Guest blog by Dr Clare Fernandes
During lockdown, in general physical health comprises of exercise, diet and lifestyle, sleep and managing health conditions. Exercise is of particular importance as I think this has been impacted upon the most during the lockdown. There are two main benefits: (i) physical – most obvious and (ii) mental – the less obvious.
Outside of lockdown the message would be the same but it is easier to ignore. Our average step count is down by 50% by not commuting to work/around offices/by not leaving our houses as much as we might normally do by leading our normal life. The benefits of the passive exercise we do in our daily lives is not being realised.
The negative effects of not experiencing this passive activity in our daily routine is perhaps not a conscious consideration. The gyms/sport centres/boot camps are closed, and social distancing makes outside exercise hard. There is increased burden in maintaining physical wellbeing with current working patterns and heightened demands:
The physical benefits
Even stretching results in these benefits:
- Maintaining physical resilience: generally speaking, our body’s response to fight the virus is through our immune system. The immune system ranges from physical barriers such as the integrity of our skin to our antibodies: that adapt to and fight off infections.
- Better circulation: to get the blood and immune cells around the body to where it is needed for regeneration and repair, but also get cell waste products away from cells and eliminated from the body.
- Stronger bones and joints: helps keep the skeleton in optimum position by improving the posture resulting in fewer aches and pains and better balance.
- Cortisol regulation: helps to maintain essential functions and regulation.
- Weight regulation: maintaining a healthy weight means less work for lungs and heart when undertaking daily activities.
- Better sleep: sleep is important for restoration of the body – for cell repair to help maintain the integrity of our immune system and general health.
Mental health benefits
Research from previous epidemics has shown that quarantine can result in high levels of psychological distress.
- For control: to control what we can control is an important resilience technique.
- For resilience: exercise can be using in coping strategies when addressing mental health problems.
- For a ‘physiological feel good’: exercise releases endorphins, a natural chemical that makes us feel good.
- Reduced cortisol release: cortisol is a naturally occurring chemical that is released in the stress response and constitutes some of the symptoms experienced.
- Reduces mental fatigue.
- Improves sleep: better sleep reduces poor mental health and exacerbations of poor mental health.
- Exercise is part of the evidenced based treatment for depression and anxiety.
The government advice
You can exercise outdoors as often as you wish, for example walk, run, or cycle – following social distancing guidelines. You can also use outdoor sports courts or facilities, such as a tennis or basketball court – with members of your household or with one other person while staying two metres apart. Infection control measures still need to be followed when doing so:
- While you’re out, always keep at least two metres or more away from anyone outside of your household. This will stop the virus spreading.
- Wash your hands when you return home.
- If you’re self-isolating because you have symptoms, or someone in your household has them, or you're defined as extremely vulnerable on medical grounds, you shouldn't leave home but that doesn't mean you should stop moving. It's really important to use movement and activity as a way of breaking up your routine, but only if you feel well enough.
- If you’re unwell, use your energy to get better and don't try to be active. If you can get out of bed, then do so, but don't try to do too much.
- Finally, if you’re feeling better after having had the virus, return to your normal routine very gradually and make sure to have additional rest periods during and after exercise.
What constitutes exercise?
PHE advice is as follows:
- Adults should do some type of physical activity every day.
- Any type of activity is good for you.
- The more you do the better.
- Even 10 minutes at a time shows benefit.
- The ideal is 150 minutes a week of moderate exercise or 75 of vigorous exercise, or a mix.
- Strength and flexibility training should be undertaken at least twice a week.
- Moderate intensity activity: will raise your heart rate, and make you breathe faster and feel warmer. One way to tell if you're working at a moderate intensity level is if you can still talk, but not sing.
- Vigorous intensity activity: makes you breathe hard and fast. If you're working at this level, you will not be able to say more than a few words without pausing for breath.
Strength and flexibility exercises are also important, particularly for those who cannot do the above and particularly due to space constraints, social distancing and quarantine. Strength and flexibility exercises can be adapted from normal home activities which can be important for those short on time and needing to multitask to include to include exercise in their day but also can also be adapted to become intensive exercise. Perhaps what you don’t think of as exercise, but are strength exercises include:
- Carrying heavy shopping bags
- Yoga
- Tai Chi
- Pilates
- Lifting weights
- Working with resistance bands
- Doing exercises that use your own body weight, such as push-ups and sit-ups
- Heavy gardening, such as digging and shovelling
- Wheeling a wheelchair
- Lifting and carrying children
To get health benefits from strength exercises, you should do them to the point where you need a short rest before repeating the activity.
How should I go about this?
Start small. Choose for your circumstance: What will benefit you the most? What do you like to do? Make a plan: to help with keeping the effort you make sustainable. Adapt to the day/or your situation. For example, if you are feeling…
- Confined to the desk? Neck/back/shoulder exercises or desk exercises may be appropriate
- Stressed? Try yoga
- Sore? Try yoga/ Pilates
- Lazy? Perhaps sofa stretches
- Busy? Take a rain check or work some exercise into housework or childcare.
Download tips on how to keep going and a variety of online resources here.