COVID-19: A psychiatrist's tips to stay mentally FIT

From a psychiatrist currently practicing in Texas, United States.USA, Dr Ashish Sarangi, Texas, FIT, United States.Added few things by Dr Dhiraj,PT

LOCKDOWN :Health Challenge Vs Benefit in terms of Exercises and with reference to COVID 19

MOST IMPORTANT TAKE AWAY OF THIS POST ARE :

1. HOW ANDROGEN,A HORMONE IS RELATED TO SEVERITY OF COVID 19.
2.TYPE OF EXERCISES THAT CAN BE/SHOULD BE  DONE

The extended lockdown in lot many ways is good for humankind existence,because the social distancing is the only treatment for the COVID 19 so far.

   However we cant keep this remedy of lock down for ever,whether vaccine come or not.So now after realizing this fact that we need more things for our survival ,for our coping abilities,I decided to to pen down the list of MOST ESSENTIAL things we need to have to deal with this essential lockdown.


1. Added general immunity.
2. Fitness which is bound to go down if we keep idle.
3. Saving capital for non essential spends.

ALL OF ABOVE THREE THINGS ARE ESSENTIALLY RELATED TO OUR EXERCISE REGIMES.

SO LETS TALK ABOUT THE ABOVE THREE POINTS WHICH ARE ESSENTIAL TO BE TAKEN CARE ABOUT.

POINT # 1.

So how and why to add to our general immunity.As we know there are two types of immunity

1.General immunity and other is
2.Specific Immunity .We all know we develop specific immunity when we are exposed to a specific virus or bacteria.

It is from the materials present or synthesized by our body for building the general immunity we  develop the specific immunity(against COVID19 here in our case)

WHAT CAN BE DONE FOR IMPROVING THIS GENERAL IMMUNITY.

1.Here I would emphasize more on males ,because females are less susceptible for severe outcomes of covid 19.
https://www.medscape.com/viewarticle/930171?src=android&ref=share

The above article explains how and  why men are more likely to have severe outcomes in COVID-19 than are women. The potential explanation? Androgen.

2.So keeping the above point in mind,an idle sitting person is much more vulnerable for the severe outcomes,because of low androgen.

Weight Training Exercise

Body weight Training Exercise

Both of above exercise can be done at home without going to gym.

FITNESS:
  It is defined as ability to undertake sustained physical exertion without undue breathlessness.

 So why do we need this fitness to be taken care of.It is because of deconditioning,which takes place in following way

So  I am Listing few exercises which you can do in 2 to 3 sets of 8 to 10 reps

                                                                                                                                                                   

                

   POINT#3                                                                                                                                                                                                                                                                                                                    If you are healthy and fit ,only then you can raise capital,save.It has got a Psychological fitness connection with fitness and Immunity.Prolonged inactivity does make you depress,reduces your capacity to innovate .

So point #3 You must follow same principles as 1 and 2 .

SO PLAN YOUR DAY WITH EXERCISE,DIET,REGIME WELL!

STAY ALERT !

STAY SAFE!

CAUSE OF PERPETUAL COMPLAINT AFTER KNEE REPLACEMENT -STIFF FEELINGS

     The most heard,rather I would classify it as the ONLY complaint I hear after knee replacement is stiffness,stone like feeling

I thought to find the cause not because it stopped patient progress but because of unnecessary psychological and physical  burden of few other questions which are sometimes  associated with this main issue.

                                         

In order to find the cause I revisited Physiology and Pharmacology for this.

Physiology of muscles and bones post surgery,a reconstruction surgery like Total knee Replacement gives us a deeper understanding of reasons.

I came across lot of points but following I am sharing for the benefit of time and knowledge enhancement.

1.During a knee replacement surgery,surgeon makes a long incision over the middle of knee and cuts the muscle,tendon and ligament .So It implies there is more tissues cut and hence there is more requirement of time to heal them.

2.Up to 20% loss of muscle mass can be compensated by the high adaptability and regenerative potential of skeletal muscle.

3.Muscle regeneration relies on a heterogeneous population of satellite cells, interstitial cells, and blood vessels and is mainly controlled through ECM proteins and secreted factors.

4.Postoperatively, quadriceps strength  decreases by 62%.(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1167681/)

5.Voluntary activation  decreases by 17%

6. Maximal cross-sectional area  decreases by 10% in comparison with the preoperative values.

7.The existing evidence suggests that patients lose approximately half of their preoperative quadriceps strength in the first month after surgery.

8.The results of preliminary studies have confirmed that reduction in muscle activation contributes substantially to early postoperative weakness

9.The associated swelling/Edema doesn't realy go away because of slow  vascularity as a result of  natural operational trauma and poor mobility and resulting poor muscle contraction. This swelling also lead to feeling of tightness.

10 .So in totality the stiffness in result of three things ,foreign body in place,Swelling and Poor muscle functioning. AND ALL OF THEM OR THEIR EFFECT IS TEMPORARY ONLY

REMEDY IS

1.Isometric quadriceps ↟

2.Elevation and Quadricps static every one hour

3.Ice therapy every one hour initialy till one week,then every two hours.(ICE IS BETTER THAN GEL PACKs)                     

                                         
4.Ankle foot movement in lying position

                                                 

5.Heel Raises in Sitting position

                                                 

                                                                  THANKS 😊

QUADRICEPS STRENGTH AND RECOVERY OF KNEE PAIN

IMPORTANCE OF QUADRICEPS STRENGTH AND RECOVERY OF KNEE PAIN

Quadriceps are major group of muscles which move our knees to straight position from bent position while walking while sitting to standing.

In the following video I am showing a weight cuff of 2 kg which you may choose according to your fitness( choose a weight which makes you feel lesser after 10 or 12 repetition).

Repeat this 50 to sixty times per day and 5 days a week. Will strengthen the quadriceps muscles. Keep adding extra weight every 10 days .After 8 weeks you will find 30 percent more strength.

More strength in quadriceps will help your knee greatly. Do not forget to add hamstrings isotonic exercises as well later in the course.

In almost all painful conditions of knee including osteoarthritis,these quadriceps muscles becomes slowly weak because of less use of it.We tend to walk in a slightly different pattern to avoid pain and hence the that pattern of walking is known as antalgic gait.

So in antalgic gait,there is lesser use of quadriceps muscles and hence it gets weakened.That is why  in conservative treatments and even if you are recovering from surgery at knee the muscle power need to be restored.

Because If we don't use or let the muscles be used of its 30% of its maximum power it is bound get atrophied or weakened.

THIS FOLLOWING TYPE OF EXERCISE IS ANOTHER FORM OF QUADRICEPS STRENGTHENING EXERCISES -ISOMETRICS OF QUADRICEPS.

DO the following 50 to 60 times a day and 5 days a week.

"Use it or lose it -- until you use it again"

THE THIRD FORM OF EXERCISE IS ALSO VERY CRUCIAL FOR KNEE STABILITY AND PAIN PREVENTION AND TREATMENT.THIS IS HAMSTRINGS STATIC EXERCISE.

Do it 20 to 40 reps daily and increase to 50 or 60 .Every press should be for 3-5 seconds

For ACL injury weakened knee ↓

https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=2808760_i1062-6050-45-1-87-t02.jpg

For osteo arthritis↓

 https://ard.bmj.com/content/57/10/588

THANKS