This week, Washingtonians rejoice as access to many of our favorite state lands open up for the first time after closing down due to precautions surrounding the Coronavirus pandemic. The collective glee is palpable as antsy recreationists, athletes and mountain-lovers return to the trails, waterways, and parks that they love.
Meanwhile my PT colleagues and I await the first wave of calls and e-mails from our beloved clients who may have gotten after it a little too hard after 6 weeks of a more sedentary “stay-home, stay-safe” lifestyle!
We want you to have a smooth re-entry so that you can get back out there into the places you love. Here are a few of our tips to promote the health of body, mind, soul and community.
1. Ease in gradually
Quarantine life has looked different for everyone. For some people, there has been more free time than ever and a drive to channel that pent-up energy into running, biking or at-home workouts. For others, the juggling of work-from-home and home-schooling or facing decreased access to gyms, outdoor spaces and classes has meant that recent life has been less active than usual. The important thing to remember is that our bodies are dynamic systems that respond to the loads that are put on them over time.
As we use our musculoskeletal system, changes happen in response to the demands placed on different structures: muscles grow, tendons get stronger, connective tissue gets blood flow to improve pliability. As much as we wish we could bypass it, the opposite is also true. Our bodies are designed to conserve energy and resources by not reducing muscle tissue that isn’t being used. This process happens pretty quickly, so even a 1-2 week break from the usual loads can lead to noticeable changes. When we come back to activities, it’s important to acknowledge that these muscles and tendons will take time, repeated loading, and gradual increases to return to the level where you left off. This is normal and healthy! Being gentle with yourself at the start will help you avoid injuries and ultimately get back to firing on all cylinders faster and smoother.
A rule of thumb I like to follow: if you’ve been away from your activity for more than 4-6 weeks – come back to it at about 50-60% of your the level where you left off. Keep it shorter duration, ratchet down the intensity. See how you feel during the activity as well as afterwards. If you have no pain or problems, increase by ~10% each week (assuming you are doing the activity consistently), so that you work back towards your full capacity over about 6 weeks. If you experience problems as you progress, drop back to the last level where you were successful and spend another 1-2 weeks there before progressing again.
The rate of progression and time to return to “normal” will depend on a number of factors including your previous fitness or performance level, the amount and types of activities that you were able to maintain during the down-time, age, and individual variances in body-responses. Listen to your body and be smart!
It’s also good to recognize that the adaptations that our bodies make are specific to the demands that are being put on them. Some activities have cross-over, but some factors are very activity dependent. For example: if you’ve been spinning away on your stationary bike lately and want to get back into hiking or preparing for some backpacking or mountaineering objective – the biking will serve you well in terms of giving you a great base of cardiovascular endurance as well as building strength in your quads, glutes, and calves. The things that will be different and require adaptation time include more demand on the stability muscles in your core and outer hips, more eccentric loading – such as the way your quads work to control descents as you go downhill, and higher loading on the joints and tendons as you add pounding activities and weight in your pack.
2. Build endurance back first, then increase intensity
There are different approaches to training and no one-size-fits all approach for different training goals, but this is the advice I give my patients most often and recommend for the majority of people as the return after a break from their sport or activity. This will allow for repetitive, lower load demands to the system to help accomplish the goals of tissue remodeling while minimizing over-use injuries and strains.
For example: Backpackers should start building up hiking distance, then increase elevation, then increase load in their pack.
3. Allow more recovery time
Your muscle and tendon tissues need 48-72 hours to recover after being pushed into their “challenge zones”. It may feel surprising when you wake up sore the morning after an activity that usually felt well within your limits. When this happens stick to light-moderate activities for 2-3 days until soreness resolves. Support with good nutrition, hydration, and rest.
4. Be attentive to previous injuries or chronic problem-areas.
As you rebuild, this is not the time for the “no pain, no gain” motto! Be kind to your body, particularly if there are regions that may be a little more vulnerable. Discerning good pain from bad pain can be tricky. It is ok to work into normal muscle soreness, this usually feels pretty symmetrical side to side and recovers within three days. Pain should never be sharp, radiating, or long-lasting. If you feel a familiar-old pain, listen to it and ease off, give extra rest and a slower progression.
5. Know when to seek support
A few aches and pains are normal as you get ease back into an activity after a hiatus, but if problems come up and persist, it is often best to get help from a knowledgeable provider to help get you back on track quickly. We recommend contacting a PT if you have new pain that doesn’t resolve within 2 weeks or if your pain resolves when you take a break, but it comes back the next time you do the activity. If you have an acute injury, take appropriate steps with a provider, urgent care, or emergency department.
See more information here: https://www.unionpt.com/when-to-seek-care/.
During this time while we observe precautions around the Coronavirus pandemic many providers, including Union PT, are providing consultations via telemedicine as well as modified avenues for delivering in-person care.
6. Take care of each other!
Lastly, as you get back out there please be mindful of the health and safety of yourself, your fellow outdoors-lovers, and the surrounding regions. We are fortunate to have many wonderful organizations locally and nationally who have provided guidelines to consider as we return to the outdoors while caring for ourselves and our communities. We will make it through this together!
Resources for Responsible Recreating:
Washington DNR – Open Regions
The Mountaineers: How to Recreate Responsibly During COVID
https://www.mountaineers.org/blog/how-to-recreate-responsibly-during-covid
Evergreen Mountain Bike Alliance: Ten New Rules of the Trail
https://www.evergreenmtb.org/blog/10-new-rules-of-the-trail#
Washington Trails Association: Hiking in the Times of COVID
https://www.wta.org/go-outside/social-distancing-hiking-in-the-time-of-coronavirus
American Alpine Club: The Next Pitch : Practical Beta on Climbing in the COVID Era
https://americanalpineclub.org/news/2020/5/1/climbing-in-the-covid-era
Access Fund: Climbing During the Coronavirus Pandemic:
https://www.accessfund.org/open-gate-blog/climbing-during-the-coronavirus-pandemic
About the Author
Kristen Vaughan is a physical therapist at Union Physical Therapy in Seattle. She completed her doctoral degree at the University of Colorado. She specializes in treating outdoor athletes including skiers, bikers, runners, and climbers and is a co-founder of the online training program: Alpine Training Project. She also has a focus on treating individuals with vestibular disorders causing dizziness or balance issues. In her free time, she enjoys spending time in the mountains back-country skiing, mountain biking, kayaking and climbing peaks.
Union Physical Therapy
We are a private outpatient orthopedic clinic located in Seattle, in the Wallingford neighborhood. Our team of Physical Therapists with advance training and experience provide one to one care to help you meet your goals and get back out there.
We are currently offering tele-health visits to provide guidance and care from the comfort and safety of your home while stay-at-home orders are in effect. We are also seeing clients in the clinic for acute or time-sensitive needs that require in-person care.
Find out more at www.unionpt.com