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.

 

 

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!