covid-19 Archives - MedFitNetwork

Studies Show COVID-19 Has Led To More Injuries

Justin Price/26 January 2022/ All MFN blog/

The coronavirus pandemic has had a major effect on all areas of people’s lives, and physical activity levels are no exception. Recent studies show that the pandemic and associated lockdowns prompted many people to go one of two ways with regard to their exercise program. They either decided to work out more in an attempt to get in the best shape of their lives, or chose to spend lockdowns sitting at the computer, watching TV and/or enjoying long phases of inactivity. Both of these choices, while seemingly unrelated, have led to an increased number of people experiencing musculoskeletal injuries.^1,2,3

What is Causing the Increase in Injuries?

The COVID-19 situation prevented most people from utilizing in-person fitness and exercise services. Consequently, those individuals who decided to increase their physical activity levels often did so without the supervision of a qualified fitness or exercise professional. In addition to engaging in exercise endeavors unsupervised, research found that they tended to work out longer and harder than would have been appropriate, and tried more extreme forms of exercise. This has resulted in many of these people experiencing musculoskeletal overuse injuries.¹

Alternatively, individuals who stopped exercising during the pandemic and instead spent more time watching TV, playing computer games, and generally sitting for longer periods of time became deconditioned. Once lockdowns and COVID-19 restrictions began to ease up, these people experienced musculoskeletal injuries as they tried to return to their pre-pandemic exercise levels in a deconditioned state.^1,2

Guiding Clients Back from Pain and Injury

Corrective exercise specialists and fitness professionals well-versed in corrective exercise methodologies are uniquely positioned to help people overcome pain, injuries and musculoskeletal issues that have arisen as a result of over- or under-exercising during the pandemic.

Helping Over-Exercisers

Clients who sustained overuse injuries in their pandemic pursuit of ultimate fitness will benefit most from incorporating activities into their exercise regime that actively promote rest, recovery and rejuvenation. Coach these people to take days off from strenuous activity to instead perform self-myofascial release and gentle stretching exercises appropriate for their musculoskeletal issue or condition. Areas of the body that were overly-strained, stressed and/or injured during high levels and intensities of exercise should now be prioritized with these corrective exercise techniques.⁴

Helping Under-Exercisers

A deconditioned client trying to resume their pre-pandemic physical activity levels without adequate reintroduction will benefit from the application of gradual progression. Coach them about the need to address musculoskeletal changes that have occurred as a result of prolonged static postures like sitting, and the importance of slowly reintroducing exercise stress to help safeguard their body from the pain and injury that can result if they overdo it upon returning to the gym.⁴

As the availability of in-person exercise and fitness services begins to resume, corrective exercise specialists are in a unique position to assist people that have sustained musculoskeletal injuries as a result of too much or too little exercise. Whether helping clients get over pain and injuries incurred during the pandemic, or reintroducing exercise safely to those who are unfit and out of shape as a result of long periods of inactivity, expertise in the area of corrective exercise is now more important than ever.

Justin Price is one of the world’s foremost experts in musculoskeletal assessment and corrective exercise and creator of The BioMechanics Method Corrective Exercise Specialist certification (TBMM-CES). The BioMechanics Method is the fitness industry’s highest-rated CES credential with trained professionals in over 70 countries. Justin is also the author of several books including The BioMechanics Method for Corrective Exercise academic textbook, a former IDEA Personal Trainer of the Year, and a subject matter expert for The American Council on Exercise, Human Kinetics, TRX, BOSU, MFN, Arthritis Today, BBC, Discovery Health, Los Angeles Times, Men’s Health, MSNBC, New York Times, Newsweek, Time, Wall Street Journal, WebMD and Tennis Magazine.

References

Clarence Valley Independent. Nov 7, 2021. Increased exercise leads to unexpected injuries during lockdown. Retrieved from clarencevalleynews.com.au on Nov. 8, 2021.
Moses, S, and Robins, M. August 2, 2021. The COVID connection: Youth sports injuries on the rise. WKYC studios. Retrieved from WKYC.com on Nov. 8, 2021.
Seshadri, D., Thom, M., Harlow, E., Drummond, C. and Voss, J. Case Report: Return to sport following the COVID-19 lockdown and its impact on injury rates in the German Soccer League. Frontiers in Sports and Active Living, Feb 18, 2021.
Price, J. and Bratcher, M. 2019. The BioMechanics Method Corrective Exercise Specialist Education Program (2nd ed). San Diego, CA: The BioMechanics Press.

A Pandemic Post Mortem

Shira Litwack/27 July 2021/ All MFN blog/

Positive points to ponder “post-mortem-ing” the COVID-19 pandemic.

I am NOT claiming an end to the pandemic, but we are starting to achieve a semblance of normality. Let’s see how far we have come.

Finding the silver lining of the pandemic

I am not minimizing at all the gravity of the pandemic. Many people died from COVID-19. We also lost many loved ones from other ailments, mental and physical, because of the lack of accessible medical care. No question, it has been a tragedy.

Lessons learned: When we learn from something so impactful and tragic, it comes with unparalleled growth and strength. Research suggests that negative experiences in life serve to boost meaning and appreciation. Difficult times stimulate deep introspection and bring an understanding of how those experiences fit into a broader narrative of the self, relationships and the world — a respected pillar of the meaning in life. We become stronger physically, emotionally, mentally and spiritually from braving life. There is no better teacher in life than the school of hard knocks.

So what have we learned from the pandemic?

Sure, health is everything. The greatest wealth is health…

We all have spoken these words. My hope: this pandemic will convince people to put “lowering chronic inflammation” at the very top of their health priorities. COVID-19 proved to be far more aggressive and fatal to some because of a cytokine storm… a massive inflammatory response. Those who have pre-existing conditions like diabetes or heart disease — all inflammatory conditions fell prey much easier. However, younger “stronger” people also suffered the cytokine storms of COVID-19. Everybody needs to be conscious of lowering their levels of inflammation.

I have penned many articles here on MFN about inflammation – and how we need to manage it. I was also honored to be part of the book released this past February The Successful Body – where I contributed a chapter on chronic inflammation. My #1 goal is to make “lowering our levels of inflammation” into our daily health vernacular.

Being our own health advocate. Be independent, take charge!

All of a sudden this unknown force called COVID-19 swooped in and overnight there went our access to doctors and diagnostics. A perpetually social species, the human species was forced into hibernation. This was a very long pandemic. We had to learn to cope; get medical attention while doctor offices were closed and hospitals were strongly encouraging people to stay home.

Thank goodness for telehealth, remote diagnostics, in-home testing. We would have lost many more lives if it were not for telemedicine. Telemedicine usage has increased by over 3000% since the end of 2019.

Telehealth and remote health have existed for a number of years, but there was a strong resistance. People (hopefully) will take charge, and now realize the need for being more independent and proactive in getting healthy and getting healthcare.

Creative thinking, paradigm-shifting & self-discipline have had the ultimate workout!

Getting our exercise and physical activity
Self-discipline to not sit on our glutes all day
Not watch TV
Not to eat nonstop, drink alcohol, smoke (the toughest challenge for many)
Working from home
Schooling kids from home
Shop for our needs
Got better with tech!

Adaptation is the greatest evolutionary advantage. We most certainly exercised our ability to adapt!

Gratitude and Appreciation

Research has found neurological reasons why people benefit from expressing thanks for our lives, especially in times of challenge and change, providing longer lasting positivity.

Harvard Medical School:
“With gratitude, people acknowledge the goodness in their lives … As a result, gratitude also helps people connect to something larger than themselves as individuals – whether to other people, nature, or a higher power”

We learned to manage the material needs, but now we really appreciate each other — how vital friendship and touch are to every aspect of our entire being.

How strong we are… this was more than life throwing us a curveball, this was a sucker punch. Pat yourself on the back for getting up, having to be more creative about how to earn your living, staying healthy, having some semblance of a social life, being with loved ones. We had to totally rewire our lives. We have charted new territories, within all the challenges and limitations of a pandemic. Kudos!

Shira Litwack has been in chronic care management and prevention for 30 years, specializing in lifestyle habits including holistic nutrition, medical fitness and oxidative stress reduction. She is frequently called upon by the media, has her own podcast bringing current research to the public. She has created and provided oxidative stress assessments, to help clients identify potential health risks. From these, she provides guidance to lower inflammation. Shira is now a product specialist with a major COVID-19 test kit supplier, working with epidemiologists educating people on COVID testing, and setting up and designing protocol for COVID testing clinics

Pandemic of Panic Is Worse than COVID-19

Dr. Mario Martinez/29 June 2021/ All MFN blog/

While the threat of the COVID-19 needs to be taken with great concern, it is as important to understand the useless and counterproductive effects of panicking. Whether you take the vaccine or not, prevention is the best approach to any viral challenge. Panic is an extreme fear response triggering stress hormones that suppress immune function increasing susceptibility to any pathogen, including viruses.

Be Physically Active to Boost Your Immune Response

Sheri Colberg, Ph.D./16 June 2021/ All MFN blog/

In these challenging times, if we only could get a medication that would boost our immune system and response to viruses, lower all stress associated with still being in a pandemic, and treat most of the pre-existing health conditions that are associated with a higher risk of dying from COVID-19, we would all be lined up for it! Guess what? We already have something that does all these things already—and that is physical activity.

Let’s consider its impact on how well your immune system works. While physical activity can boost your immune function, here’s what else we know about the immune system and all the lifestyles factors we can manage:

Exercise: A single workout may temporarily suppress your immune system, but chronic training (assuming it is not excessive) boosts immunity to the common cold, other viruses, and a whole host of pathogens (1). Being regularly active generally makes you less likely to get sick.

Stress: Any type of stressor, be it physical or mental, can weaken your immune system, most commonly through increases in levels of the hormone cortisol and other factors (2). Exercise overtraining raises cortisol levels and can make you more likely to catch a cold or the flu.

Sleep: Lack of sleep—particularly deep REM sleep—and short sleep duration cause a rise in cortisol levels that can dampen immune function (3). Many people with type 2 diabetes and overweight/obesity also have sleep apnea that interferes with getting quality sleep, making them more susceptible to getting sick. Better management of all of these conditions helps.

Nutrition: Chronic malnutrition lowers the ability of the immune system to function optimally. Low levels of vitamin D (which acts as a prohormone) in the bloodstream has also been tied with lower immunity, and many people with diabetes and older adults have low vitamin D status. Getting adequate vitamins, minerals, and calories in your diet can boost your immunity.

Alcohol: While a moderate intake of alcohol may give you some health benefits, abuse of alcohol suppresses your immune system (4). “Moderate” is one drink per day for females, two for males—and there is no rollover from one day to the next if you miss one!

Smoking: Tobacco smoking increases inflammation and lowers immune function, and it may also lower your immune response to certain vaccines. Quitting smoking can help restore immune function.

We also need to discuss how our bodies react to vaccinations. All of us are facing possible vaccination for COVID-19 once we all can get access to the many safe and effective vaccines that are now slowly being distributed around the US and the world. You may be, like I was previously, assuming that vaccines work the same for everyone. In reality, there is no guarantee of a universal and equally protective response, and a whole host of factors (inside your body and out) can impact how well a vaccine actually works for you (5). Not surprisingly, all of the lifestyle factors listed above can impact the strength of your immunity post-vaccination, and making improvements in any/all of them can help. But your age can also have a negative effect.

COVID-19 is unlikely to be the last threat to our collective health, so it is worth discussing why we are more vulnerable to threats to our immune system as we get older. For starters, older adults have a less robust immune response to everything, including strains of influenza, and they suffer from a more rapid waning of antibodies. Basically, our immune systems are getting less robust and effective as we age—and that potentially impacts our response to vaccines.

Generally, older adults have a lesser immunity to any virus that they have been vaccinated against, and that will likely include the current global coronavirus once a vaccine is available. However, engaging in regular aerobic training improved flu vaccine responses in a group of older adults who had been previously sedentary (6): participants who did a regular moderate-intensity physical activity like brisk walking were 30 to 100 percent more likely to have an antibody response sufficient to keep them from getting the flu. Although research on this topic remains limited, exercise is likely to help boost the immune systems in people who are currently sedentary and start being active.

Other confounding health issues may make immune responses weaker when you are exposed to a virus or vaccinated. For instance, many seniors with diabetes develop kidney disease requiring dialysis. In these individuals, many fail to have an adequate immune response when given a vaccine for hepatitis B; how well it works depends on their age, how long they have been on dialysis, their diet, and other factors (7). In children (and adults) with type 1 diabetes, certain vaccines have been shown to be less effective, particularly when they also have celiac disease and consume gluten (8).

So, what can you do? Fight back by adopting the healthiest lifestyle that you can—one that includes being regularly moderately active—and stay as healthy as you can for when the next virus comes along. Protect yourself with a daily dose of exercise!

Sheri R. Colberg, PhD, is the author of The Athlete’s Guide to Diabetes: Expert Advice for 165 Sports and Activities (the newest edition of Diabetic Athlete’s Handbook). She is also the author of Diabetes & Keeping Fit for Dummies, co-published by Wiley and the ADA. A professor emerita of exercise science from Old Dominion University and an internationally recognized diabetes motion expert, she is the author of 12 books, 30 book chapters, and over 420 articles. She was honored with the 2016 American Diabetes Association Outstanding Educator in Diabetes Award. Contact her via her websites (SheriColberg.com and DiabetesMotion.com).

References

Cerqueira É, Marinho DA, Neiva HP, Lourenço O. Inflammatory Effects of High and Moderate Intensity Exercise-A Systematic Review. Front Physiol. 2020 Jan 9;10:1550. doi: 10.3389/fphys.2019.01550. PMID: 31992987.
McEwen BS. Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008 Apr 7;583(2-3):174-85. doi: 10.1016/j.ejphar.2007.11.071. PMID: 18282566.
Vgontzas AN, Zoumakis M, Bixler EO, et al. Impaired nighttime sleep in healthy old versus young adults is associated with elevated plasma interleukin-6 and cortisol levels: physiologic and therapeutic implications. J Clin Endocrinol Metab. 2003 May;88(5):2087-95. doi: 10.1210/jc.2002-021176. PMID: 12727959.
Rodríguez-Rabassa M, López P, Sánchez R, et al. Inflammatory Biomarkers, Microbiome, Depression, and Executive Dysfunction in Alcohol Users. Int J Environ Res Public Health. 2020 Jan 21;17(3):689. doi: 10.3390/ijerph17030689. PMID: 31973090.
Zimmermann P, Curtis N. Factors That Influence the Immune Response to Vaccination. Clin Microbiol Rev. 2019 Mar 13;32(2):e00084-18. doi: 10.1128/CMR.00084-18. PMID: 30867162.
Woods JA, Keylock KT, Lowder T, et al. Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. J Am Geriatr Soc. 2009 Dec;57(12):2183-91. doi: 10.1111/j.1532-5415.2009.02563.x. PMID: 20121985.
Udomkarnjananun S, Takkavatakarn K, Praditpornsilpa K, et al. Hepatitis B virus vaccine immune response and mortality in dialysis patients: a meta-analysis. J Nephrol. 2020 Apr;33(2):343-354. doi: 10.1007/s40620-019-00668-1. Epub 2019 Nov 7. PMID: 31701375.
Opri R, Veneri D, Mengoli C, Zanoni G. Immune response to Hepatitis B vaccine in patients with celiac disease: A systematic review and meta-analysis. Hum Vaccin Immunother. 2015;11(12):2800-5. doi: 10.1080/21645515.2015.1069448. Epub 2015 Sep 17. PMID: 26378476.

How to Turn Your Fitness Facility into a Health and Wellness Facility and WHY!

Debbie Bellenger/7 May 2021/ All MFN blog/

2020 came and went with a pandemic and the resulting crash of our fitness industry as we knew. It seemed like time stopped. Fitness facility doors closed. Staff were furloughed and separated. Fitness delivery models changed overnight – hybrid models of live streaming and on-demand services. Business plans were re-done for a budget year that evaporated.

The OPPORTUNITY… there has been an increased awareness of the value of good health and the importance of exercise. Much of the research shared post-COVID clearly demonstrated that the sickest were at the highest risk with COVID and that those who were mostly healthy fared much better when diagnosed with COVID.

CDC reported that obesity worsens outcomes from COVID-19. Obesity increases the risk of severe illness, tripled the likelihood of being hospitalized, and is linked to impaired immune function, decreased lung capacity and many other risks. Obesity is forecasted to exceed 50% in Americans by 2030.

How do we go forward as business owners to capitalize on a perfect storm of individuals now realizing and valuing their health as an asset? How do we go forward to create environments in which our facilities feel like a home away from home for new exercisers, de-conditioned, COVID recoveries, overweight, out of shape and scared individuals who now wish to exercise?

American Psychological Association reported recently that Americans’ Physical Health has taken a back seat since the start of the pandemic. It was reported that 47% delayed or canceled healthcare services and that 53% have been less active than they wanted.

How do we fill the gap to provide services and welcome all ages, stages, shapes, sizes into our facilities to capitalize the business opportunity and to support those who need us most to get healthier?

Bring communities together by offering health and wellness programs to non-members that teach good health and prevention. Some examples:
- Post-hab COVID health program: 30 days to reset your health
- 8-week weight loss programs/challenges, 8-week pre-diabetes classes, 8-week cardiovascular health and wellness programs.
- Any program that can target a COVID risk factor that targets a certain element of health: cardiovascular, flexibility, strength, stress management, sleep, etc… or certain disease states such as asthma, obesity, diabetes, hypertension etc. all can be made into health and wellness programs for potential new members.
Consider offering these health and wellness programs (with a nominal registration fee) without requiring a membership to your facility. So, include a membership to your facility for the duration of the program, offer a discounted sign-up fee to convert them to members at the completion of the program, and perhaps a friends and family rate to enroll. Leave a trail of financial incentive crumbs with some skin in the game to get them to value your facility and programs to stay long-term. Show them the value-added they experience by having you at your facility. Let them “try before they buy” — but in the wellness space first. Not “gym and swim” first…that is too much for some.
Offer intro level and disease-specific type group classes that may group like-minded individuals with common goals. Example: Beginner cardio class, where you clearly accommodate beginners, new exercisers, those who are low-level fitness and who need a shorter duration of work.
Offer personal training programs that clearly measure pre and post-health metrics to show improvement to give individuals confidence in their improving health and an appreciation of the value of the services they pay for. This also allows for your trainers and your facility to connect their improved health outcomes to their primary care providers so you can get future referrals as a credible source for a patient who needs exercise.
Offer healthier food choices and nutrition education as part of your centers’ offerings. Consider adding a Dietitian to your team.
Partner with local health departments, health care systems to host health checks to promote good health awareness and to get more foot traffic into your center.

THINK “A GYM without WALLS” and offer wellness to all – become the health hub of your community!! It makes good business sense for all!

Debbie Bellenger is a skilled presenter, public speaker, TRX Master Trainer and Reebok Master Trainer. Over the past 30 years, Debbie has been developing and delivering medical wellness programs in an integrated continuum of care model with providers using EPIC as a platform of referrals and communications back and forth. She also successfully developed a new service line for CaroMont Regional Medical Center called Employer Wellness services which sold over $500,000 of corporate wellness programs with coordinators to local companies.

Debbie is the 2014 Medical Fitness Association Corporate Wellness Director of the Year – Employee Wellness. She is the 2017 IDEA Program Director of the Year Award recipient, which recognizes a Director who develops and delivers health, fitness and wellness programs for employees, participants and patients that have successfully changed behaviors and demonstrated positive outcomes of improved health.

Immunity in Question

Eric Durak/30 April 2021/ All MFN blog/

When I was in graduate school, cardiac rehab was THE big issue in exercise science. Most graduates who wanted to work in clinical chose cardiac rehab as their mainstay. However, much of the discussion about the medical benefits of exercise changed in the late 1980s when Dr. David Nieman from Appalachian State University published the first in a series of reports on exercise and the immune system. In my opinion, Dr. Nieman changed the conversation on exercise as his research looked at one of the first biological mechanisms for change in the body due to acute and chronic exercise.

The State of Immunity

Why are we discussing exercise and the immune system? Because thirty years and hundreds of papers on the effects of exercise on immune enhancement, we are still as a nation not educated (let alone convinced) that exercise should be a mainstay of maintaining and improving overall health – especially in persons with infectious disease.

Let’s look at some of Nieman’s work. First, Dave was a marathon runner, who noticed that after long races he and his friends felt “drained” and some came down with colds. He took blood samples pre- and post-marathon race and found on numerous occasions that specific immune cells such as lymphocytes dropped dramatically after races – leaving persons (himself as well) more likely to come down with colds. So, his response was to train accordingly and get plenty of rest in days after races.

His second area of research looked at the chronic effects of exercise on the immune system, such as white cells, natural killer cells, and other specific immune groups. His conclusion after his research is that exercise does stimulate immune cell function, and this may help in persons with cancer (immune damage due to chemotherapy), and other metabolic diseases.

Today’s Immunity

Over this same 30 years the nation has gotten fatter, lazier and sicker. To the point where many people have no idea that their diet and exercise regimens can actually improve their immune function – so they resort to medications.

Today we are faced with a COVID infectious disease, where many people literally fear for their lives. The crux of this report isn’t to cherry-pick statistics, or to point fingers, but the bottom line is that persons who are physically fit suffer much less severe symptoms of COVID, the flu or other infectious diseases than sedentary counterparts.

The immune system is one of the strongest areas of biology that cement the strength of regular exercise. Along with changes in blood chemistry and telomere length, immune changes represent one of the foundations of clinical exercise benefits for young and old. Especially old.

Why Americans Should Start Exercising

Physical fitness has been left out of the discussion relating to COVID. This, along with proper nutrition and supplementation are not only NOT mentioned in the media, but many are disregarding the basics in favor of specific medical therapies.

Exercise should be touted if not for just ONE area of concern – and that is obesity. As one of the main comorbidities for severe COVID, losing weight would reduce severity in many people. This alone would reduce the burden of the disease from a death, healthcare expense and severity aspect. Of course, there are other complications relating to COVID, but in general, exercise has many positive effects, with few side effects. Its contribution to enhancing immunity is one of the biggest attributes.

Using proper assessment and outcome metrics, trainers and coaches can correlate the effects of their programs with other health and medical scores (such as a change in blood sugar or blood pressure each session, or loss of body fat over a one-month period). These are important because they will correlate to changes in overall blood labs, which will have both an acute effect (reduction in the risk of heart attack, stroke, or asthma attack), or long-term effects, such as reduction in diabetic complications, risks of falls, and peripheral vascular disease. Trainers may not understand just how powerful regular exercise can be for specific medical populations, but since the 1970s, the data is clear that exercise has an effect on almost every type of medical condition – even relatively new conditions to exercise training such as autism and Ehlers-Danlos Syndrome.

If we understand that just a moderate amount of exercise will improve circulation enough to enhance the immune system, then we should be detailing it to new members as they come into the health club setting.

Why Health Clubs Need to Open – and Stay Open

Even mom and pop clubs can play a role in improving health. The first is to have a member tracking system that can keep people coming to the club, at least twice a week. For health’s sake, perhaps 3-4 days per week would be preferable. The “essential” label is a bit misleading because there are no true metrics for what an “essential” business may be (outside of trash collection, medical triage, and grocery stores). Clubs can position themselves through medical fitness and in the near future, have the technology and assessments necessary to look at health outcomes as persons who normally would not be in a health club see the benefits of a medically based program that will cater to their needs while improving their health along the way.

Eric Durak is the President of MedHealthFit, and founding partner in the Fitness Is Medicine Initiative. He is a 35- year veteran of the health industry. He has worked for health clubs, medical research centers, and continuing education. He has been at the forefront of the medical fitness movement and appreciates the opportunity to work with MedFit Network to move medical fitness to the forefront of health care. Email him at edurak@medhealthfit.com

References

Nieman, DC. Moderate Exercise Improves Immunity and Decreases Illness Rates. 2011. Am. J. Lifestyle Med. https://doi.org/10.1177/1559827610392876.
Oldridge, N, Pokosh, M, Grace, SL. A systematic review of recent cardiac rehabilitation meta-analysis in patients with coronary heart disease or failure. 2019. Future Cardiol. 15(3):227-49. DOI: 10.2217/fca-2018-0085
Russek, L, Simmonds, J. Evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome / hypermobile Ehlers-Danlos Syndrome. The Evidence-Based Rationale for Physical Therapy Treatment of Children, Adolescents, and Adults Diagnosed with Joint Hypermobility Syndrome/Hypermobile Ehlers-Danlos Syndrome (for Non-experts) | The Ehlers Danlos Society : The Ehlers Danlos Society

Safely Returning to Exercise Post-COVID-19 Illness

Megan Johnson McCullough/28 April 2021/ All MFN blog/

The world of exercise and fitness was struck hard by the COVID-19 pandemic, taking access to gyms and fitness centers away for a period of time. With these facilities returning to their open availability, many individuals who personally experienced having COVID-19 have been posed with the question of when is it safe and okay for them to return to exercising again. Factors to consider include, of course, not wanting to spread the virus. But from a medical perspective, when is the body ready to safely return to exercising?

Internally, the immune system has just been through warfare depending on the strain and severity of the contracted virus, so the first consideration is feeling confident that symptoms have been eradicated during normal daily living activities, before venturing on to performing more strenuous or even mild/moderate forms of physical activity. COVID-19 affects the lungs (respiratory system), causing severe inflammation. Normal functioning of taking in oxygen and releasing carbon dioxide becomes impaired when the virus impedes by increasing fluid in the lungs and inflammation. Therefore, breathing becomes the common exercise inhibitor when first getting back into movement patterns. In fact, the CDC estimates that 3-17% of COVID-19 patients develop a complication known as Acute Respiratory Distress Syndrome (ARDS). A simple test for readiness is trying to walk quickly for 500 meters without feeling breathless or fatigue. From this self-assessment, endurance and intensity can progressively improve.

Returning to strength training can be challenging when considering cardiac output and fatigue depending upon resistance training goals and modalities. Therefore, it is best to work in the endurance phase for 2-4 weeks prior to strength or power training. This will help prepare the body for more intense training as well as let the body adjust to feelings of fatigue and breathlessness that might occur. A negative COVID test does not equate to the body returning to its normal workload capacity right away. Patience is key and although this can be a frustrating feat for athletes and avid gym-goers alike — movement is medicine but overtraining in sub-optimal conditions only prolongs the perceived setback.

There is no exact timeline upon returning to exercise post-COVID, but one way fitness professionals and individuals can gradually and safely do so is to utilize the “Rate of Perceived Exertion” to modify and accommodate for any potential risks. An example of this is the Borg Rating of Perceived Exertion (RPE), using a scale of 6-20 with 6 being no exertion and 20 being maximal exertion. Realistically working between 6 and 11 to start and pacing oneself to 12-15 and above is a good road map. Wearing a heart rate monitor can also be helpful with the understanding that if you are working at a higher level than what your lungs currently want to or can even do, taking resting breaks before returning the exercise is recommended. Exercising over time will help repair the body’s systems to again function as efficiently as before.

Megan Johnson McCullough is the owner of Every BODY’s Fit in Oceanside CA. She is a NASM Master trainer, holds an MA in Physical Education & Health Science, and is a current candidate for her Doctorate in Health and Human Performance. Megan also holds specializations in Corrective Exercise, Senior Fitness, Fitness Nutrition, Drug and Alcohol Recovery, and is an AFAA Group Exercise Instructor. She’s also a fitness model, professional natural bodybuilder, and published author.

References

Salman, D., Vishnubala, D., Le Feuvre, P., Beaney, T., Korgaonkar, J., Majeed. A. et al. (2021). Returning to physical activity after covid-19. BMJ, 372:m4721. doi:10.1136/bmj.m4721
Yale School of Medicine (2021). Challenge 5: How does covid-19 affect the respiratory system? https://medicine.yale.edu/coved/modules/virus/respiratory/

Pandemic Proofing our Muscles

Shira Litwack/4 March 2021/ All MFN blog/

My first published article as a medical fitness pro (30+ years ago) was “Muscles…our True BFF (Best Friend Forever) in Life.” Fast forward over 30 years later in a global health pandemic, this is even more critical. Alas, our muscles have not prospered as Netflix and liquor sales.

We all know that muscles exemplify “use it our lose it.“ Fascinating study August 2020:
“Exercise Induces Different Molecular Responses in Trained and Untrained Human Muscle”

Conclusion: “…several key regulatory genes and proteins involved in muscular adaptations to resistance exercise are influenced by previous training history. Although the relevance and mechanistic explanation for these findings need further investigation, they support the view of a molecular muscle memory in response to training.”

⇒ Our “muscle memory” speeds the process by which we regain our former muscular strength and size. This merits the word “awesome”.

What an evolutionary advantage to regain muscle mass, for both physical and mental health. Survival of the fittest in action.

Before the pandemic, studies showed 60% of US adults do not strength train. We are our own worst enemies.

During the COVID pandemic: Working from home, not getting up and going out to work — various factors have made us more sedentary. A study from eMarketer said TV viewing dramatically increased this year, ending a 9-year steady decrease in television viewership. Studies show there’s been a 32% reduction in physical activity this year, and not surprisingly, another poll says 53% of people struggle with mental health issues due to the pandemic.

Sitting truly is the new smoking.

I think gyms were closed more in 2020 than they were open. Many of us love the gym — a real adrenaline rush. Many people are dependant on the gym for exercise, whether it’s to see their trainer, attend a class, discipline, motivation. The fallout: this pandemic has been more of a sit down than a lock down!

If there is ONE thing, COVID has taught us: Adaptation, the ability to change to our environment, is truly paramount to survival.

Exercising and working our muscles is a vital part of preventative health, even more so now. Muscle wasting is a product of aging, too much tush time and many diseases, including COVID.

Pop exercise advice always mentions get 10k steps per day”. And yes, “strength train 2-3 times per week”. Sadly, the perception of strength training is that it must be with heavy barbells and machinery at the gym. No gym, no strength.

May I suggest we encourage muscle mindfulness? Working our muscles is not just for “exercise time”. We can encourage muscle work in many forms, multiple times per day. Just like we eat, use the washroom, have screen time… let’s help people anchor some muscle time to daily activities.

Example: cooking in the kitchen – hang on to the counter and give me 10 squats.

Muscles are a key factor in our metabolic equation. Increasing our muscle mass boosts our resting metabolic rate, burning more calories at rest, not just during exercise. Muscles help balance hormones such as leptin, insulin, estrogens, androgens and growth hormones. These are all imperative for appetite control, cravings, metabolism and body fat distribution and management. At the ripe old age of 30, we start to lose muscle mass (sarcopenia) unless we are mindful to nurture it. And yes, people over 90 can still build muscle mass.

Amongst the many functions of our muscles is utilizing the glucose in our blood, therefore reducing blood glucose levels, irrelevant of the presence of insulin.

Diabetes is an inflammatory disease. Type 2 diabetes causes the body to become less sensitive to insulin, and the insulin resistance leads to inflammation. A vicious cycle.

1 in 3 people in the US are pre-diabetic
Most people are unaware of their diabetes
13% of the population has diabetes
42% of the population are obese

Diabetes is a gateway disease. It is a red flag for the potential to develop other diseases such as heart disease, cancers, kidney disease, eye issues. As I mentioned before, insulin resistance leads to greater levels of chronic inflammation, which greatly increases the risk of all of our plaguing chronic diseases.

Lowering chronic inflammation has been the focus of my medical fitness journey, research, coaching and published work. Getting people to move “chronic inflammation” into their daily vernacular, permanently affix it to the top of their health wish list has been my professional raison d’être.

My last article here on MFN was all about chronic inflammation, how it is at the root of all of our chronic illnesses, mental & physical: diabetes, many cancers, mental health challenges, heart disease, arthritis, prostate issues, Alzheimer’s, neurodegenerative disorders… and yes, COVID-19. One line here: Please don’t get caught up in pop anti-inflammatory diets causing people to eliminate vital food groups.

The inflammatory response of COVID-19: The severe reactions to the virus happen more in seniors, and those with diabetes or obesity, or other preexisting inflammatory issues. No coincidence. COVID provokes an exaggerated immune response, excessive inflammation and inflammatory products called cytokines – the infamous cytokine storm. Exercise is a crucial factor in controlling inflammation – moderate cardio (NOT long high-intensity cardio, which actually can increase chronic inflammation) and preserving muscle.

So just how important is it for us to encourage our clients to build muscle? Obviously, it is HUGE, and unfortunately, most people do not focus on muscle work. It is our job as MedFit pros, friends and family, to demonstrate how to creatively and seamlessly incorporate muscle mania into their daily lives — yoga, Pilates, resistance bands, dancing…

The COVID pandemic is going to have far-reaching complications for many years to come. Adaptation is key. Integrating muscle work throughout the day along with other activity bodes well for lowering our levels of inflammation — helping to pandemic proof our bodies. Don’t just depend on a vaccine, we could have a new normal for a while. Preventative health is more important now than ever. Our muscles are truly our BFF.

Deliberate Wellness at Home

Debbie Bellenger/23 February 2021/ All MFN blog/

In the daily grind of life, it can be challenging – between doctors appointments, grocery shopping, meal prepping, upkeeping your home – to prioritize what benefits your wellness and wellbeing. Things like enjoying healthy meals, making the time to go out for a walk, maybe even taking an art class – these activities take deliberate effort, planning and determination to find, coordinate and attend.