Working from Home: Pandemic Edition Part 2


Many Americans recently saw a change in their daily work routine. With
the current stay-at-home advisory extended, many of us are working or attending
school from home. In a previous blog, we talked about how prolonged sitting can
have negative short-term and long-term effects on the body. We went over
sitting posture at a desk, muscle groups affected by sitting, and the American
College of Sports Medicine’s recommended activity levels. If you have not read
it, go check it out

In today’s blog post, we will go over a few stretches that
you can do to combat the short-term effects of sitting. Stretches should be
done every 1-2 hours.

Standing Back Extension


Stand with your feet about hip-width apart, place hands on your hips. Bend
backwards slightly. Return to starting position. Repeat this 10 times. This
exercise is not for you if you have spondylolisthesis, spondylosis, or nerve
pain/leg pain that worsens with each repetition.


Burdenko Sitting and Head Turning (Modified)


Begin sitting on stable chair. Place your hands behind your head,
elbows are up and turned out. Simultaneously stretch your arms out to the sides
as you turn and look to the right. Return to starting position. Repeat on the
left side. Repeat this 10 times on each side. Be careful if you have any
shoulder limitations/injuries, or neck limitations.


Burdenko Bench On/Off Stretch


Start sitting upright in a chair, facing a second chair. Lift one leg
up onto the chair in front of you and reach for it with the opposite hand.
Return to starting position. Repeat on the other leg. Return to starting
position. If you can, lift both legs up simultaneously (back should be
neutral), and reach for your feet with both hands. Repeat 5-10 times each side.
This will stretch your hamstrings. If you have a preferred hamstring stretch,
go ahead and do that instead.


  

Seated Hip Flexor Stretch


Sit with half your buttocks on the chair, support your self with your
arm. Stretch the leg that is “hanging” off the edge back until you feel a light
stretch along the front of your hip. Hold for 20 seconds. Repeat 3 times on
each side.



Interested in more exercises related to posture? Check out this blog
post: https://fitplancapecod.com/2015/03/10/5-quick-exercises-to-help-correct-poor-posture/
Blog
post by Damaris Marques PT DPT.

About Damaris
Marques PT DPT

Damaris
(“Dee”) joined Cape Cod Rehab in August 2017 after receiving both her
Doctor of Physical Therapy and Bachelor of Science from Springfield College.
She is certified in Part I and Part II of the Burdenko Method and believes in a
patient-therapist partnership where both are working together to meet the
patient’s functional goals. Dee is bilingual (English and Brazilian Portuguese)
and lists crocheting as a hobby along with singing and a little dancing when no
one is looking!

Working from Home: Pandemic Edition Part 1


Many Americans recently saw a change in their daily work routine.
With the current stay-at-home advisory extended, many of us are working, or attending
school, from home. We do not know when we will be able to go back to “normal.”
So, for now we find ourselves mostly at home, and if you are anything like me,
you are sitting for most of the day.
While sitting may seem like a harmless activity, it can cause both
short-term and long-term problems. A small research study1 looked at
the effects of prolonged sitting (2 hours) on the stiffness of the spine, and
found that in university-age men, stiffness of the spine increased after only 1
hour of sitting, whereas in women it varied in the 2 hour window. The reality
is that many of us are sitting for longer than 2 hours. Chronic prolonged
sitting can be detrimental to your long-term health. In a recent study2,
researchers found that sitting for long hours (usually 6+ hours) is associated
with all-cause and cardiovascular disease mortality risk in sedentary adults,
but this association is decreased or completely undone when the recommended
levels of weekly moderate/vigorous exercise are met.
What does this tell us? That prolonged sitting today can cause
problems both today and tomorrow. Here are 3 tips to combat the risks
associated with prolonged sitting.

1: Office Ergonomics




Some basics: Sit up with your back supported, use a lumbar roll or
a towel roll along the small of your back for support. Elbows should be
approximately 90 degrees, with wrists in a neutral position. Your neck should
be held in a neutral position (ears aligned with your shoulders; shoulders set
back). Ideally, have your monitor set up to eye level.






Knees should be approximately 90 degrees, and feet should rest
comfortably on the ground. Use a phone book (or your pathology book from
college) to adjust the “height” of the floor if you are short like me.








If you are using a laptop, try angling the laptop to help with the
eye level. This is not ideal.
  










2: Take Stretch Breaks


Sitting keeps the hamstrings, hip flexors, chest musculature, and neck
extensors short and tight, while it lengthens and weakens the quadriceps, neck flexors,
and upper back/shoulder blade musculature. Get out of that seated position
every 1-2 hours to stretch out and walk around the house. Some people have
standing desks. If that is you, use that to your advantage. Otherwise, stretch
the chest and squeeze your shoulders back, stretch your hamstrings and your hip
flexors, and do a lap around the house.

In our next blog post about working from home, we will go over
more specific stretches to do at home.

3: Hit the Recommended Activity Levels


Regardless of how long you sit for, regular moderate to vigorous
activity is still the best way to combat long term health issues associated
with chronic prolonged sitting.

For most adults, the America College of Sports Medicine recommends
150-300 minutes of moderate-intensity aerobic activity per week, or 75-150
minutes of vigorous-intensity aerobic activity per week,
and 2 or more
days per week of strength training of all major muscle groups
of the body.

Similarly, older adults should engage in 150-300 minutes of
moderate-intensity activity,
and this should include a mix of aerobic
training, strength training, and balance training. Older adults should also
take special consideration of any co-occurring conditions. Remember to always
consult with your physician or physical therapist when starting a new exercise
program.

Here are some ideas of aerobic activities: walking around the
neighborhood, hiking along the beautiful trails of Cape Cod, walking on the
beach, a light jog or run outside, body-weight circuit training, bike riding, roller
blading, jumping rope, dancing/aerobic dance to name a few. If you need some
help getting started, or feel most motivated when working with others, check
out our offering of FitPlan Live VIRTUAL classes at Mashpee Fitness.
I hope you find these tips helpful. Keep an eye out for the next
blog!
Blog post by Damaris Marques
PT DPT
.
About Damaris
Marques PT DPT
Damaris
(“Dee”) joined Cape Cod Rehab in August 2017 after receiving both her
Doctor of Physical Therapy and Bachelor of Science from Springfield College.
She is certified in Part I and Part II of the Burdenko Method and believes in a
patient-therapist partnership where both are working together to meet the
patient’s functional goals. Dee is bilingual (English and Brazilian Portuguese)
and lists crocheting as a hobby along with singing and a little dancing when no
one is looking!
References
1. Beach TA, Parkinson RJ, Stothart JP, Callaghan JP. Effects of
prolonged sitting on the passive flexion stiffness of the in vivo lumbar spine.
Spine J. 2005 Mar-Apr;5(2):145-54.
2. Stamatakis E, Gale J, Bauman A, Ekelund U, Hamer M, Ding D.
Sitting Time, Physical Activity, and Risk of Mortality in Adults. J Am Coll
Cardiol.
 2019 Apr 30;73(16):2062-2072. doi:
10.1016/j.jacc.2019.02.031.
Resources
2. Link to the Physical Activity Guidelines for Americans: https://health.gov/our-work/physical-activity/current-guidelines

Rules of the Road and Safety Tips for Runners & Walkers

Ahh springtime during a nationwide
quarantine!  The beach parking lots may
be closed but the roads are always open and it’s great to see so many new
people running, walking and biking.
Maybe you’ve been cooped up on the couch
watching Netflix all day or sitting at a desk working from home for 8 hours
straight, it’s important to get out of the house for some fresh air, Vitamin D
and get the blood flowing as long as you are not sick or at-risk of spreading
the virus.
Your safety is also important and so is following
the unwritten rules of the road:

Travel on the correct side of the road.

Run and walk against traffic.  Bike with traffic.  It’s crazy how many people either don’t know
or don’t follow this rule.  Not only is
it much safer, in some states it’s even a law. 
And with social distancing being such a hot topic right now if everyone is
on the wrong sides of the road, it’s more difficult to avoid close contact when
passing fellow runners and walkers.  It’s
always best to run or walk on the sidewalk but on roads without them, travel on
the side of the road so you can see the cars coming towards you.  Don’t assume drivers can see you.  Stay alert and be ready to jump out of the
way from distracted drivers. 

Keep your dogs on a leash.

I am 100% a dog lover but please keep
them on a leash.  It doesn’t matter how
well behaved you believe your pet is, a charging dog and one misstep can lead
to an injury and a few weeks of recovery. 
Many leashed dogs are triggered by off-leash dogs so even if you’re dog
is friendly, another dog could react.  On
a similar note, for goodness sake pick up your dog’s poop!

Wear a mask to cover your nose and mouth…
even outside.

The CDC is recommending everyone wear “cloth
face coverings in public settings where other social discancing measures are
difficult to maintain to reduce the spread of the virus from spreading between
people interacting in close proximity.”
 
If you’re running on crowded sidewalks or trails, it may be difficult to
follow the 6-foot rule.  Play it safe and
cover your nose and mouth with a mask, BUFF or other breathable face covering
especially when approaching/passing others because COVID-19 can be transmitted
outside through the air if someone coughs or sneezes.

Get comfortable running alone.

Now more than ever it’s important to run
solo and ditch the running group and training partners.  Need that motivation to get out on the door?  Check in with your run buddies daily.  Create Facebook accountability groups.  Follow your friends on Strava.  Some run clubs are even doing virtual runs.  And you’re worried about running alone for
safety reasons, there are different apps and GPS watches that send tracking so
others can keep track of your whereabouts. 
My family uses the Road iD app which sends “ecrumbs” so we can follow
along.  The app even sends an alert if
you are stationary for more than 5 minutes. 
I also bring along mace (I only recommend it if it’s legal in your state
and if you’re familiar with using it) and my scary 80-pound pup to keep me feeling
safe.

If you’re out at night, see and be seen.

Did you know that according to the
National Safety Council the chances of being struck and killed as a pedestrian
increase 1100% after dark? 
Some runners are practicing social distancing by waiting
until dark to run outside in hopes that they will encounter less people on the
roads, just make sure you invest in a good headlamp and some reflective gear.

If you’re driving, yield to pedestrians
at the crosswalk.

Not only is it a Massachusetts state
law, it’s rude!  Just a personal daily run
frustration that I had to mention.

Acknowledge your fellow runners and
walkers.

If you run past me, a friendly nod is
nice.  A smile or wave is even better.  You may be suffering
but we suffer together.  The running community is special and we’re all out
there for different reasons with different goals but even alone we are all in this together and I believe it is absolutely necessary to at least acknowledge those
that are out there pounding the pavement with you.
Good luck out there!  Stay safe & happy running!
Blog post
by Jen Skiba.

Maintaining Healthy Routines in Quarantine


In these unusual times it can be
difficult to maintain our regular healthy routines.  Our daily lives have been disrupted and now
home is also the gym and work and our favorite coffee shop. We are accustomed
to our homes being places of rest and rejuvenation and they now must also be
places of productivity. If you find that you are struggling to achieve your
mental and physical goals during this time, here are some tips to help you
schedule your day and create new routines to benefit your health.

Sleeping


Try to go to sleep and wake up at the
times you normally would. It may seem easy to go to bed a little later, but a
couple of hours difference can throw off your schedule significantly. Not
getting enough sleep or sleeping too late into the day can throw off your
body’s circadian rhythm. If you end up not getting enough sleep, a short nap
can help you feel more rested and energized. However, napping for too long or
too often can detract from your nighttime sleep. Shoot for around 20 minutes.
If you don’t normally sleep enough and find yourself relying on caffeine to get
through the day, this could be a great opportunity to adopt a healthier sleep
schedule. The average adult needs 7-8 hours of sleep to function well and
promote health, especially during times of stress. Be mindful of your body’s
needs and sleep your way to better health.

Eating


With increased time at home, bad eating
habits can arise. It is easy to snack throughout the day when there is full
access to food in the next room. Eating full meals at planned times can help
you establish boundaries that will prevent excessive snacking, and ensure you
are staying well nourished. It is also a great opportunity to try new recipes
that may have taken too long to prepare under normal circumstances. Spending
more time at home does not mean we have to stop trying new things and being
creative. Along with eating, it is important to continue to hydrate as you
normally would. Keeping a water bottle by your side is a good reminder to drink
throughout the day.

Scheduling
Activities


Scheduling out specific activities day
to day can be helpful while spending so much time in your home. Make a list of
tasks and goals you would like to accomplish throughout the week to help
prevent boredom and the feeling that you’ve wasted time. A list is a great tool
to remind you of your goals when you don’t know what to do next. It can also
help steer you away from excessive screen time. Each day pick a few things from
your list to get done and alternate productive tasks with enjoyable activities
or hobbies. To switch up your daily schedule or to take a break from indoor
tasks, track the weather and make plans for outdoor activities on the most
appropriate days. The increased time at home is a perfect opportunity to
continue or try new hobbies. Exercise, reading, crafting, and cooking are just
a few examples of activities that can be taken up in the home.
The important thing during this time is
to maintain your mental and physical health. Do not overwhelm yourself with
unrealistic tasks or expectations but try to keep your mind and body engaged
each day.
Stay safe and healthy so you can hop
right back into your normal routine when quarantine is over!
Blog
post by David Reme.

Social Distancing & Staying Entertained at Home


Social distancing as described by the Centers for Disease Control
and Prevention (CDC); Social distancing, also called “physical distancing,”
means keeping space between yourself and other people outside of your home.

To practice social or physical distancing:

  • Stay at least 6 feet (2 meters)
    from other people
  • Do not gather in groups
  • Stay out of crowded places and
    avoid mass gatherings (CDC).

Tips for social distancing:

  • Follow guidance from authorities
    where you live.
  • If you need to shop for food or
    medicine at the grocery store or pharmacy, stay at least 6 feet away from
    others. 
    • Use mail-order for medications, if possible. 
    • Consider a grocery delivery service.
    • Cover your mouth and nose with a cloth face cover when around
      others, including when you have to go out in public, for example to the grocery
      store. 
      Stay at least 6 feet between yourself and others, even when you
      wear a face covering.
  • Avoid large and small gatherings
    in private places and public spaces, such a friend’s house, parks, restaurants,
    shops, or any other place. This advice applies to people of any age, including
    teens and younger adults. Children should not have in-person playdates while
    school is out.
  • Work from home when possible.
  • If possible, avoid using any kind
    of public transportation, ridesharing, or taxis.
  • If you are a student or parent,
    talk to your school about options for digital/distance learning.

Staying connected while staying apart!

Even though we can’t connect in person, it is important to
maintain contact with friends, families and loved ones. Here are some ways to
do so:
  • Phone Calls
  • Video chats
    • Zoom
    • Facetime
  • Social Media

Keeping yourself active and entertained!

Staying at home can grow to be boring, but it doesn’t have to be!

  • Exercise! 
    • Virtual classes
    • Your own home routine
    • Run/walk while maintaining social
      distancing
  • Read 
    • Books
    • Online magazines
    • Research a topic of your interest
      and learn more about it 
  • Cook 
    • Try new recipes 
    • Perfect old ones 
  • Organize 
    • Rearrange your furniture
    • Get an early start on spring
      cleaning 
    • Go through clothing and decide on
      what to keep, toss, or donate
If you still feel
that you are becoming stir crazy at home, try to create a routine to help
normalize your day. Set up a time to do any work from home, time to make calls
to friends, time to exercise, and time to relax.
Stay safe, active,
and healthy!
Blog post by Erin Womboldt.

Boston’s Postponed – Now What?!


The COVID-19 Pandemic has left many of us stuck in our tracks when
it comes to our spring marathon training. Being 1 month out from Boston,
several of you likely had long runs of close to 20-miles under your belt. I can
appreciate how disappointing this is for everyone, and wanted to give some
advice as to how you can make the best of the situation and go into your newly
(re)scheduled fall marathon with confidence and injury-free.
So how do you make this happen? Should you stop running for a
while because Boston postponed? Should you consider taking part in a new
fitness program? How do you avoid becoming injured in this process?
The new Boston Marathon date is September 14, 2020 and marathon
training programs typically being 12-20 weeks long depending on your “base”
mileage. This means that if you are planning running Boston at the new date,
your training could start as early as the end of April, or as late as the end
of June.
Regardless of your training start date, you’re going to want to
take a week or two off from running in order to give your body a proper break. In
a 2018 study, Wiewelhove
et al looked at various fatigue markers in individuals following a marathon.
What they found is that both massage and cold-water immersion (ice bath) helped
to reduce post-race fatigue markers quicker and more effectively than active
recovery (continuing training). This doesn’t mean that you have to stop
exercising completely. In fact, doing some light stretching and strengthening
is all OK, but I definitely recommend that you keep it light and use the time
to rest.
If you are a more experienced runner who is used to running
several races a year, you might not need to completely rest your legs, but
instead cut your mileage way back and add in more cross-training. If you are
more of a novice or intermediate running you are probably better off taking a
week or two (max) off completely and starting back at your base mileage for a
couple weeks prior to starting your formal training.
Here are some suggestions for some low-impact cross training that
you can do during your “rest” week:

You can also take this time to get really good at those exercises
that your Physical Therapist gave you way back when (hint hint).
If you have more specific questions pertaining to training and/or
injury prevention don’t hesitate to myself or another member of the CCR Run Team by emailing running@capecodrehab.com.
Blog
post by Tiffany Sadeck.
About
Tiffany Sadeck PT DPT OCS CSCS
Tiffany is a member of the Cape Cod Rehab
Running Team with a Doctor of Physical Therapy degree. She is also a Board
Certified Orthopedic Clinical Specialist and Certified Strength &
Conditioning Specialist with a long history of running which began her freshman
year of high school. A 3-season athlete, Tiffany was captain her junior
and senior year and went on to run Division 3 Cross Country and Track &
Field at Springfield College. She competed in events ranging from the
800-2 mile and high jump. Tiffany began running longer distances up to the
marathon and would like to help runners to help better times and meet goals
while preventing injuries and maintaining a fun, friendly training environment.
References
Wiewelhove T, Schneider
C, Döweling A, Hanakam F, Rasche C, Meyer T, et al. (2018) Effects of different
recovery strategies following a half-marathon on fatigue markers in
recreational runners. PLoS ONE 13(11): e0207313.
https://doi.org/10.1371/journal.pone.0207313