Our local restrictions have been eased slightly for certain groups but for those more vulnerable to Covid-19, time in the home will remain for many weeks yet. 

Below we discuss what can be done to keep strong and fit in the comfort of your own home.

As we get older it becomes more important to adapt our exercise and training routine to maintain our strength, fitness and well-being. From having an active lifestyle you may accumulate nagging injuries that never quite went away or joints that grumble from time to time. With proper management and the right advice, these issues can be overcome and need not hold you back. 

Our friend Peter Picot –who recently ‘climbed Everest’ on a ladder in his back garden to raise funds for the Salvation Army– showed that, despite injury, anything is possible with a little determination… and some good fortune! 

“I’ve had some big sports injuries over the years but have been lucky enough to come through relatively unscathed. I also think a positive mindset helps a little as well as the luck” 
– Peter Picot (64) 

Public health exercise guidelines remain the same for older adults– 150 minutes of moderate intensity exercise which includes incorporating 2 hours of balance practice per week (NHS). Balance practice can include dancing, balance exercises, Tai Chi, petanque, tennis… your imagination is the limit! 

Staying fit & strong comes with a range of benefits  

• Exercise improves quality of life in seniors (Oh et al., 2017) 
• Stronger muscles = better quality of life, this study (Yang et al., 2020) shows this association becomes stronger with age! 
• Exercising regularly will boost confidence in your physical abilities, opening up doors to new opportunities and challenges 
• Many different types of exercise help to prevent falling (Finnegan et al., 2019)– from Tai Chi to strengthening 
• Exercising may even help you live longer! (Kujala, 2018) 

Understanding that strength training is imperative to maintain muscle mass and prevent injury, and that when we get older we should focus on balance training, these two areas are a great place to start. 

We put together a short strength and balance sequence that you can try at home or print out & pass on to your relatives or neighbour who isn’t able to get out to their weekly Tai Chi class at the moment and could do with some guidance! This is a whole-body program designed for older people who aren’t accustomed to exercising regularly. 

Chair squats– challenge yourself, parents or grandparents to see who can do more of these in 15 seconds on Zoom! 

Chair lunges– great exercise to boost confidence in getting on and off the floor 

Calf raises– important muscles for walking, running & stair climbing 

Overhead touches– you can try these holding light weights 

Leg raises– great for thigh strength, try in bed if you struggle to get on or off the floor 

Bridges– strengthens your back and glutes, try in bed if you struggle to get on or off the floor 

Download the PDF of these exercises Exercises for strength balance seniors

Unfortunately as we get older and less balanced our risk of falling increases, which is why practising balance regularly is important. For those who are interested and would like to challenge themselves further; the Otago programme is a great evidence-based resource to improve balance, lower risk of falls, improve strength and reduce injury! (Cederbom et al., 2020)  

If you’re not already convinced that exercise is the way to stay happy and healthy in old age then check out [this routine] from the incredible Johanna Quaas who (at 94) is the world’s oldest competitive gymnast. 

 Johanna and Peter are extreme examples but the message is that it’s never too late to start exercising– start small with 5 minutes extra each day & build from there! 

If you have any questions or have an injury that is holding you back then please get in touch [here] get for help. 

Today’s Blog Post written by:

Fiona Robertson BSc (Hons) Physiotherapy, MCSP

With some time yet before we’re all heading back into the office we wanted to write this piece about the importance of work breaks, or what we are calling hourly ‘pits stops’. Yes, just like Formula 1!

We’re all getting used to our working from home strategies, you’ve made a plan [here] with goals in it, how are you getting on with them? While it can be difficult to see the bigger picture and keep on track when uncertainty still remains, what we can control is what we do in our day! 

It’s important to make a plan for your day– all you need to do is decide when & which breaks to take. Experts suggest one to two short breaks every hour to improve well-being, mood and energy levels– (UK Public Health) (WHO, Beddhu et al, 2015)

My plan includes a mixture of exercises I know I will benefit from immediately– by getting my heart rate up or changing position– and working towards my isolation goal of nailing handstands! 

Here’s my example of today’s break plan, it is on the side of my laptop screen to serve as a visual reminder… 

Here are some ideas of how to fit movement into your day… 

1- Start the day with a short yoga sequence 

2- Set a reminder alarm every hour to stand up and choose an option from our selector! This study showed that setting a reminder makes you much more likely to take a break (Cooley & Pedersen, 2014) 

3– Take a proper lunch break
Prepare a fresh lunch and spend an hour away from the screen, catch up with your family or housemate 

4– Walk around on phone calls
Walking increases metabolic rate, alertness and increases creativity! [Oppezzo & Schwartz, 2014] As a bonus it gives you a screen break 

5- Mid-afternoon have a posture break
This is often when we feel we are stiffening up- take ten minutes and work through these exercises [Fiona’s back stretches video] 

6- Doing a repetitive task that doesn’t require concentration?
Pop some catchy music on and have a dance in your chair at the same time! 

I hope this blog has given you some inspiration on how to incorporate movement into your day which will ultimately lead to helping you get #StrongerAtHome  

Disappointed there is no mention of KitKats in our take a break blog? Despite extensive ‘research’ I couldn’t find an answer as to how many burpees equal one KitKat in calories… But we have learned that if you get up and walk for 2 minutes this can help offset things.  But… for healthy ‘break food’ please check in with our good friends at True Food for nutritional ideas. 

Once again thanks for reading team!

Today’s Blog Post written by:

Fiona Robertson BSc (Hons) Physiotherapy, MCSP

No two pregnancies are the same and all women’s experiences are unique to them. A pregnancy during a pandemic may pose extra challenges. However, regardless of the ‘Pandemic Status’, all women who are pregnant deserve the time to keep themselves well, both physically and mentally. This is also of paramount importance for the short and long term well-being of the little human growing inside them.

Whilst I cannot share any personal experiences of having had a #pandemicpregnancy I can share some tips and exercises that have helped many women in the past, me included, and hopefully will help you.…

This video is an intro to a free mini course for all pregnant women, just click on the title to get to the course page.

#StrongerAtHome Pregnancy Special

found at the website www.restoreyou.health 

But for right now here are 5 tips on how to help your well-being during a pandemic.

1. Walk every day – even just for a breathe of fresh air

Walking has been proven again and again to be one of the best forms of exercise for everyone. Even if you are experiencing pelvic discomfort it can be helpful to do a short walk every day, this may only be 5 minutes. For women who are happy walking then ideally this should be a good 30 minutes 5x a week (p.s. this counts as your daily exercise! [see link]

2.Control stress and negative emotions

It is perfectly normal and perfectly acceptable to have times of feeling worried or even overwhelmed during your pregnancy but do not dwell on these. Stick to the present and practice your diaphragmatic breathing to breathe through any worries or stresses.

Talk to your baby about your hopes and dreams, share you happy thoughts and practice visualisation.

3.Do Your PELVIC FLOOR Exercises!!!!

Sorry, did I shout? Too right I shouted! Getting a good strong pelvic floor will likely stop you having incontinence of urine or vaginal prolapse during pregnancy; it will likely make your labour easier and even shorter; it will reduce your risk of having vaginal tears during labour and it will most certainly reduce your risk of having incontinence of urine (wee) or faeces (yes…poo!) after pregnancy.

If you cannot feel the squeeze and lift when you try to contract your pelvic floor, or you are not sure, then please do see your local Pelvic Floor Physiotherapist. Getting it right is vital and 50% of woman need some 1:1 support to help get it right so do not be afraid to ask your midwife for a referral to a physiotherapist specialising in Pelvic Health. In the UK you can check if they are Full Members of the Pelvic Obstetric & Gynaecological Chartered Society of Physiotherapy.

4. Take & plan mini-breaks

You may be feeling absolutely fantastic and be having the perfect pregnancy, in which case we are delighted for you. Many women however, do find that the day’s can start to feel a little longer and a little more fatiguing. Take a look at your day and your week; your jobs at work and at home and other commitments and see if you can break the day into smaller sections or take mini breaks. E.g. do little bits of housework every day rather than a 3 hour super blitz at the weekend.

Use the opportunity during transitions in activity to do some mindful movement. If you can, do something like the ‘Happy Mummy Morning Routine’ throughout your day (it doesn’t have to be just in the morning!).

This is a morning routine I used to do when I was pregnant, but would also follow these exercises at any given opportunity during my day (the benefits of working in a Physiotherapy Clinic where this kind of thing is acceptable!)

5. Join the FREE #StrongerAtHome Pregnancy Special Course

An information and exercise course for all stages of pregnancy. Share this link with any one you know who will benefit. There are video’s on how to do your pelvic floor exercises and how to practice mindful breathing, and the main website has useful information on other common pelvic related issues.

Please share this blog with pregnant women during this time. They all deserve that little extra support right now. Feel free to comment and put requests in for other information you would like to read about on this topic.

And of course, do not hesitate to contact us at Performance Physiotherapy Jersey if you need any individual advice.

Thanks for reading!

Blog post written by Alexandra Frankham 

MH Prac, PGCert & BSc (Hons) Physiotherapy, MCSP

Performance Physiotherapy Jersey

  In the face of a crisis humans exemplify an urgent biophilia (Tidball, 2012)

Would you like help finding Calm among the Chaos?

And have an extended quality life? Sounds good, does it not? 

Our life in lock-down is certainly different. There is fear, sadness, uncertainty and joy.

For some this is a time of chaotic busyness, trying to juggle the ‘home-school’ for the kids whilst trying to hold down a job or two. For others it is the immense stress of having lost a job and the not knowing when another one will come up. For those living alone it is the fear of the persistent silence of loneliness. And for those on the ‘front line’, working in care homes and hospitals, it is the stress of a battlefield, something any who has experienced this would hope no one else ever has to. But for all of us, at any time of life, there is struggle.

It is human nature to struggle and suffer

It is human nature to survive and thrive (Tidball, 2012)

So far in our #StrongerAtHome series we have focused on keeping the physical body limber and active, by understanding when [here], where [here] and how [here] to exercise. These are all very important for good mental and physical health. 

However the stresses and strains of living and working in a confined space, amongst any other number of other very real stressors currently, and for a prolonged period of time, can have a profound negative effect on our health, both mental and physical.  

The longer term negative medical impact of stress is well documented: cardiovascular problems such as high blood pressure, stroke, sexual dysfunction, gastrointestinal dysfunction and immune dysregulation leading to chronic diseases (Dhabhar et al., 2014).

So bearing this in mind, noticing how your body feels and learning how to reduce a fight or flight response is not just a good idea, but essential for living a long and healthy life [fascinating meta-analysis on telomere length in folk who meditate]. There are some very helpful and scientifically robust techniques, methods and apps out there to help and I have listed some useful resources and local professionals at the bottom of the blog for further information. But you have to actually do them for them to be effective!

The first prompt to gain a sense of mental and physical calm is to go back to your plan.

Make sure you plan in time for relaxation and equally importantly for an appropriate amount of sleep, actually diarize when you are going to go to bed, when you are going to sleep and when you are going to get up (make it 8 hours, no less than 7 and no more than 9). Chances are if it doesn’t get written down then something else will take precedent and you will have another late night. Sleep is critical, it is when we process, restore and heal. Sustained lack of sleep can get us in a real pickle, and we don’t need that right now.

A good way to help you to relax before sleep is to do a whole body visualisation relaxation. Have a lie down on a comfortable mat or bed and play.

The second prompt is to practice mindfulness.

Mindfulness is accessible to all of us, at any point in our day. It is simply the ability to be present, to notice one’s body, state of mind, surroundings, tastes, smells and sights.  

The third, and arguably most essential, is to practice a form of meditation.

Research has proven immediate and long term benefit in reduced anxiety and depression as well as objective reduction in biological stress hormone cortisol and positive changes in brain imaging in functional MRI studies in (Avenutti et al., 2020; Rosencranz et al., 2016; Creswell et al., 2014).

Meditation is an opportunity to sit with the mind, the breathe and suspend our judgment of our-self and others. My personal journey to meditation is in another blog, feel free to read it [here].

A good way to start to practice meditation is through the breathe and with a mantra. A mantra is a nondescript word / sound so that your mind does not apply memory or thought specific to the sound. Focusing on the breathe can help bring the mind back when it wanders off.  So how should we breathe?

Breathe…

Diaphragmatic tidal breathing has been shown to improve the function of both the autonomic and the central nervous system.

This means that your whole body will work better and you will be more relaxed.

Click [here on this link] for further direction and watch the video for how to practice this technique.

Now your breathing pattern is calm and relaxed you can focus on the meditation, here is a useful start…

Meditation Basics

1. You can start by sitting comfortably, with your feet grounded on the floor, your back and maybe even your head and neck supported. If you really want to, you can sit in classic lotus position, but if you are not used to this position or if you have a stiff body then sitting on a chair or sofa is just perfect. 
2. Notice your legs and feel your feet heavy on the floor. 
3. Rest your arms and hands on your legs or wherever feels comfortable. 
4. Soften your gaze or close your eyes. 
5. Bring your attention to your breathe. Feel the air drawing in through your nose, into your chest and abdomen and then feel a pause before the air disappears out of your nose or mouth. As we slow and deepen our breathe, our heart rate and pulse slows too, this stimulates a physiological relaxation of the autonomic nervous system.  
6. Just sit breathe and notice the breathe. If you have a mantra, you can repeat this sound in your head. 
7. Your mind will likely wander to other thoughts, and this is ok. When you notice this, just bring your thoughts back to your breathe or your mantra. Sometimes this is easier than others to do, be kind to yourself and do not judge yourself or your thoughts. 
8. When your time is up, gently open your eyes or lift your gaze.
9. Feel your feet again on the floor. Notice your environment, the sounds, the light, the smell. Notice how you feel, your mind and your body.  
10. Ideally you will sit for 20 minutes, but even stealing 3 minutes in a busy day will help. I always set my alarm, in case I fall asleep!

You are now ready for a productive day or for a restful nights sleep, set an intention and off you go! 

Blog post written by Alexandra Frankham (MHPrac Phys, PG Cert Acup, PG Cert, BSc Hons, HCPC, CSP)

Useful Links to help with meditation and mindfulness.

Local Practitioners

Dan Ireland , Val Murray 

Phone App’s 

Calm App, Head Space app

Resources

Jersey International Mindfulness centre

Jersey talking therapies

Types of exercise 

During this lockdown we have the ability, like never before, to be flexible with when we add exercise, See our initial stage of making a plan [here] where we talk about goal setting. If you’ve set any goals then be sure to share them with us! 

We all know that exercise is good for us and helps us to stay healthy by improving heart health, reducing risk of cancers, controlling inflammation and improving immune system strength, but what to choose? (Nystoriak & Bhatnagar, 2018)

Public health experts tell us that we should be doing at least 150 minutes of moderate intensity exercise per week though it can be tricky to decide which exercise to start with and where to go from there [ref NHS] 

This blog will break down the main three types of exercise to help you decide what to fit into your weekly routine. 

Cardio 

Cardiovascular exercise is anything which makes you breathe faster & feel warmer, this can include jogging, cycling, dancing around the kitchen, gentle yoga or hoovering. 

During this lockdown you might be trying to start running, maybe you have a dream of doing Park Run or running a 10km race? A great place to start is by following a couch to 5km program. We love the Public Health England couch to 5km plan [here] which is downloadable on to your phone. 

Running not your thing? It’s not for everyone– the impact can sometimes be too much for troublesome knees or ankles, try getting out for a low impact cycle or sea swim instead! If you’re sea swimming then make sure you check the tide and go with someone who can help out if you need it as there is no lifeguard service right now. Here is Fiona, one of our physiotherapists enjoying the recent good weather and trying all three! 

Need to stay in the house? No problem- Joe Wicks has you covered with his daily ‘PE lessons’ that are definitely not just for kids! Or try a gentle yoga sequence– we love the Down Dog yoga app which is free and offers endless customisable yoga routines which you can do anywhere

Strength 

Strength training is paramount for maintaining muscle mass, bone health, improving tendon pain and preventing injury. If you don’t have a set of weights then that’s okay– just refer to [our post] on makeshift exercise equipment and see what you can find from around the house. 

How do I know what a strength exercise is?  

If you struggle to repeat it more than 8 times then you’ll get stronger by doing it! Just take an exercise, complete it up to 10 times, take a short break then repeat this 3-4 times. 

Try out our speedy full body circuit 

The first time you complete a strength circuit you might feel a bit achey the next day, which is called DOMS (delayed onset muscle soreness) this is normal and it won’t be as bad the next time– we promise! 

All you need to do is two strength circuits per week and you’re already preventing injury. It will take around 12 weeks for your tissues to adapt and get stronger but you’ll feel stronger, fitter and more coordinated long before this. We may be in some semblance of lockdown for a few months so it’s the perfect time to set strength goals, whether that is to get stronger legs to help your knee pain or build rock hard abs to help you pop up surfing!  

Some simple things to remember when resistance training that will help you to not injure yourself are… 

• Make sure you’re not swinging the weight, you should be able to pause the movement at any time 
• Take it slow– performing an exercise slowly is what takes it from being too easy to challenging enough, and make you Stronger at Home! 
• Remember to breathe!
   

Mobility 

Hate stretching? Feel like you should do it more often but can’t find the motivation?  

The good news is that we don’t rate stretching for preventing injuries!! We much prefer lengthening exercises called eccentrics to increase muscle length and strength within that range (Hody et al. 2019)

We’re not saying that you shouldn’t work on your mobility- you can choose to if you like but don’t feel like you have to in order to prevent injury. 

You might set a goal for lockdown like being able to touch your toes, put your socks on or something more ambitious like being able to do the splits! 

Check out our video for some great examples of exercises you can do instead of stretching which increase muscle length in the legs and get you strong in that range. 

Love stretching? Great- there’s no problem with it & you’ve very unlikely to hurt yourself doing it so crack on! 

We hope all of the above can get started on your journey to being #StrongerATHome !! 

If you feel you’re being held back from exercising right NOW by an injury, please book online for a Video Consultation with us [here], so we can keep you healthy and in top form!

Thanks for reading!

Blog post written by Fiona Robertson 

BSc (Hons) Physiotherapy, MCSP

Performance Physiotherapy

kit1 [ kit ]
noun
a set or collection of tools, supplies, etc., for a specific purpose

In this case, the above specific purpose is… to get #StrongerATHome

We hope you all read out previous ‘Stronger At Home’ instalments, and have made a plan, and also set the scene in your home. Now it’s time to tune up and prep what you might need in your home workout kit bag.

We can all do body weight exercise, it works, we get results, BUT, adding resistance can have HUGE extra benefits.

Studies have shown that resistance training can help promote bone health, decrease pain in conditions such as osteoarthritis, low back pain and tendon pain, improve balance, improve blood circulation and many other fantastic benefits (Kristensen et al. 2012).

It has also been shown that we don’t need gym style equipment to have these benefits, with a recent study showing that low-cost resistance tubing is equally effective when compared with conventional weight machines (Lima et al. 2018) .

Below, Paul shows how simple around the house items can replace weights, and the rewards available once completed!

In an ideal world, and where possible we aim for that ideal world, we would recommend the following.

1. Dumbbells between 2 kg and 10 KG
2. Kettle bell somewhere between 5-15 KG
3. Yoga mat
4. Resistance bands
5. Massage ball
6. Foam roller

Home workout equipment

Let’s say you don’t have any of these, can’t order any, don’t want to order any? No worries.Your list could look like this.

1. Bottles of water/wine, bricks
2. Basket filled up with heavy items or backpack
3. Towel on the floor
4. Old innertube from bike
5. Tennis ball
6. Rolled up towel

Alternative home workout equipment

You’ll be amazed what you can find around the house which can be used as simple resistance tools.

Now you’ve got your home workout kit set, standby for some great routines in our upcoming blog posts.

In our last blog post ‘Make a Plan’ we discussed the importance of organising our diary to include allocating blocks of time to both exercise and relax.

Today we are ‘Setting the Scene’ for both work, and play, within your house! This is both with your workstation and a chosen area for exercise within your house.

Of course exercise outside is required, however this is weather permitting, and at the moment, for good reason, we are restricted to outdoor exercise once a day!

The Home Workout area

It’s important to decide on an area that you will choose and return to for daily exercise. Often this will be as simple as moving some furniture to create space in the middle of your lounge – see Alex’s morning routine area below.

Or you can choose to designate a corner of your bedroom or spare room to lay out some equipment (More to come on what equipment is best for home workouts in another post)

 Home work-out area

The Home Workstation

When it comes to your homework station you may feel that you can get away with a laptop on the sofa or sitting with a dining chair at the table. You can get away with this …. but only for a small amount of time! We have come across a number of people who have developed neck and back pain doing this. Remember that now you are working your full work day at home and a good set up will help reduce the likelihood of you getting some of these problems. Our advice is to formalise this area as much as possible. This may mean ordering in certain equipment, extra monitors, office chair, external keyboard to get the best possible set up. Likewise, you can simply convert your laptop by adding a keyboard and raising this toward eye level using books.

As a general rule you are aiming to be looking near the top of your screen with your elbows around 90° to your shoulders and at the level of your table. Your hips and knees should be at 90° to each other and to the floor with your feet flat on the floor.

In the seated photos, Alex looks like she is sitting up with a fairly straight back. This position is comfortable for her for a short while. After a little while it is likely that she will then ‘slump’ into her chair and be supported by the back of the chair. Both of these postures, upright and slumped, are perfectly fine – all for short amounts of time. The key to reducing aches and pains that are commonly associated with sitting at a computer work station is to vary your posture and position – there is no such thing as a perfect posture! This is where the makeshift kitchen stand-up desk comes in. The great thing about this is that Alex and I can still ‘home school’ the kids and work at the same time (Good luck to all the Mum’s and Dad’s out there juggling the same gig!)

 Desk-top set up 

              Makeshift kitchen stand-up desk

      Ergonomic laptop set up 

Over the past two weeks, since we have been doing online video consultations, we have found that people who have decided on areas within the house to work out and who have formalised their workstations have been well set up to avoid injury and improve general health. They are more relaxed and are certainly more in control of their situation. At a time when we have little external control it is vital to boost your internal control – making the time to make your environment organised, comfortable, and easy to foster good habits #StrongerATHome 

Now you’re all set and it’s time to go!

We would love to see your workout stations and workstations so please share your photos to our facebook page – let’s get imaginative!

We all know what we must do now – Stay at Home & Save Lives.

This simple task requires strength, commitment and patience.

At Performance Physiotherapy we want to make it our priority to help with your health and wellbeing at home. Our new series, ‘Stronger at home’, is directly aimed at this. As families with children, young people, parents and grandparents, we are all in this together.

To help with your physical and mental health and wellbeing, we are going to post a series of tips and videos that can be shared amongst family and friends so you ALL can stay ‘Stronger at Home’

Your first crucial step is to make a PLAN! Winston Churchill said ‘He who fails to plan is planning to fail’ which we cannot agree with more.

What do we mean by that?

If you haven’t done this already, try this tonight…Take out your diary or write down Monday to Sunday on a piece of paper. Now we want you to add 5 sessions of 30 mins of exercise a week, (British Medical Journal guidelines of 150 mins weekly), this can help in a multitude of ways and build the immune system, which is now and always very important.

We also want you to Include at least 3, 20-minute sessions of either meditation or a relaxing task such as music or reading. Now, you need to include the EXACT times you are going to do this and on which days. If you’ve got this far… you’re already halfway there! Make sure you tell as many people as you can about this so they can help hold you to it.

You can include some of these sessions with family such as bike riding, walking, online exercise sessions or weighted workouts. Likewise, it’s good to have a few sessions on your own so that you can challenge yourself and can be specific.

Watch this space as we will be regularly sharing tips, videos, resources as we extend our ‘Stronger at Home’ series.

And remember, no plans are set in stone. If something doesn’t work for you, you can adapt the plan and improve.

Good luck and have fun!

The Performance Physio Team