'Moving' Through COVID-19

During the COVID-19 pandemic, with the stay at home orders in place and gyms closed, I have seen many more people walking and running when I’ve been out running or on our family walks. It’s great to see people out doing the same thing and spending time together. Here are some tips that may be helpful.

1. Choose an appropriate shoe. Thanks to Lori Thomsen, MPT, PRC at The Hruska Clinic (the PT clinic started by Ron Hruska, founder of The Postural Restoration Institute), we have a list of shoes that meet specific criteria. We recommend shoes that have a solid heel counter (to allow for heel stability and the foot to supinate and pronate as it should during the gait cycle) and bend at the toe box and not in the middle of the shoe (to support your arch and allow proper push off). Here’s the Recommended Shoe List link.

   As you will see the list is organized by what type of arch you have (low, average or high). When you try on a shoe, it should feel comfortable right away. If you feel like you have to “break it in” it’s not your shoe. When walking in the shoe, you should be able to “sense” your heel, arch and big toe. In the ideal scenario, I (or your PT) would perform objective tests on your neck, shoulders/ribcage and hips/pelvis to determine the best shoe for your body. However, currently we are limited with social distancing. The best way for you to pick a shoe right now is by feel and comfort. We are fortunate to have Big River Running in St Louis making home deliveries. My current clients are ordering 2-3 pairs from the appropriate column and determining the best shoe by comfort when walking in them and then returning the ones that don’t work. Perhaps you have a local running store in your area that would be happy to have your business. If you need assistance to determine your arch type, I can do this remotely; please contact me: nancy@integrate360pt.com.

2. Swing your arms. When you are walking or running, it is very important that you swing your arms. Forward motion of your arms allows your trunk (ribcage and thorax) and therefore your pelvis to rotate and move as it should. I encourage my clients to see their fingers in their peripheral vision as they are walking. This will help ensure that your arms are moving forward. This will necessitate that you take your hands out of your pockets when you are walking. In addition, if you are walking your dog, consider a waist leash to free your hands allowing for arm swing.

3. Increase your distance gradually. There’s a tried and true 10% rule in running. It states that you should increase your distance by 10% each week. For example, if you are running 10 miles/week, you should increase to 11 miles the following week. This is to avoid overuse injuries. It’s tempting with being cooped up in the house and then going for a walk or run in the nice spring weather to not push yourself to go further when you are feeling good and strong. But don’t give in. Be smart and remember slow and steady wins the race!

4. Stay nourished, rested and hydrated. Eating healthy, consistent meals, being well rested, and staying hydrated are all essential to keeping your immune system strong! These three may be common knowledge, but during this pandemic, it’s especially important to eat nutritious meals throughout the day and also get 7-8 hours of sleep at night. Maybe not as known is maintaining adequate hydration. You should drink 1/2 to one ounce of water for every pound you weigh. So, if you weigh 150 lbs, you should drink 75-150 ounces of water per day. Of course, you will need more water if you are exercising and sweating more.

   Please keep moving! If you are working from home or staying home more, it’s difficult to get in as many steps during the day when you are not walking around the office, walking to and from public transit or running errands. You will have to make a conscious effort to get up from your desk and go out for a walk or run. But once you keep moving, you will feel better!

How To Breathe When Working Out And Running! Via Bodybuilding.com

Image from bodybuilding.com

There’s a great article on Bodybuilding.com entitled How To Breathe When Working Out And Running! I wanted to share it with you all it gives some great, concise information. I love how to emphasize the importance of breathing during every type of exercise. However, I wanted to give a little more information or my thoughts on some of the topics in the article.

First, most of our patients are not performing dead lifts, therefore, I DO NOT RECOMMEND using the valsalva maneuver at all. This is a tool that can be helpful as they described, but only during certain activities and only with proper training. I want to be sure that anyone who reads the article does not think it’s appropriate to performing the maneuver when lifting lighter loads like an overhead press, leg press, or something similar. As the author writes in the article, it is appropriate to exhale slowly through pursed lips during the lifting portion of those activities. 

Breathing out through pursed lips is a great technique as it creates more resistance to an exhale and effectively makes you work harder to breathe out. This sets you up to more effectively use your abs (specifically your internal obliques and transverse abdominis) when exhaling. When we exhale with these muscles, our diaphragm is in prime position to be utilized during the next inhalation. This leads to more effective inhalation, better oxygenation, and less overflow into our lower back and/or neck muscles to help us get air in quickly. 

Second, the author describes that as we exhale our ribcages shrink. This should be, but isn’t always, the case. Depending on what exercise we are doing and what position we are in, we may not allow our lower ribs in the front to fully collapse or drop down during an inhalation. When this is the case, our diaphragm is not in a good position for our next inhale and we will compensate to get air in. This can lead to shortness of breath, poor endurance, fatigue/pain at the neck or lower back, and other problems. 

When you position yourself in a supine position (lying on your back), try to keep your lower back as close to the floor as you can get it. Use your abs to pull your lower ribs toward the floor and flatten your back. Try to keep your lower back as close to the floor as possible during your activities WHILE BREATHING. If you are on a bench doing chest work, you may need to keep your feet up on the bench with you. If you need or choose to put them on the floor, be aware that it will be much more challenging to keep your abs engaged and your lower back in a safe position during your activity. Be sure to exhale through pursed lips and drop those ribs toward the floor/bench as you lift. 

Lastly, I love the idea of paced breathing with cardiovascular work. I simply want to mention that just because the author suggested breathing in for 3-4 stairs as well as out for 3-4 stairs does not mean that it is a good pace for your individual body. Because you are doing cardiovascular work, expect to be slightly short of breath during that activity, but please alter your pace if it feels like you are starved for air or that you’re panting. Also, recognize that your pace will change from day to day. If you go into your work out feeling well energized and motivated, you may notice that you are able to ascend/descend 4-5 stairs during a breath without much effort. However, you may feel sluggish at your next work out and notice that you are starving for air at 5 stairs. No problem! Slightly increase your pace of breathing so that you are comfortable again. Listen to your body and react accordingly. 

Just be sure that, no matter what you’re doing with only a few exceptions, never stop breathing and breathe at a rate that feels comfortable to you!

Written by Lesley Callaham, MPT, PRC on January 22, 2019

Shoes: The Right Pair Can Make All the Difference

{image credit Greatist}

Typically when we shoe shop we typically limit selection criteria to fit. But considering size alone is only looking at a portion of the issue. There's balance, positioning, support and a wide number of factors at play here that combine to create the ideal shoe for you. Use this handy fit guide & list of recommended shoes to find the right pair for your needs: Download the guide.