When you think about a person going into intensive care, you probably picture someone who’s very ill and likely fighting for their life. They may be on a ventilator or other equipment that’s keeping them alive. When you’re in that situation, surviving would be a win. But what happens after these people survive? Do they recover and go back to life as it was? What’s the road to recovery look like?
Fortunately, medical advances have led to higher survival rates for people who end up in intensive care units – it’s now between 71% and 90%, which is great. But, survival is not the end goal, and getting out of the ICU is not the end of the battle. Many patients show significant losses of physical, mental and cognitive abilities after discharge. It makes sense – if you don’t use it, you lose it! This cluster of problems is called Post-Intensive Care Syndrome or PICS.
PICS is now recognized as a public health burden. Interventions against PICS need to start in the ICU. Then they need to continue after discharge.
Physical declines often include significant losses of strength, endurance, and mobility. These can lead to serious difficulty completing basic daily tasks like getting to the bathroom, preparing a meal, or walking to the mailbox. This may keep some people from returning home. For others, it means they need a caregiver to safely return to their previous setting. 50% of ICU survivors have limitations in daily activities 1 year later, so this is a serious and long-lasting problem.
Mental health is also a very real concern for ICU survivors. They show significant rates of depression – the mean is 28%. 24% of survivors have anxiety and 21% report PTSD. Again, these conditions have a real impact on the quality of life after leaving the ICU.
Last, declines in cognitive abilities are very common in ICU survivors. 77% have cognitive impairments at 3 months post-discharge and 71% have impairments 1 year out. Cognitive issues after discharge can include poor memory, slower thinking, problems making decisions, or difficulty concentrating.
Physical therapists play a significant role in the fight against PICS. PT typically begins while the patient is in ICU, focusing on getting the patient up and walking early. Patients begin a progressive exercise program as soon as it’s safe for them. We expect a rise in PICS due to the number of people who COVID-19 has put into critical care and/or on a ventilator.
While we can’t prevent every problem that critical illness causes, recognizing the losses that remain after discharge from the ICU is an important step. Physical therapists play an important role in combating the effects of PICS and helping people return to higher-quality lives.
Returning to Activity After a Pandemic
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.
When the Weather Gets Cold, Don’t Forget to Warm Up
Colder weather means some changes to how we exercise. Of course it’s harder to motivate
yourself to get outside for a run or bike ride when the temperature drops, and the shorter days
compress our schedules, but there are changes in your body that affect your ability to exercise
too. For many people with arthritis or other joint problems, cold weather brings more complaints
of pain. To stay warm, our bodies narrow blood vessels to reduce bloodflow to the skin, and
more superficial muscles. That means that there is an increased risk of muscle strains in the
cold. There is also an increased strain on the heart because of the narrowed blood vessels. This
isn’t to say that you shouldn’t be active outdoors in the cold, it just means you may have to
make a few changes to your routine. Here are a few to consider:
Warm up right
A good warm up is always important, but because of the tendency for joints to be stiffer, and
bloodflow to muscles to be reduced in the cold, it’s even more important that you do it right this
time of year. To start, do something to get your heart rate up a bit, maybe a brisk walk or light
jog. Follow that up with a dynamic warm up rather than static stretches. This could include
walking or jogging while pulling your knees up high to your chest. Maybe some high kicks in
front of you with straight knees to get your hamstrings loosened. A walking lunge with an upper
body twist can get your whole body moving. Cater your warm up to what you have planned in
your workout. If you’re not sure how it should look, ask your physical therapist!
Dress right
Dressing in layers allows you to adjust your insulation to your activity level. After you warm up,
you might want to take off a layer to avoid getting too hot during your main activity. You’ll have it
there later to put back on when your activity level drops and you start getting too cold.
Don’t forget about the sun either – just because it’s cold doesn’t mean the UV rays are gone.
Sunscreen and sunglasses aren’t just for the summer. A lip balm with SPF can protect you not
only from the sun but from the wind too.
Stay hydrated
Drink water before, during, and after your workout. The temperature may be down, but you’ll still
sweat and you’ll still lose water vapor in your breath. The drier air in winter lets your sweat
evaporate more quickly, so it’s easy to underestimate how much fluid you’ve lost.
Cool down
When you’re done, don’t rush to get inside and crawl under a blanket. Cool down properly. Keep
moving with a walk or another form of active recovery to let your heart rate come down. After
exercise is the right place for static stretching. You can also head inside for some foam rolling or
self massage.
The days being shorter and the temperatures being lower don’t mean you’re stuck inside for all
of your exercise. If you follow these tips, you can safely keep moving outside. If you’d like a
customized warm up or cool down, or have questions about your exercise routine, your physical
therapist is a great person to ask!
5 Reasons You Need a PT to Coordinate Your Fitness Regimen
Physical therapists aren’t just for people that are injured or have had surgery. Physical
therapists can also help healthy people improve their fitness. Here are 5 reasons why you
should consider seeing yours.
You Want a Baseline
When you see a physical therapist to improve your fitness, you’ll get an assessment of your
strength, range of motion, posture and movement patterns. This not only helps your physical
therapist design a customized program just for you, it gives them a baseline to compare things
to in the future should you start having pain or suffer an injury.
You Want Expert Guidance
Sure, other professionals could help with your fitness routine, but the fitness industry is not well
regulated. Some certifications just require an online course and paying a fee. There are no
licenses or other requirements to use many titles. Becoming a physical therapist requires at
least a bachelor’s degree and most PTs practicing today have a doctorate. Every PT has
passed a national board exam and maintains a state license. That guarantees you that every
physical therapist is a verified expert in human movement.
You Want to Prevent Injury
Physical therapists don’t just work to heal injuries, they are also experts in preventing them.
After a thorough assessment, a PT can help you design a program that will not only help you
reach your fitness goals, but that can address any issues that increase your risk for injury.
You Want Unbiased Advice
Yoga instructors will want you to do yoga. Personal trainers will want you to come to their gym.
Pilates instructors will want you to do Pilates. Strength coaches will want you to strength train. A
physical therapist doesn’t have a bias or vested interest as to what type of fitness regimen you choose.
They are only interested in helping you reach your goals.
You Have a History
If you have some kind of history that affects your ability to exercise, a PT is the best person to
help you design a fitness regimen. It doesn’t matter if it’s an old injury from athletics or work,
back pain that comes up from time to time, COPD, arthritis or heart disease, a PT can help you
safely work around it and meet your fitness goals.
ARTHRITIS & FIBROMYALGIA & AQUATIC THERAPY
Relaxation is one of the most important aspects of controlling arthritis and fibromyalgia pain. Therapeutic warm water provides sensory stimulation, which encourages relaxation and stress relief. Combining this warm water with our deep penetrating massage system can greatly reduce the stress and pain on aching muscles and joints.
Walking on the underwater treadmill or exercising against the resistance jets can also help manage your pain. When standing chest deep in water, the body is 80% weightless, bearing only 20% of its body weight. This weightlessness significantly reduces the stress on joints and muscles.
BENEFITS OF AQUATIC THERAPY FOR THOSE WHO SUFFER FROM ARTHRITIS AND FIBROMYALGIA:
-Relaxation
-Increased joint range of motion
-Pain relief
-Enhanced mobility
-Improve flexibility
-Mobility and strength
-Removes weight from joints and bones
-Strengthens muscles and joints after surgery
-Decreased side effects
Call Freedom today to set up your appointment OR ask about our free 30 minute session.
