Physiotherapist Elle Hetherington experiences a rise in health concerns from clients due to COVID-19
The pandemic has caused many of us to suddenly have an overload of spare time on our hands, and people have either taken this opportunity to get fit and healthy or have set up camp on the couch. However, both can cause some unwanted aches and pains to arise. So whether you’ve worn out your running shoes or you’ve just finished a movie marathon, stress and tension will impact your body the same way and leave you vulnerable to more serious injuries.
In the article below, physiotherapist Elle Hetherington explains how COVID-19 has impacted the health concerns experienced by her clients and shares some tips on how to keep your body in optimal condition, whether you’re stuck inside or on the move.
I grew up in Melbourne, Australia with a very active, outdoors lifestyle. Still to this day, I’m not sure how my mum managed to get my siblings and I to all our games and training sessions – Wonder Woman! Between netball, distance running, dancing and swimming I spent a lot of time in physiotherapy which led me to my interest in the body and exercise at an early age.
I studied physiotherapy at the University of Melbourne and recently graduated from a post-graduate certificate in Sports Physiotherapy at La Trobe University. After spending 5 years working in a sports medicine clinic in Melbourne I relocated to New York City and haven’t looked back.
Upon moving to NY I redirected my work into movement retraining, focusing on individualized assessments and goal-oriented, specific, tailored training. My passion is working one-on-one with clients to identify deficiencies that contribute to chronic discomfort or recurring injuries. From here, I work closely to correct imbalances, improve neuromuscular control, muscle activation, strength and endurance for optimal performance and posture. A typical session will combine my physiotherapy expertise with my learnings from pilates, yoga, conditioning and boxing.
What are the 3 most common injuries you see with your clients?
Low back pain is certainly the number one complaint I treat. Reflecting on our 2020 lifestyles, with an increase in prolonged sitting and reduced incidental exercise there is no wonder low back pain is an issue. Activating and strengthening the muscles down the back of the body, also known as our posterior chain, is one of the best ways to counteract our relatively sedentary lifestyle, optimise posture and reduce pain.
Neck and shoulder pain is also common and again I link this to prolonged postures and increased device use. Being more aware of our posture and seeking an ergonomic workspace assessment to help with this is a great idea.
Finally, quarantine has sparked a new generation of runners and subsequently I have seen a spike in knee pain. With any new sport or exercise it’s essential to monitor your load and progress slowly. My advice for runners is to slowly progress your distance and speed and always incorporate conditioning to strengthen your core and glutes.
Has COVID-19 impacted the concerns or injuries of your clients?
I have noticed an increase in neural symptoms (pins and needles, numbness and tingling) and pain over the past few months as a consequence of heightened stress levels and what we call central nervous system sensitization. It is important to recognise that as far as the body is concerned, stress is stress. It doesn’t matter if our stress arises from a session of intervals, emotional strain or a romantic break up, on a cellular level the body doesn’t differentiate. Whilst we may want to believe our back pain is caused by poor posture it is likely that an element of it is maintained by stress and without addressing this component we will never be fully pain-free. The uncertainty and instability in the world has no doubt impacted our bodies in a magnitude of ways. As a result, now more than ever we need to look after our psychological well-being to optimise our physical performance.
My hope is that in the post-pandemic world everyone is outside moving and prioritising health and wellness. We have all had a surplus of time to reflect inwardly and set new fitness and health goals, so I really do believe we will come out the other end of this stronger and healthier as a community.
What are ways we can prevent these injures?
There’s no recipe for injury prevention, everybody’s genetic makeup is different and you need to do what works for you. However, I do have some generalised advice that I think most people benefit from:
- Move: Move your body intuitively every day and vary the types of exercise that you do. Now is a great time to try online classes in the comfort of your own home to see what you do and don’t enjoy, get out for a walk or try doing some sessions in the park.
- Load Management: Research tells us that increasing your load too much and too fast is the biggest risk factor for injury. Be conscious of the quantity and frequency of load that you are putting your body under. Prioritise rest days and incorporate gentle stretching and mobility sessions.
- Stress Management: As I mentioned earlier, stress is a key driver of pain manifestation. Check in with your mental state and find ways to manage your stress levels and reduce nervous system sensitisation. Meditation is an incredible tool and there are plenty of apps designed to help beginners. If meditation isn’t of interest to you, find something you enjoy like walking, reading or cooking and incorporate it into your daily routine.
- Sleep: Our bodies heal and regenerate whilst we sleep. A minimum of 8 hours of sleep is recommended to enable adequate healing and adaptation. I highly recommend “Why We Sleep” by Matthew Walker for a great read on all things to do with sleep and the body.
- Get Advice: If you are starting something new or you have a niggling injury, seek advice from your physiotherapist. The longer you leave an injury, the more difficult it becomes to manage.
Do you think New Yorkers are more aware of the incidental exercise they do during the day?
It’s funny you mention that! I don’t think I realized how much more incidental exercise I was doing until I came back to Melbourne for a visit and noticed myself sitting in traffic ALL the time. I think walking and cycling as a form of commuting in NYC is so ingrained in daily life and something a lot of New Yorkers take for granted. I feel very lucky that I get to walk and explore the streets of the city as I commute between clients and am very excited to get back to it when it’s safe to resume home visits in NYC.
What are your top 5 tips for a pre- and post-workout routine?
I don’t have a set pre- and post- work out routines to be honest! I listen to my body and adjust accordingly and do so for my clients as I assess them individually on a day-to-day basis. I think it’s best to tune in to what you are feeling and tailor your workout and recovery to what your body needs. That being said, below are some key recommendations that are a great starting point:
- Hydration: Your body tells you when you’re dehydrated. Listen to the cues, there is no need to chug water – if you’re thirsty water tastes delicious, if you’re hydrated water can taste disgusting. Rule of thumb – drink when it feels good.
- Nutrition: I am not a qualified nutritionist so this is not my field but, without stating the obvious, the most important factor is to ensure you are ingesting enough food and not depriving your body of nutrients. Maintain a balanced diet and treat yourself when you need it.
- Pre-workout mobility: I like to begin sessions with gentle mobility sequences to lubricate the joints and to scan to see how my body is moving and feeling. I always begin sessions with clients with a mobility sequence and activation of stabilising muscles before layering intensity and complexity to the workout.
- Post-workout stretch: If you notice anything that feels particularly tight during your workout, focus your attention on stretching that muscle group at the end of your session.
- Sleep: Need I say more? Prioritise your sleep, which in turn will manage your stress, maximise muscle adaptation and prevent injury.