Coming out of Lockdown

Tripti Gyan, Senior Physiotherapist in Occupational Health, shares her reflections of lockdown and provides helpful clinical advice for those affected by physical deconditioning.

Consider this scenario.

It is the start of 2020. You have been sticking to your New Year’s resolutions and making slow but steady progress in developing new strategies for healthy habits, and just starting to reap the rewards from all your concerted efforts. Yes, things had been going pretty well for a while there! But then something unexpected happened: a global lockdown amidst the Covid-19 pandemic.

Upheavals in the organisations that we work for changed our roles almost overnight. Some of us were made redundant, some were furloughed, whilst others needed to quickly adapt to new ways of working remotely, perhaps even with an increased workload. Gone was the daily commute to work and our social lives as we knew it, only to be replaced by disrupted day to day routines, with us trying to juggle all our families’ needs, and external activities now having to take place under one roof.

By anyone’s reckoning, it has been a very challenging year. Life happened to all of us. Loss of contact with family members, separation, fear, pain, depression, concerns, and worries. We must not be naive in thinking that our physical selves are somehow immune to the emotional and psychological shifts that we have gone/are going through.

 

I was doing so well, but now I’ve lost it.

 

On balance most of us would have succumbed to an overall level of decreased general physical activity as a result of being mostly at home during lockdown. Simply put, we have been moving far less than we used to when we were at work. When at home, we have reduced interaction with colleagues and reduced need for all the ‘incidental’ movement that usually occurs en route to work, and when we are at work.

Over the past weeks and months, this insidious reduction in regular and sometimes sustained general movement, depending upon what our job tasks were, would have resulted in physical deconditioning. In other words, our bodies would have gradually gotten accustomed to, and adapted to undergoing less physical activity. When we move less, our physical condition declines. As a result, we may feel as though we have lost ground in our overall fitness. As stated in his blog, Ash James mentions that this is potentially the most important factor regarding our physical health in the transition from daily working to staying at home during lockdown.

 

What is deconditioning?

Humans are bioplastic. That means we respond to what we do with our bodies. Usually, our body responds positively to regular movement and exercise. When engaging in such activities, we get fitter and stronger, and our mental and physical health improves. When we stop being active, our physical condition declines. Tasks that we had mastered (both in and out of work) may now seem more difficult to carry out than we previously remember. This is known as “deconditioning”. Deconditioning can happen very quickly. In fact, some studies show that significant decline in muscle mass, physical function, strength, aerobic capacity and metabolic function can occur in as little as ten days of inactivity. So many people go through this experience, causing them to feel as though all their progress in maintaining good habits and fitness levels have been lost.

 

So how does “deconditioning” present?

Unsurprisingly, one of the first signs you would notice is that some niggles that you had previously been able to keep on top of have crept back in – a grumbly hip and sore knee have started to complain again. You might experience the occasional episode of lower back pain, not to mention the building up of muscle tension at the back of the neck and shoulders with some joint stiffness creeping back in, perhaps due to working sat on the sofa or at the kitchen table, wherever you could carve out some “office” space!

It is also worth remembering that our postural and muscle control can fluctuate in response to our emotional experiences. This is unique to everyone. During the period of lockdown, which can for some be very stressful, we may have lost some of our movement fluency which contributes to making us perhaps feel physically inhibited and disconnected.

 

The first thing to acknowledge is that not all has been lost.

 

As is the first rule of technology when something does not work- we just need a reboot! Whilst deconditioning can be rapid, reconditioning the body is slower. Whilst the information and experiences of our previous physical activities have not entirely disappeared, upon returning to work or to the gym we might feel like our muscles are “tighter” and that we are breathing more heavily. We may also feel that our joints are stiffer, or that we reach our pain threshold well before we were previously used to. These are all normal signs that should improve after a few workouts or over a few weeks. With time, effort and repetition, our fitness levels shall return.

 

Looking at life through a new lens with renewed focus.

 

As we ease back into “the new normal”, consider how will this affect you?

Coming out of lockdown presents us with the ideal opportunity to make our wellness a priority by focusing on re-establishing healthy habits as part of our daily routine. Setting realistic goals gives your body time to adjust. It is wise to acknowledge everything happening in your life, tempered with a realistic view of your current condition, and not the memory of your physical ability three months ago. It is worth noting that physical responses to new and unaccustomed exercise are influenced by a range of factors. Poor sleep, stress, nutrition, alcohol intake, our history of exercise and many other factors can affect our body’s response to physical demands and may increase the risk of injury.

 

Gaining and maintaining new habits

Looking after your health and wellbeing involves checking in with yourself. Your main responsibility/asset/liability is your body – the permanent address where you live. What you eat, what you do to keep fit, how you manage stress and how much rest you allow yourself will ultimately play a role in how your body responds. By monitoring how you feel, this allows you to recognise and thus modify exercise and workloads.

Repetition and a steady increase in intensity helps to prevent you from overdoing it. Remember that returning to your previous fitness levels will take time, consistent effort and pacing, against the backdrop of good nutrition, rest and sleep. Take the opportunity to add movement to each day.

Continue to be fit and to take care of yourself. Remember that this has been a difficult time for all of us, so let us continue to be kind and supportive to ourselves and each other.

Find out more about how you can help to re-establish healthy habits relating to sleep health, alcohol intake, healthier food choices and many other factors relating to your wellbeing by taking a look at our dedicated patient resources on healthy lifestyle advice here.