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Running tips: Stay healthy and avoid getting hurt

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The COVID-19 pandemic has changed daily routines for a lot of us. No longer do we leave the house to stop for coffee, drive the 40 minutes to work, or move about the office for meetings. While working from home has had many pros and cons, it has caused a lot of us to be less active throughout the day.

To make up for this lack of action and social time during the day, many people have turned to more intense workouts. Sales of remote fitness products, such as Peloton, Mirror, and Nordic Track, have boomed during the past year. Of all types of activity, running has seen a huge surge, with many people running to help their physical and mental health.

With more running comes more risk for injury. Before COVID-19, most of us had not prepared our muscles and joints to handle so much impact and mileage. Common running-related issues include shin splints, ankle sprains, plantar fasciitis, stress fractures, knee pain, and back pain. To avoid getting hurt, follow these tips:

  1. Maintain your shoes. Both miles and time affect your running shoes. Not only does the impact of running wear down your shoes, but the material of your shoes breaks down even if you’re not using them. We suggest you change your running shoes every 300 miles or every year, whichever comes first.
  2. Warm up and cool down. Going straight from the couch to a sprint is not a good idea. Try doing some light calf and quad stretching to loosen up your muscles. You can also start with a walk for the first few minutes, then ramp up to a jog, and then walk again at the end of your run. Warming up and cooling down protects your heart by making the change between resting and moving more gradual.
  3. Don’t tire yourself out too much. As you get tired, your form gets worse, which can cause injuries like sprained ankles. The “talk test” is one great way to measure if you’re overdoing it or not (i.e., would you be able to chat with a friend while running?) Another is the Karvonen heart rate formula, which can help keep you in a healthy heart rate zone during your exercise session.
  4. Avoid doing too many types of sports. Instead of jumping into hardcore circuits, biking, and running all at once, try sticking with one type of workout at first. Then, try adding in a second type once you have built up some strength. This will help you prep your body for the added stress of a new workout.
  5. Take days off. While many of us may want to come out of this year fitter than ever, working out every day can get you hurt. Take a break every other day, and make sure to take stock of how you’re feeling before you work out.
  6. When in doubt, seek someone out. If you have questions, don’t hesitate to reach out to a health care provider for guidance. Your routine may have changed a lot in 2020 and 2021, so it’s important to consult with an expert before you exercise. If there’s anything that COVID-19 has taught us, it’s that our health and safety should be top concerns.

Sean Kinsman

Sean Kinsman, PT, DPT, is the chief clinical officer at RecoveryOne. He is board-certified in orthopedics and has more than 15 years in clinical practice.

“Hurt” isn’t always “harm”

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Pain is hard on your body and your mind. It can limit the things you can do in daily life, which might make you angry, annoyed, anxious, or depressed. To treat pain, you may need to work not only on your physical health, but also on your mental health. Even though pain isn’t just “in your head,” most people find that using their minds to manage pain is key to getting better.

The first step to honing your mental skills is to be aware of the tie between emotions and pain. Just like pain has an effect on how you think, how you think has an effect on your pain. For one, when you expect something to hurt, it often hurts you more. You might also feel more intense pain when you are already upset.

Fear is one emotion that can have a strong effect on pain. If you feel pain when you move a certain way, you might fear that you are doing harm. Then, you can become more fearful of moving, which can cause you more pain. Soon enough, you’re afraid to move at all, even if it would be good for you!

If there’s one thing about the mind-body link that can help you recover, it’s learning to split “hurt” from “harm.” Feeling a little pain when you move doesn’t mean that you’re doing harm to yourself. Once you realize this, you can keep pushing forward with your recovery. The more you keep yourself on track, the less pain you should have… and the more relief you’ll feel that you’re getting back out there.

Sheri D. Pruitt

Sheri D. Pruitt, PhD, is a member of RecoveryOne's medical advisory board. She is a licensed clinical psychologist and behavioral science consultant.

Pacing yourself: How to keep moving when times are tough

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It’s common for humans to avoid things that make us feel bad, and pain is no different. When moving makes you feel pain, you might want to stop moving. The more you avoid movement, the more you’re afraid of it — and soon enough, you don’t want to move at all. This lack of activity can actually make your pain worse, reduce your muscle strength, and make it harder for you to do certain motions. Once you’re stuck in this cycle (fear of movement, avoiding movement, and worse pain), it can be hard to get out of it.

To prevent this cycle of pain and fear, you can try an approach called pacing. Pacing is the balance between movement and rest. When you pace yourself, you won’t overdo it when you’re feeling good and underdo it when you’re not feeling great. Here are some ways you can pace yourself in physical tasks you want to do:

  1. Break tasks into smaller parts, with rests in between.

Do your tasks with frequent rest breaks. In the long run, you will be able to get more things done if you don’t do too much at one time.

  1. Work at a slower, less intense pace.

Slower ways of movement, like walking instead of running, can keep you from overdoing it when you’re feeling good. Going slower doesn’t mean that you’re not working hard; rather, you’re taking better care of yourself.

  1. Switch tasks often.

Instead of doing the same task for long periods of time, switch it up. Get up from your desk after some time to give your neck, back, and arms a rest. Instead, try doing something that requires you to stand.

  1. Use different parts of your body throughout the day.

If you’ve been using one part of your body for a physical task, move to actions that use a different body part every once in a while. This will keep you from putting too much stress on one area.

Now that you’ve learned about pacing, take some time to reflect. Have you ever over- or underdone it with exercise? If so, how did that make you feel? How do you catch yourself doing too much or too little, and what will you do if it happens again? What are one or two ways you could try pacing this week?

While pacing might mean you adjust the way you move about, you can still feel good as you achieve things each day. You can apply these tactics to your chores, hobbies, and physical therapy exercises.

Sheri D. Pruitt

Sheri D. Pruitt, PhD, is a member of RecoveryOne's medical advisory board. She is a licensed clinical psychologist and behavioral science consultant.

Working from home: Tips for a safe at-home work environment

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In the Age of COVID-19, working remotely has become commonplace among office workers.  While it certainly comes with its perks – lack of a commute, flexible schedules, increased quality time with our families (questionable if this is a perk for some of us, I’m sure) – there are also some real risks to general health and wellness with our new normal. 

For many of us, our work life balance is blending together – a personal example: I am writing this blog at 12 AM because I can’t find a more productive time while balancing homeschooling, cooking, and meetings.  Behavioral disorders are on the rise as a result – the risks for increased stress, depression, insomnia have all increased during the pandemic. 

Weight gain is another common theme of this pandemic. A recent poll by WebMD found over 50% of respondents reporting gaining 1-5 lbs., with another 25% gaining 10 lbs or more.  Much of this weight gain can be tied to several factors: increased alcohol intake, stress eating, lack of activity.  Whatever the cause, the changes to our homelife is placing increased stress on our bodies in ways that could have long lasting effects. Added weight places greater strain on our heart and cardiovascular systems.  It makes it more difficult for us to fight off infections (particularly concerning given the current state of affairs) and can strain our muscles and joints, leading to greater risk for injury (low back and neck pain are most common).

To make matters worse, for many of us working from home comes the plight of poor ergonomics.  Pre-Covid, most of us had a decent office chair, a desk, and a workstation with a relatively good ergonomic set-up. Now many of us are working on the couch or at the kitchen table, slumped over our laptops for hours on end.  While short term, these postural abnormalities are fleeting, without the distraction of co-workers to chat with down the hall or the need to step into a meeting, we’re spending longer periods of time in those poor postural positions. This can cause major structural changes to our spinal alignment, and lead to long term pain and discomfort if left unchecked.

Here are some simple ways that you can minimize your risks:

  1. Set personal time on your work calendar
    You’re not likely to miss that work meeting, because most of us link greater importance to our work calendars than any personal one.  Place boundaries on your time, and sprinkle in some “You time” throughout the day
  2. Set reminders on your computer to get up and move around every 30 minutes
    It’s easy for us to lose track of time when we get involved.  With many of us working from home now from the couch or the kitchen table, our necks and back are at greater risk for injury.  Using your work computer to set audible reminders to get up and move every 30 minutes will reduce your risk of injury related to poor posture.
  3. Connect with your team
    Make sure to connect with your colleagues and friends. An easy way to do this is to build social time into your work meetings, where you talk about non work topics. Adding a face to the interaction can help overcome some of the isolation you may feel during this pandemic.
  4. Use household items to augment your workstation
    Sitting on a soft couch, try placing a baking sheet or tray under the cushion to provide more support.  Improve your sitting angle by rolling up a towel and placing it behind your lower back or under the edge of your bottom.  Mirror your laptop to the TV screen so you can maintain your neck in better alignment.  If you’re at the kitchen table, grab a chair with armrests and roll a towel behind your back.  Consider placing an extra cushion on top of the seat to raise you up to a more optimal sitting position and plugging in your laptop to an old computer monitor that is raised up to eye level to limit slouching.
  5. Take a walk
    You risk for covid is lowest during the day in open spaces. During one of your midday work breaks (see item 1 from above) get outside and take in the fresh air now that summer has arrived. It will help your mind and your heart!

Health Plans and Employers ‘Muscle Up’: Virtual Care Delivers Safe, Effective MSK Recovery

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During the COVID-19 global health emergency, people are avoiding hospitals and other health care facilities because they’re concerned about being exposed to the virus. In fact, a recent Sage Growth/Black Book research survey found that 33% of respondents feel unsafe going to their doctor’s office and 41% feel unsafe going to a hospital. While that reticence may help hospitals avoid being overwhelmed, it’s absolutely not helping the people who’ve chosen to delay getting the care they need. How big is the issue? A recent Morning Consult-American College of Emergency Physicians poll found that nearly a third (29%) of survey respondents said they had avoided or delayed seeking medical care due to concerns about contracting the virus.

Half of American adults (127 million people) are estimated to be living with musculoskeletal (MSK) disorders. For them, the impact of delaying or going without care is significant and includes:

  • Living with ongoing pain, which in turn has the potential to increase use of and reliance on opioid medications
  • An increase in dysfunction that results in an inability to perform daily activities or work
  • A progression of the disease’s severity that may increase the likelihood of surgery or permanent disability

Before the pandemic struck, people with MSK disorders could access care safely and fairly easily. But even pre-pandemic, there was a significant unmet need for this care. Insurers typically pay for a limited number of physical therapy visits. If the person’s condition hasn’t improved, he or she needs to get approval for another limited number of visits, which can be time-consuming and frustrating. In addition, completing even this limited course of therapy can be challenging for many people who need to take time off work or secure childcare and travel to the location where their therapy is provided.

“I think it’s fair to say that the advent of telehealth has been just completely accelerated… there’s absolutely no going back.”
– Seema Verma, CMS administrator

A better way, now and moving forward

For the foreseeable future as the pandemic continues without an approved vaccine, people need a safe new way to access MSK care. And even if the pandemic can be contained, not everyone will feel comfortable returning to health care facilities, especially those who are more vulnerable and at risk from the virus, like people over 65 and those with underlying chronic health conditions. There’s also likely to be a backlog of people in need of care, which may make it a lot more difficult to get an appointment with an orthopedist or physical therapist, further delaying access to care.

The solution, for both the current situation and the future, is making quality MSK care available on patients’ terms—safely, outside a health care facility, when and where it’s most convenient. Telehealth can provide that solution in both the short and long term.

CMS Administrator Seema Verma

CMS Administrator Seema Verma (courtesy of Wikimedia Commons)

The time is right for telehealth to expand its reach. Medicare has relaxed its guidelines on the type of telehealth services it covers and enhanced its coverage through the summer, and many commercial insurers are following suit. And it’s likely these coverage enhancements will continue in some form indefinitely. Even CMS administrator Seema Verma has gone on the record saying, “I think the genie’s out of the bottle on this one. I think it’s fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there’s absolutely no going back.”

Along with better coverage and reimbursement for telehealth, patients are also embracing virtual access to care. At the end of March, the Wall Street Journal reported a marked increase in telehealth visits by Medicare patients, from 100,000 per week to 300,000 per week. A Sage Growth/Black Book research survey also highlights patients’ growing desire for and acceptance of telehealth services. Of survey respondents, 48% are seeking more digital health solutions to manage their health and well-being and more than two-thirds (69%) of respondents want their provider to offer more telehealth visits as an alternative to office visits even after the pandemic ends.

But not all telehealth or digital solutions will deliver what people with MSK disorders truly need. Beyond ease of access from the safety of home, people need to receive care on an episode basis, not on a limited visit basis, so that they can receive care as long as it takes to recover. They need clinically validated assessments and recovery pathways, and access to personalized exercise plans overseen by physical therapists and coaches.

The good news is that RecoveryOne has already created this new model of care and is delivering on-demand, clinically validated MSK recovery care to people across the country. A growing number of insurers and employers are including this new resource in the benefits they offer, opening access for hundreds of thousands of those who will need this care long after the pandemic ends. After delivering millions of sessions, we’ve proven that this model can improve outcomes by up to 54%, reduce the need for surgery, lower costs for patients, payers, and employers—while earning a patient satisfaction rate of over 88%.

The essential role of health plans and employers in the safe delivery of care

But even as more health plans and employers make coverage for telehealth an integral part of their benefit offerings, there’s more work to be done to keep people safer during and after the height of the pandemic. They need to move from passively offering new virtual MSK solutions to taking proactive steps to identify and engage those who most need this care.

That means mining their own databases to identify those who’ve been pre-certified for MSK surgery, who have an existing MSK disorder that has gone untreated, and those prescribed opioid medications for pain related to MSK disorders. Plan administrators can connect these populations with virtual MSK services, helping them avoid unnecessary visits to healthcare facilities where they risk exposure to COVID-19.

Health plans and self-insured employers cannot afford to be passive, communicating the availability of telehealth coverage on a one and done basis. We all need to be proactive partners in the effort to keep people safer in this new world by encouraging the appropriate use of remote care.