After fourteen months of virtual only sessions, I am finally seeing clients in-person again. It's both a scary and exciting time. As we all struggle to return to some type of normalcy, it will be interesting to see which pandemic habits tick around and which ones get scrapped. What changes in your life are worth keeping? What things are you glad to see go?
One of the biggest changes during the pandemic for much of the world was the switch to teleworking. For me, this was in the form of virtual treatment sessions using Zoom, Facetime or some other video calling platform usually referred to as telehealth or telerehabilitation. It was a challenge at first but I learned a lot from the experience that I plan to integrate into my in-person sessions. Virtual sessions allowed me to spend more time working with my clients rather than working on them. I spent less time instructing them and more time communicating and educating which allowed for more personalization of their programs and, I believe, better adherence. The convenience and improved accessibility of care provided by telemedicine and telehealth means that it is here to stay. I am excited to continue offering the option to my clients.
I miss shaking hands. I have no idea if we will ever get back to the practice of a good old fashioned firm handshake but I will be glad to see the elbow bump and fist bump go. Please, please let them be gone. First of all, who thought of the elbow bump? Who thought that leaning in close enough to another person to touch elbows was a good idea during a pandemic? You're already within three feet of the person why not go ahead and give a hug? The fist bump is a better idea but I still can't help feeling a little silly doing it. I'm a touchy feely person so I won't pass on a bump but I look forward to a return to the shake.
Masks. Ugh. The most impressive feat during the whole pandemic was getting so many people to wear masks for prolonged periods. Considering how uncomfortable it is to wear a mask, I believe the relatively small number of people who refused to wear them is impressive. Masks are one of those things I wish we could say goodbye to but I know that we shouldn't. Despite their faults, masks are a useful tool to combat the spread of viruses that we should make sure sticks around as a socially accepted practice. If we all continued to utilize a mask when we have a fever or cough or if we have been exposed to someone with a virus, we could save so many lives from influenza, coronavirus or any future virus that will inevitably come our way.
We have inhaled and absorbed so much alcohol during the pandemic that I'm surprised we're not all walking around a little tipsy. The world has gone crazy with sanitizers and disinfectants trying to wipe away every virus known (and unknown) to man. We now know that COVID-19, like most viruses, is fairly fragile outside the body and does not survive long on surfaces. We do not need all of this disinfecting in our normal lives. Even before the pandemic, many healthcare workers like myself had developed allergies to disinfecting chemicals due to the normal usage in clinical settings. What do you think the ramifications will be from this current overuse? Sanitizers and disinfectants have their benefits ut let's not forget that simple soap is just as good, if not better, at killing the virus.
One thing is for sure. Just like other major world events, life as we know it will be forever changed post-pandemic. We still have a ways to go before we truly return to our new normal but now is the time to start figuring out what we want that normal to look like. We all will have a hand in shaping our future. Let's learn from the negative and hold onto the positive. Raise your glass of lemonade and toast to a future that is bright with opportunity.
Choosing Post-Exercise Recovery Techniques
Recently, I have had a number of discussions about the importance of recovery after activity. Recovery time is not just important for elite athletes. It is important for anyone who is challenging themselves with increased physical activity. Walking that extra half mile, playing one more set of tennis, adding one more pound to those hand weights, all of these can potentially lead to mild inflammation for which your body needs time to recover. Recent evidence has shown that the best way to recover from activity is with massage. Massage was the most effective method of reducing delayed onest muscles soreness and perceived fatigue. Compression garments and cold water immersion were also effective strategies in reducing these factors but to a lesser degree¹. In a separate study, evidence showed that, in particular, effleurage and kneading were the most beneficial types of massage for recovery as well as tapotement specifically for delayed onset muscles soreness². Self massage in the form of foam rollers and balls seem to be better suited for warm up to improve blood flow and range of motion with no evidence of benefit toward recovery beyond that of rest³. Percussion massage, in the form of the popular "massage gun", has also been shown to be beneficial for warm up but there is not enough evidence currently to know if it is helpful in recovery⁴. Its design to mimic tapotement could possibly mean some benefit in reduction of delayed onset muscle soreness but more studies are needed.
1) Dupuy O, Douzi W, Theurot D, Bosquet L and Dugué B (2018) An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Front. Physiol. 9:403. doi: 10.3389/fphys.2018.00403
2) Kerautret Y, Di Rienzo F, Eyssautier C and Guillot A (2020) Selective Effects of Manual Massage and Foam Rolling on Perceived Recovery and Performance: Current Knowledge and Future Directions Toward Robotic Massages. Front. Physiol. 11:598898. doi: 10.3389/fphys.2020.598898
3) Wiewelhove T, Döweling A, Schneider C, Hottenrott L, Meyer T, Kellmann M, Pfeiffer M and Ferrauti A (2019) A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Front. Physiol. 10:376. doi: 10.3389/fphys.2019.00376
4) Konrad A, Glashüttner C, Reiner MM, Bernsteiner D, Tilp M. The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles' Range of Motion and Performance. J Sports Sci Med. 2020 Nov 19;19(4):690-694. PMID: 33239942; PMCID: PMC7675623.
What else helps with recovery? Limiting the need for it. Lengthy recovery time is needed when you overwork your muscles and body. Increasing physical activity should be done slowly over time. The quicker the gain the longer the pain (and recovery time). So how do you know if you’re doing too much too soon? Ratings of perceived exertion is one way of determining how hard you are working during an activity and can give you limits that can prevent over doing it. It can be used with any activity you’re doing from walking to weightlifting and even housecleaning. Download the RPE scale and start putting it to good use. Check yourself before you wreck yourself!
Self massage of the lower leg to demonstrate massage techniques that help with activity recovery.