Keep Exercising During this Pandemic
I have wanted to try my hand at blogging and spreading information that I feel is important for people to know about exercise and medicine, however, when I wanted to start, a freaking pandemic decided to hit the nation and world. How’s that for luck… But as a quick introduction of myself, I am Dr. Christopher Ketter. I am a primary care and sports medicine physician working in central Iowa. I am an Osteopathic physician and trained at an Osteopathic Medical School in Parker, Colorado. I went to residency in Des Moines for Family Medicine, and then completed a Fellowship in Sports Medicine in Southern Illinois. As you can read from that, I am not a professional writer, so please forgive me for errors in grammar…
We all find ourselves in an interesting time with the Covid-19 pandemic causing us all to stay home and not go out. While this helps ‘flatten the curve’ and prevent rampant spread of the disease through close contact, it doesn’t help our exercise routines and limits activity levels. Many will find this time difficult to navigate and find themselves binge watching on streaming platforms daily and switching from one social media app to the next (but as a side note—have you watched “Tiger King” yet?).
We are learning things about Covid-19 every day, yet there is still much we don’t know about it or at least to not make public because the research hasn’t been proven to an acceptable level. One thing that has been consistent is that severe cases seem to be more likely in people with ‘co-morbid conditions’, which are pre-existing medical conditions such as Kidney disease, heart disease, COPD, etc. Now if you happen to be one of the people out there who does not have one of these conditions, the best thing you can do at this time is to ensure you optimize your fitness level prevent developing them. For those who do have these conditions, the best thing to do is ensure you are optimizing your health to its maximum potential to limit the impact should you contract Covid-19. One great way to do this is through exercise.
Now exercise will not prevent you from contracting this Sars-Cov-2 virus that causes Covid-19. It has proven to be quite infectious and not something to underestimate. However, exercise does boost and maintain the immune system and improve many of those ‘co-morbid conditions’, and there is good research to help back that up. So, while you may not be 100% protected from the disease, you may be better protected if your immune system is operating at its best ability. Genetics will play a role in this, and there are people with deficiencies in their immune system which won’t get as much benefit, but most people will have substantial benefit with exercise.
Regarding the research about exercise and immunity, there are studies that suggest that regular exercise boosts immune function by improving number and function of T-cells and B-cells in the body, which are the main players in fighting infection. This comes at what are considered mild-to-moderate levels of exercise. Your typical exercise class at the gym you may have prior to their closing. A brisk walk or run has also shown to be efficacious (while keeping social distancing!). Whatever gets your heart rate up into the aerobic zone. There are several fitness and heart rate trackers out there now you can use. If that isn’t your cup of tea, then you can go off the ‘perceived exertion scale’ where you rate how hard you feel you are work from 0 (sitting and doing nothing) to 10 (About to pass out from extreme exercise). For good aerobic exercise, you should probably shoot for the 6-7 range on the exertion scale.
The same research did show that ‘over-exerting’ yourself was detrimental to your immune system, though this was in more endurance athletes at long periods of time, participating in hours of exercise at a time. Those and those people that did not rest well enough in between their exercise, were found to have a drop in immune function and become more susceptible to infection. The morale of the story is: Exercise helps but primarily at moderate exertion and with proper rest and nutrition.
Exercise has many other benefits: it can improve respiratory function, it can improve blood pressure, help get diabetes easier to control, and again possibly improve immune function. So many of the things that are found cause more severe cases, exercising regularly could improve and may help. Now this doesn’t mean being physically fit makes you invincible. There is still a chance a health person can contract Covid and have a severe case. But, I’d say other than the social distancing, hand hygiene, and proper Person Protective Equipment (PPE), exercise is an additional tool to maximize our bodies own protection.
“Okay, that’s great… But how?” We are cooped up in many spots throughout the United States. Maybe locally you can go out and start up a run or jog. But how far should you go? What about people that aren’t allowed outside? Many might only be allowed outside to get groceries or essentials. Some may have kids to care for or things to do around the house. AND, when this eventually passes and we’re allowed to return to normal, my least favorite excuse always seems to come up, “I just don’t have time”. Let’s talk about these.
How Far should I run, or what should I do?
Short answer… It doesn’t matter! Running, walking, slogging (slow-jogging), the distance doesn’t matter at all. Time is the only thing that matters. The recommendation is to get your heart rate up, for about 30-60 minutes in a day, and a total of 150 minutes in a week. This has shown to help with chronic disease management and help with weight loss and overall fitness. That may mean you run or walk for 30 minutes but only go 1.5 miles. No, you didn’t make it through a 5k and that is okay. Distance will come over time, as your body gets used to the exercise and as you train. You can run 30 minutes every time and get a different distance every time. If you hate running, you can cycle, or you can get your heart rate up by doing body weight exercises and even those chores around the house. The point is just to get your heart rate up for the recommended time.
Having to take care of children at home or another family member
Great, they need to exercise and run around too. That’s and important part of growing up and development. Incorporate them if you can in the exercise. Stay on your property and get in the backyard and play tag or something. If it is an infant, you can CAREFULLY use them as weight resistance as you walk around. A baby Bjorn can act as a weighted vest. Holding a baby or children for long periods of time will get anyone’s heart rate up. I tend to think I am in shape and I couldn’t do that for longer than 30 minutes without resting.
Whether you include your children or use exercise as ‘alone time’, you can’t take care of someone else if you aren’t taking care of yourself. There is always a breaking point. Make time to care for yourself to make sure you can care for others.
Stuck at home and can’t go out
There are plenty of home workouts that require no equipment, only a clear place to be able to move and not hit things around you and make sure things will not fall of you. Could you image if you knocked the TV over?! That would only make a bad situation worse (no Tiger King?)… Anyway, there are plenty of workouts on the internet for free. And right now, local gyms are going on to social media platforms to get workouts out to people that would normally go into the gym but can’t. If you were a member at a gym and they closed, check their website/social media page. They may be offering something free for home workouts. Personally, my gym started a whole app to workout at home doing bodyweight exercises. As someone that normally likes to push weights around, it is an ego hit that these actually do a great job getting my heart rate up and burn calories. The content is there if you look for it. You can also make up your own workout, anything that gets your heart rate up. Whatever gets you moving!
I don’t have time, especially after this is all over.
To bust out an old term that has become more popular lately, Malarkey! If something is important to you, which exercise should be I would argue, you can always find time for it. If you find yourself watching television to unwind, do something during the commercial break (be it cable TV or streaming if you haven’t paid for the premium packages).. The best part about the guidelines for exercises and that you don’t have to get the 30-60 minutes a day in one chunk. It is cumulative throughout the day, but they do recommend getting in 10-15 minute bites. Almost everyone has 10 or 15 minutes points throughout the day that they can incorporate activity. You can fit in exercise, you just need to get creative at times.
Exercise and activity can really be the best medicine. Not only can it help the above listed diseases, but can also help with anxiety and depression as well, but let’s be honest, all of us are feeling some form for that right now. Why not do something that can help you and improve mood? In my experience as a physician, my job managing disease would be much easier if people exercised more.
As a disclaimer, always make sure that when you exercise, you don’t have any chest pain or shortness or breath, or you will need to see your physician to be cleared to exercise. In GENERAL though, moderate intensity exercise is considered safe and encouraged. But if you have any concern consult your primary care provider (they may offer telemedicine care now).
With many people experiencing some downtime right now and stress from all the things going on, exercise and be a way to get through and make sure you are doing everything you can to protect yourself. Let’s all take some time to focus on our health and take our minds off the stress of the country and world.
Stay safe out there!