Transcription:

Scott Webb (Host): Staying mentally and physically well is often a challenge, but perhaps especially so during COVID-19. Joining me today to help us all do that is Dr. Mark Cipriani, he is fellowship trained and Board Certified in Primary Care Sports Medicine, and an Orthopedic Physician at Summa Health. This is Healthy Vitals, a podcast from Summa Health, I'm Scott Webb. Okay. So thanks Dr. Cipriani for joining me today, we've got a lot to talk about here. Mainly want to get to talking about, you know, maintaining fitness and physical health during the pandemic. So let's just start here. What tips do you have for just overall fitness and physical health during these interesting times.

What are some tips for fitness and physical health?

Dr. Cipriani: The pandemic time when our time access to gyms, yoga studios, cycling groups, running groups, those types of things are limited depending on where we are in the country or the world. The best thing that we can do is just to stay active. And that is what we're going to talk about today. Different ways that we can maintain or even increase our physical fitness despite some of the limitations that we're seeing right now, based on our quarantined statuses or shelter in place orders, those types of things. So a lot of people are feeling maybe stuck at home. And then one of the most important things is that even if we're at home, we don't sit at home all day. So that may be as simple as, Hey, I'm going to set an alarm for once on the hour, every hour, I'm going to make sure I get up and I'm going to move around, do something. And it may just be that it may be stand up and walk around the house. Maybe not stopping at the refrigerator each time, but walking around and just getting those muscles moving, getting that blood pumping a little bit.

Now we can get a lot more specific with other things to try and keep moving, keep active, increase both our cardiovascular and muscle fitness. So there are a couple of things that I would think about with that, and it depends on your comfort level. So if you're just starting out, you don't have a prior exercise routine. We always want to make sure that we start low and go slow. As far as anytime we approach a new activity with regards to our physical and mental health as well. Things like body, weight exercises sounds pretty simple, right? I'm not going out. I'm not trying to set any personal bats for power lifting. I'm not trying to look like Arnold Schwarzenegger. I'm just going to do some body weight exercises. Well, what's really important about those is the mechanics of how we do things. And that's actually one of the main things that I want to focus on is that with all of these exercises that we might talk about, the mechanics become very important so that we don't set ourselves up for injury. A couple of things that I would think about exercise wise, as far as the body weight, body weight exercise is easy to do at home.

And we can do these in a couple of different variations that could be sets working towards a number of repetitions, and then doing that in succession. It could be doing exercises for a set period of time and then counting those reps to be able to compare and mark progress as we go. So a few kind simple things that we could be thinking about would even just be getting up out of the chair. So something that we refer to as sit to stand, and what you're going to want is a nice supportive chair, arms on the chair are okay. But if we can get up out of it without using our hands, that would be better. That's going to be more focused on the quads and on the gluts. And it's something that, while it sounds really simple, 30 seconds of repetitive sit to stands can be very tiring. So that's a good one to think about for A, I'm going to compare repetitions over time here and 30 seconds of sit to stands. How many can I do, or how many laps around the house can I do in 60 seconds? Those types of things that can give you a little bit of a marker for progression.

Other body weight exercises that we might consider are things like squats. And what's important about doing a squat is trying to make sure again, it's almost just the reverse. It's like we're sitting down into a chair. We want to make sure that our back is upright and that we're sitting backwards. We want our knees to stay in line with, but not cross our toes. And we don't want our knees to fall into the center or out to the sides. We want to try and keep everything in as nice aligned as we can. That's really going to isolate those quads and those glut muscles. Other things that we can think about would be a little bit more advanced things like planks and pushups. It's going to really focus on some of the core muscles and the back shoulders. So planks for those unfamiliar with that, is the term that's used, basically getting the body into a position of rigidity where you're down, either on your elbows and lying flat on the ground, lifting up the torso, onto getting up onto your toes and elbows.

And this can also be done up onto the hands. And then there are variations that can be considered one side versus another as more advanced exercises as well. We can consider more impactful activities. Things like lunges, things like jumping jacks even can be something to help get the heart rate moving a little bit more than just testing the muscles, but we can be creative with this as well. So even things like dancing, just getting up and cutting loose nobody's home to watch any moves you might be ashamed of, but it can be something that gets the heart rate going a little bit.

Host: Yeah, I think that's key, right? Getting the heart rate up. But you know, I think one of the concerns for people who aren't used to working out is how they should get started, what level they should get started at. Should they consult with their physicians beforehand? What are your recommendations on those things?

Should you consult with your physician before starting to work out?

Dr. Cipriani: I would recommend a discussion with your medical team, for anybody getting started with a new program, especially if you're having any type of chest pain with activities, any shortness of breath, dizziness, or lightheadedness, those would all be symptoms that to me say, Hey, we definitely need to talk to a physician before we get started. Now, if we start to develop those symptoms while we're working out, we want to stop that activity, take a rest, make sure that we're staying plenty hydrated. And I would consult with your medical team at that point before advancing the activities. Now musculoskeletal concerns can also limit our progression or our ability to participate in an exercise routine. And there are a few things to me that would say, Hey, we need to stop doing this activity. We want to touch base with somebody on the medical side of things before we keep going, symptoms that I would consider sort of warning signs or red flag symptoms, specifically with regards to joints and muscles.

Anytime anybody feels unable to bear weight through a joint, whether that's their foot, ankle, knee, hip, etcetera, for having difficulty putting weight through that lower extremity, that's something that we need to get checked out, sharp pain with an activity while we're doing a certain exercise. We want to try and back down from that and either reduce the weight or alter the mechanics of how we're doing that. If it persists something that we want to talk to the medical team about. Any mechanical symptoms within a joint. And what I mean by those are swelling instability, a feeling of walking, catching, that the joint just doesn't move freely or that it's getting stuck. I would again recommend complication with your medical team. And if there's something where you feel a pop and then have swelling or bruising afterwards, or any recurrent swelling of any joint, again, warrants evaluation with the medical team just to go over things and see, is there anything underlying here, any problems with the soft tissues, like the tendons or muscles or the joints themselves thinking about things like arthritis can certainly could be limitations on the musculoskeletal.

Host: So, I want to talk to you about mental wellness. You know, physical fitness certainly is an important thing, and you've given us some great suggestions and tips and things to be on the lookout for. But what are your thoughts about staying mentally well or mentally alert during a time that is, you know, confusing?

Is it important to be alert of your mental wellness during the pandemic?

Dr. Cipriani: Yeah, I think that the mental wellbeing component can't be understated. I think that that's so important. And I think that both have an integral role with each other, as far as both our physical and mental health. I mentioned apps that I personally use or am a fan of, recommend to my patients. There were a few that specifically started out as mental health and guided meditation mindfulness apps that have actually started to incorporate some exercise in with them as well. Those apps being specifically Headspace and Calm. And I believe those are available both on Apple and Android and they have some great guided meditations for those of us that think of meditation as this unattainable thing where, you know, Hey, I don't even know where to start. How do I meditate? You know, isn't that just is sitting cross legged on a pillow, and thinking about nothing? I'm not sure. So some of these apps can really help guide through mindfulness and being present, can guide us through some paced breathing exercises to really help with that idea of mental wellbeing, reducing stress and anxiety. Which again, I think plays an extremely important role, not only from a mental standpoint, but also physically. And then the flip side, the physical activity can help us feel better mentally as well. And there are some, like I referenced in the Headspace and Calm apps. They kind of incorporate both pieces and there are a lot of apps and programs that are starting to try and incorporate both of those.

Host: Yeah. Good to know. And great suggestions there for apps that are easy for people to get their hands on. And I know during this time I've been seeing a lot through social media and YouTube, a lot of people putting out yoga videos and meditation videos. I wanted to get your thoughts on that. For me, I look at yoga and think, boy, that looks really difficult to do that looks really painful. Maybe I'll feel better afterwards, but the act of doing yoga is just something that's hard to get my mind around. What are your thoughts about yoga?

Dr. Cipriani's thoughts about yoga

Dr. Cipriani: Yeah, I think yoga can be a great full body exercise. And that can be both from a mind standpoint, from a breathing standpoint, not only flexibility that we think about with yoga, but especially with muscle building as well. It requires a lot of strength to do some of these positions and we're not all going to start out and be able to do all of the most advanced poses. And that is okay. And we don't want to push to the point where we're having pain with every activity that we do or every pose we attempt to do. So you want it to go to a point where you start to feel a stretch and they start to feel a little bit of discomfort, but again, no sharp pain, no pains above the level of what I would call a three out of 10. Zero being no pain, 10 being an unimaginable amount of pain. So not pushing to the point where we're stressing those muscles and tendons soft tissues too far. But I do think there are a lot of things out there that are beginning to explore that more for people. There's another app that I'm familiar with. It was actually put together by Chris Hemsworth, an actor famous for the Thor role, it's called Centrs, C E N T R. And again, the idea of being strength, training, body, weight training, but he also incorporates through his team of fitness staff, mental wellbeing, even some dietary things, cooking recipes. I think it's a really well rounded app. It does require a subscription, but I believe he's had some free trials during this period for those who were interested.

Host: Definitely. And you mentioned there about diet and I wanted to talk about that, that we know during this time and you even referenced this, that, yeah, we want to get up and we want to move around the house, but maybe not end up in the kitchen. And I think a lot of us do, we kind of get up and we move around and then we find ourselves at the refrigerator or in the pantry. So maybe you could talk a little bit about just general dietary tips. What can we do during this time when we're home a lot and we're more sedentary, what can we do to keep an eye on eating right and calories and so forth?

What are some general dietary tips?

Dr. Cipriani: Calories in versus calories out is always an important discussion that we think about when we're talking about weight management, athletic training and, and physical activity. Now with specific regards to the dietary piece here, there's not necessarily one perfect diet that's right for everybody, whether it's weight loss or muscle gain. But what we want to be careful of is that we're not taking in excess or empty calories. So things like soda pops, candies, those kinds of things that can be very much a comfort food in a time that is stressful and uncertain. I would use that as, okay, Hey, a small treat. Okay, I'm going to have one candy and that's going to be my limit for the day, or I'm going to have one candy after I have done this as a small reward. Now, what I always recommend that as the positive reward, well, maybe not, but if we've got those out there with a sweet tooth, that can be something where, Hey, we just really want to make conscious effort to limit that consumption. I think one thing that can be helpful for people is to crack what are we eating? And just to have a notepad in the kitchen or next to the fridge, a whiteboard on the refrigerator and just making a note of, okay, at this time I had this, at this time I did this, and there are again, plenty of apps out there to help people with food tracking. My Fitness Pal by Underarmour is one that is routinely used by a lot of athletes that I see not only tracking their physical activity, but also tracking their calorie intake. Calorie King is another one that can be helpful for those who are trying to keep a food journal and understand what does their calorie consumption look like?

Host: So, Doctor, any specific resources there that you want to mention?

What are some specific resources? 

Dr. Cipriani: It is always an option to talk to your medical team. If you have specific concerns about your diet or weight, those kinds of things, and continuing to be active. One of the underutilized resources, I think that we have in our medical communities can sometimes be our dietician or nutritionist who can help us kind of go through things sometimes with a little bit of what I would call a fine tooth comb and say, okay, let's look at how we eat during the day. What do our meals look like? What are our snacks look like? And where can we make changes? Where can we choose for healthier options or changing our portion sizes, those types of things. So that's typically something that you would get a referral from for a discussion to meet with the nutrition team through typically your primary care provider, but most medical providers should be able to provide a referral such as that. And again, it's not to say that, you know, okay, Hey, we can't ever have suites or we can't ever have those things that you know, maybe serve as a little bit of a pick me up or as a guilty pleasure. I'm going to have a slice of cake for my birthday.

Of course, that's normal human nature. And there are days where yep, Hey, we're not going to be perfect. And that's okay. It's just about trying to monitor those trends. And is this something that becomes a regular treat as opposed to a special treat? And I think that that does play again into our physical and our mental health and all of this cycles back and forth just as we've been talking about. I wanted to give just another plug here for something that my wife and I have actually been doing during this time we have started, what's called the couch potato jar. We are trying to maintain our activity as best we can. We were working long hours. And sometimes it's yup, Hey, we want to just watch a show and just relax a little bit, but then Netflix or Hulu, whatever streaming content you're using, that turns one show into three. So what we try and do is we have a little bit of a toll. If we're going to watch TV, we're going to make sure that we've done something active prior to, so we have some exercise dice where you roll it. And it says, okay, you're going to do 15 reps of this or 30 seconds of this and then a second die. And it's okay, we're going to do pushups. We're going to do squats.

So, things like that, it doesn't have to be dice, could just be a piece of paper that you pull out of a bowl, but if we don't do that, okay, we're putting a little bit of a toll into what we call the couch potato jar. So it's just something to try and keep us motivated and serve as a reminder that, Hey, we want to make sure that while it's okay to relax and it's okay to sit, we do want to try and maintain our activity level as best we can when we're kind of stuck in the house here a little bit. One other pitch for somebody who is doing some really great activities that people can follow along with online, that doesn't require a subscription. Her name is LA Thoma, T H O M A. And she is a physical therapist out of Hollywood who is doing some exercises and really goes into the mechanics of how we should be doing these things correctly. And she has some longer, you know, hour long, high intensity training videos that will really get you going. But I think she has some great 10 minute stretches and some basic beginner exercises as well. And that can be a good starting place before we ramp up into some of these higher intensity activities.

Learn more about Summa Health

Host: Well, I love that the couch potato jar, that is awesome. What a great suggestion. And as you say these streaming services, they make it very easy for one show to become three. And we find ourselves sitting there for far longer than we intended. So why not, you know, mixing a little physical activity, have some fun with it and make a game of it. So Doctor you have given us some great suggestions today on how to stay physically and mentally well during this time, some great resources and apps and things like that. So really appreciate your time and you stay well, thank you. For more information or to book an appointment, to visit Summahealth.org. And if you've found this podcast helpful and informative, please share it on your social channels. Check out the full podcast library for topics of interest to you. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb stay well, and we'll talk again.