketing, either writing an article like this one, or making a video, which will be loaded up to youtube, and shared across the various social media platforms.

I'll also take a walk with my wife after lunch to get some fresh air.  This will be along with playing with our dog in the garden, as she's 12 years old, and arthritic, and so doesn't normally want to walk too far!

Although during a lockdown it's difficult to exercise in groups, you may still be able to engage a personal coach online, or even have an exercise video link with friends and family (easier if you are exercising the the house rather than cycling round the village).

Many running coaches have a couch to 5k programme, and may be able to help you do this remotely during the lockdown.  Search your local area, and I'm sure you'll be able to find someone interested in helping you.

The key item at the moment is to stay home where possible, exercise safely, and lets keep the burden off our NHS Heros!