COVID-19 Rehabilitation

COVID-19-Rehabilitation is fast becoming a completely new field of Physiotherapy. This is a new condition and globally we are continuing to learn more about how best to treat and manage it daily.

We now know that in some cases it can take a long time to recover from the effects of COVID-19. Thankfully, the majority of COVID patients will recover from their respiratory illness, fatigue and pain without specialist care however, about 5% become severely unwell.

Data analytics have shown that older people, men and Black and Asian ethnic minority populations have shown poorer outcomes, however persistent symptoms (post COVID-19 syndrome and Long COVID) have been noted across all  population groups.

Definitions

Acute COVID-19: Signs and symptoms of COVID-19 for up to 4 weeks.

Ongoing symptomatic COVID-19: Signs and symptoms of COVID-19 from 4 weeks up to 12 weeks.

Post-COVID-19 syndrome: Signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis. It usually presents with clusters of symptoms

Long COVID: In addition to the clinical case definitions, the term ‘long COVID’ is commonly used to describe signs and symptoms that continue or develop after acute COVID-19.

It includes both ongoing symptomatic COVID-19 (from 4 to 12 weeks) and post-COVID-19 syndrome (12 weeks or more).

COVID-19 and post-COVID-19 syndrome: Symptoms after acute COVID-19 are highly variable and wide ranging.

The most commonly reported symptoms include (but are not limited to) the following.

What are the most common symptoms associated with post COVID-19 and long COVID?

Respiratory symptoms

  • Breathlessness
  • Cough
  • Decreased exercise tolerance

Cardiovascular symptoms

  • Chest tightness
  • Chest pain
  • Palpitations

Generalised symptoms

  • Fatigue
  • Fever
  • Pain

Neurological and Speech and Language symptoms

  • Cognitive impairment (‘brain fog’, loss of concentration or memory issues)
  • Problems with word finding
  • Headache
  • Sleep disturbance
  • Peripheral neuropathy symptoms (pins and needles and numbness)
  • Dizziness
  • Delirium (in older populations)

Gastrointestinal symptoms

  • Abdominal pain
  • Nausea
  • Diarrhoea
  • Anorexia and reduced appetite

Musculoskeletal symptoms

  • Joint pain
  • Muscle pain

Psychological/psychiatric symptoms

  • Symptoms of depression
  • Symptoms of anxiety

Ear, nose and throat symptoms

  • Tinnitus
  • Earache
  • Sore throat
  • Dizziness
  • Loss of taste and/or smell

Dermatological

  • Skin rashes

COVID-19 can have a significant effect on quality of life.

At Vitality Physio, we have teamed up with several expert clinicians to offer a specialist COVID-19-Rehabilitation service to help you recover and re-establish your quality of life.

What can you expect at a COVID-19-Rehabilitation Appointment?

1. Screening for serious illness that requires further investigation

Our respiratory trained Physiotherapists are able to decide whether any of your symptoms require further investigations or blood tests. Typically, this could be related to your respiratory and heart function.

 2.Your case history and current functional challenges

Your Physiotherapist will take a full history and talk to you to fully understand all the challenges that you are facing. This will help signpost the interventions they will use to treat you as well as help set your goals and treatment outcomes.

3.Your examination:

Respiratory:
  • We will listen to your chest (auscultation) using a stethoscope to listen for breath sounds, abnormal breath sounds (such as wheezes) and vocal resonance (found in specific lung conditions).
  • Your Physio will also percuss (tap) over your lungs to listen for any abnormal sounds associated with some lung illnesses.
  • We will also measure your chest expansion, respiratory rate, Oxygen saturation and blood pressure.
  • If you have any current chest X-rays, we are also able to read and interpret them.
  • We may then proceed to looking at how well you can tolerate exercises, this can vary from doing some simple activities such as standing up from a chair to cycling on a bike or running on a treadmill.
Musculoskeletal
  • This involves looking at the affected areas of you body where you may have pain or dysfunction.
  • Your Physiotherapist will choose appropriate tests to measure the strength, range of motion and quality of movement. They will where appropriate, assess nerve function if they expect a problem with this.

4. Physiotherapy Treatment

At Vitality Physiotherapy we use an holistic COVID-19-Rehabilitation programme, with you at the centre of care. Based on your specific goals and objectives as well as using the functional markers that we find in our examination, we design you a custom made treatment plan.

This may include techniques to tackle breathlessness, improving your lung capacity, pacing of activities, fatigue management, improving you exercise tolerance or rehabilitation of muscle and joint dysfunction.

5.Onward Referrals

We use both telephone triage to strictly screen for any suspicious symptoms. If we suspect anything in either your triage call or our examination that requires further investigation, we have a large network of specialist clinicians to refer you to, including Specialist Medical Physicians, Respiratory consultants, GPs, Psychiatrists, Sports and Exercise Medicine Consultants.

Should we establish that you would benefit from Speech and Language therapy, Occupational Therapy, Psychotherapy or any other allied health professionals, we have a network of specialised professionals to refer you to.

At the core of our value system we want to understand our patient’s concerns, experiences, and help manage their symptoms and co-morbidities, referring patients as needed. Our objective with our COVID-19-Rehabilitation service is to help solve every problem in the complex Long-COVID puzzle, with a multi-disciplinary patient-centric approach.

 

 

Our Special Infection Control Measures

Physiotherapy services are open during the new Lockdown for urgent as well as non-urgent appointments, as per governmental public health advice

Providing Effective Physiotherapy During and Post Lockdown

It is of the utmost importance to us that yours and our team’s health and wellness is our priority.  We are therefore taking every precaution necessary to ensure that our clinics are a safe place for us to work in and for you to be treated.

We have looked at every aspect of our service and every point of our patient’s journey with us, making changes wherever necessary.

We will be opening our Roupell Street, Waterloo, and Esher, Surrey Clinics only until further notice.

Just some of the actions and measures…

  • We will continue to implement our already stringent hygiene measures, but further cleaning between patients and sterilising of contact surfaces after every single patient.
  • Ensure that windows are open to maximise airflow.
  • We will continue to provide video appointments as our first option to patients.
  • Face-to-face sessions will be offered to patients ensuring they meet the necessary requirements set by our professional bodies.
  • Screening all our patients 24 hours before each and at every appointment.
  • All our Team will ensure that they are symptom and will check temperature checking before their workday.
  • For your safety we will not be doing face to face treatment with anyone who is pregnant, vulnerable or over 70 years old until further notice.
  • We will ask all our patients to wear a mask to their appointment
  • Controlled access to the clinic and providing alcohol hand sanitiser to all patients on arrival.
  • We request that our patients do not come more than 5 minutes earlier to their appointment.
  • Temperature checking all patients immediately before their appointment.
  • Staggering appointment times and allowing for buffer time between our appointments to reduce social interactions.
  • Social distancing signage and reminders throughout the practice.
  • Removing magazines from our reception area.
  • No use of paper or pens in treatment rooms.
  • Intensified infection control measures in the treatment rooms and gym areas.
  • Using all the relevant and appropriate PPE (your Physio will be wearing at gloves, eye protection, a mask and apron)
  • Changing our equipment use policies

Rest assured that the health and wellbeing of all our patients and team is our primary concern.

You can help us by heeding government advice…

Current Government and NHS Advice

Please do not attend your appointment if you:

  • Have a temperature
  • Are experiencing a new persistent cough
  • Have recently lost your sense of taste or smell
  • Have been in close contact with someone who has been diagnosed with, or suspected of having, COVID-19 / Coronavirus

If this is the case, please call us to rearrange your face-to-face appointment. We will still be able to help you with an online video consultation.  

Top tips to keep you tip top when working from home

https://www.facebook.com/vitalityphysiotherapy/videos/508652306492867/

1. The early bird catches the worm

Increasing your metabolism at the start of the day will not only make you think more clearly but improve your circulation and tissue flexibility to help stop working from home being a pain in the back! Get up at your usual time, resist the temptation to catch a few more zzz’s. Make your bed, brush your teeth, get into your gym kit and how about heading out for exercise bright and early?

2. Dress up, show up

Lounging in your snug Pj’s might sound like the easier option, but a little sprucing up and getting dressed in your usual work clothes will help you mentally relocate-also you never know you may be summoned on an urgent Zoom call!

3. Desk Jockey kit

Ensure that you’re sitting at a proper desk and chair. Most offices have been happy to send teams the right tools such as office chairs  and desks to help minimise the impact and risks associated with the use of inadequate equipment.

4. Task master blaster!

I love ticking off a list. Sometimes I make lists containing a few things I’ve already done, just for the sheer delight of ticking the item off the list, I know… weirdo, but I’ll almost certain that I’m not the only one! Try Trello, Microsoft to- do. The added structure, the small victorious feeling you get when you tick off that task, will, if you’re anything like me, make you feel like a little Champ!

5. Food is medicine

How about using the time gained from not commuting to prepare yourself a healthier than normal fresh lunch? Not only will it help you feel better, but your waistline will be grateful too!

6. Take a breather

Every 20- 30min, stand up, walk around- go to the watercooler-ie kitchen sink, break away area- i.e living room to boost your circulation and avoid static positions. If you’d like a free copy of our general desk exercise routine, please email us: info@vitality-physio.co.uk and we’ll send one out to you.

7. Body, Soul, Spirit

This unprecedented season has caused much stress, and the uncertainty of the future can be overwhelming at times. Prayer, meditation or practicing mindfulness can play a huge role in interrupting the negative power that this stress can play. Headspace, Calm have great solutions, or get in touch with Samaritains if you need help or can’t cope. https://www.samaritans.org/

8. Get Connected

Yes indeed this is a time of social distancing, but we humans, are communal animals. How about a skype lunch date or call that person you have been meaning to in ages? Casual conversations, deep musing with a friend or reminiscing with family might be exactly the little boost you or they may need during the day, so get connected.

Despite closing our clinics, we are still operating our Physiotherapy services. We know that your treatment to alleviate pain, weakness and continue your post and pre surgical care is paramount to your physical and mental wellness and therefore we are staying open for online appointments only.

Physiotherapy video consultations are evidence based and have proven to be clinically effective to treat musculoskeletal conditions. During your consultation, your Physio will be able to establish a diagnosis and offer you treatment through exercise as well as manual therapy and self-mobilisation techniques, offer technical expertise, advice and guidance on your condition, your exercise regime or training plan.

Book online here: https://www.vitality-physio.co.uk/book-an-appointment-online/

Drop us an email: info@vitality-physio.co.uk if you have any questions or concerns.

Finally, may you find peace in the chaos, joy on tough days and the wisdom to keep mobile and active!

Janine

Top 5 Summer injuries and how to prevent them

It’s been a brilliant summer and the Met office promises more sunshine yet! If  you’ve enjoyed a chilled glass of rosé, weekend bbq’s and sunny adventures exploring new places, well then, you’ve found good company!

Summer fun times can however often cast a painful shadow on the unsuspecting, as summer injuries are quite common, so here are some handy hints to help you get the most of you long summer days:

 

 1. Gardening injuries

Gardening injuries are common in the summer. Extended pruning time, using inappropriate tools, and heavy lifting with a poor technique are often the biggest culprits.

  • Try the following to keep your love for gardening alive: 
  • Warm up by taking a brisk walk to get your heart rate up, prior to starting 
  • Sit on a stool or kneel on foam pads to help prevent knee and back pain when planting or weeding. 
  • Long handle tools will reduce the work and prevent you from over stretching. 
  • Impose a 15minute limit especially if you’re a gardening novice.  

 

 

2. Neck strains

If catching some rays on your back is a priority this summer, be sure to set a timer or get someone to wake you. Apart from the obvious perils of turning into a lobster and the pain associated with it, getting a stiff neck from lying prone (on your tummy) on the beach will certainly put a damper on your holiday. Reading for long periods on a sun lounger can also cause a crick in the neck, so be sure to do a few neck stretches every so often to keep your neck mobile. Here are some useful neck stretches to try. 

  • Tilt your head to one side and hold for 15-20 sec and then to the other side. 
  • Roll your shoulders forwards 5 times and then backwards. 

 

3. Running shin splits 

Trying to get beach-fit quickly? Trying to run away those extra pounds? Sudden increase in running thresholds (especially if you’ve never run) is one of the biggest single causes of shin splints. This, together with wearing inappropriate footwear, a higher BMI and  flat feet are among the top factors that can result in shin splits.  Try switching to swimming or cycling instead and seek physiotherapy advice before hitting the pavement again.  

 

 

 

 

4. Plantar faciitis: 

In warmer weather, we tend you swap our more supportive shoes for flip flops, pumps and sandals. Whilst increasing the air flow helps us feel cooler, our feet have to work a lot harder to help us move. This can cause aching burning feet at the end of the day. The intrinsic foot muscles may have deconditioned over the long winter and therefore be subject to strain and fatigue. If you suffer from burning feet, try doing the following: 

Place a bottle of water in the freezer for an hour or so. Place it under you foot to act as a ice roller- trust me, it will absolutely hit the spot to relieve your burning feet! 

 

 

5. Cycling injuries 

Fair weather cyclists the world over can all relate to a “dead pinky” or lower back pain after getting into the saddle. Bike set up is crucial to your cycling comfort and can also contribute to the work of cycling. Your pre-bike fitness however will set you up to ensure you’re recruiting the correct muscles for your pedal power and avoid injury. Weak gluts are sometimes responsible for overworking the lumbar spine or hamstrings. A simple bridge exercise is a useful hip mobility and strength exercise particularly for cyclists as it replicates the action of the downward force of pedalling and isolates glut muscles.  

 

We hope that these few simple golden nuggets will help keep those summer injuries at bay and that you have a wonderful and long summer! 

5 injuries you didn’t think you could get from cycling

1. Runner’s knee

Yes, I said it! You can get runner’s knee from cycling. Contrary to popular belief, this painful problem is not confined to those who hit the pavements in their trainers alone. In fact, there’s a growing number of cyclists that land up on my treatment table that have been plagued with this pesky problem. The problem with cycling (cue “gasp” from our lycra-clad friends) is that the answer may not always be straight forward.

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Football season is on: watch that hamstring!

The Premier league season has just started with a couple of big surprises already. The transfer market is heading for a record this year but the number one priority of every club will be to keep their players in shape, whether they are new recruits or existing ones.

Hamstring injuries in particular will be watched very closely by the clubs’ physios. According to Football Association Medical Research Programme, hamstring strains are the most common injury sustained costing an estimated 90 days and 15 matches missed per club per season. [1]

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Usain Bolt – a biomechanical perspective on a sprinters’ foot

That’s it, we won’t have the delight of seeing Usain Bolt competing ever again. And despite his disappointing result at the 2017 World Championships here in London he is still the man to beat with an incredible World Record set at 9.58secs. We at Vitality Physiotherapy wish him very well after his injury in the 4x100m.

In his television interview on the BBC a couple of years ago, Usain said that he was less hard working than his younger teammate, Yohan Blake (who incidentally thanked his physiotherapist when he won Silver in the 100m men’s final in 2012). Bolt, however attributes much of his success to his talent!

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Suffering from a side stitch?

If you’ve ever run a long distance before, you probably would have experienced a side stitch (exercise related transient abdominal pain (ETAP)) at some point.
It is usually experienced just below the ribs, often affecting the right side. It usually results in ceasing to run further.

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“Snow” need to worry about a niggly knee this ski season!

Thinking of warming away the winter blues with a bit of Alpine Sun? Concerned about an injury? Fear not, Vitality Physiotherapy is here to help!

The most common injury sustained on the slopes, is an ACL tear. The Anterior Cruciate Ligament (ACL) is located within the knee joint and connects the tibia (leg bone) to the femur (thigh bone). It is an important stabiliser of the knee joint. The ACL is commonly ruptured as a result of quick decelerations, hyper extension or excessive rotation.

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Vitality Physio featured in Women’s Fitness Magazine

Lead Physiotherapist, Janine Enoch talks to Amanda Khouv from Women’s Fitness Magazine in the Ultimate Runner’s Guide April 2012.

In this article, Janine recommends a few general principles to avoid running injuries but remember, always consult your GP or Physiotherapist if you suspect that you may have sustained an injury or are at risk of developing one.

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