Reconditioning

00:00:00:02 - 00:00:25:18
Speaker 1
Hello and welcome to your reconditioning program. I am very excited you're here. Let's get started. So what you're going to learn is what's happening. What? What is the conditioning? How does that happen? I'm going to introduce you to your program and then I'm going to show you how to recondition safely and effectively during concussion recovery. So why darkening guided conditioning happens is the simplest way is that phrase.

00:00:25:18 - 00:00:48:23
Speaker 1
If you don't use it, you lose it. So any time as a human being, we stay in a static position. Maybe we're sick, so we're laying down a lot or we're laying in bed for an extended period of time. Our body will start to do what's called the conditions. So our strength will go away, our cardiovascular conditioning. So how much we can move around our balance, all those things can go away.

00:00:48:23 - 00:01:08:14
Speaker 1
So to use a dramatic example to make my point, say you were in a coma and you were in a coma for, I don't know, a month and you woke up and magically everything, you're perfectly healthy. But now you've been laying down for a month. You can imagine that when you would get up you'd be a little bit dizzy because, like, maybe your blood pressure is not adapting.

00:01:08:14 - 00:01:28:09
Speaker 1
Or when you try to stand, you feel really weak because your muscles aren't as strong. Or then you try to go to the sink and you're exhausted. There is nothing else medically wrong. It is just deconditioning. So that's obviously an extreme example. But deconditioning can happen really easily. A concussion recovery because people aren't feeling as well. So they're not as active, they're not doing as much.

00:01:28:09 - 00:01:51:12
Speaker 1
And oftentimes as people have been told to do nothing and to rest or to lay in a dark room, which we know is no longer recommended. So all of those things can lead to deconditioning. The great thing is that you've taken any of the appropriate testing to know that there's not any other nervous system problem going on. It is just good old fashioned deconditioning itself and we can absolutely help you with that.

00:01:52:20 - 00:02:19:06
Speaker 1
So I'd like to introduce you to your program. So whenever we have deconditioning, we do what's called reconditioning and get you reconditioned. And we use the guidelines by the World Health Organization, Organization or Health and Human Services. They're all on the same page right now internationally, and that is 150 minutes of aerobic exercise per week and strength training 2 to 3 times a week for general conditioning and human health.

00:02:19:18 - 00:02:45:00
Speaker 1
Now, typically, if you were to go into your doctor and get a program, they would have a physical therapist, you would meet with them and they would prescribe you a program. So I am a physical therapist. I have my doctorate in physical therapy. So I'm going to walk you through a general reconditioning program for concussion recovery. What I will say is please make sure you're seeing your doctor to make sure you're healthy enough or if there's anything else going on.

00:02:45:16 - 00:03:07:11
Speaker 1
I am a physical therapist. I'm not your physical therapist. I haven't personally evaluated you. I don't know your health history. I don't know what medications you're on. And I really, really value your health and safety. So always check with your doctor to make sure everything is safe for you. So a reconditioning program has two parts to it. The first is conditioning, and that's aerobic exercise.

00:03:07:11 - 00:03:32:16
Speaker 1
So walking, swimming, biking, rowing again, they recommend 150 minutes per week. So that would be like five days a week exercising 30 minutes at a time. The other component is strength training. So it's recommended we start with body weight exercises and then we move to weights as desired and that's recommended 2 to 3 times a week. So how do you choose your starting point then?

00:03:32:16 - 00:03:47:17
Speaker 1
What do we usually say is we want to preserve what people have? So if you were to come in to me in my office or in my office when I was in the clinic, we would get no sense of what you're able to do now. So I want you to start thinking of what you're able to do right now.

00:03:47:17 - 00:04:09:16
Speaker 1
Are you someone who, you know, getting back and forth to the mailbox? Is your max right now, or are you someone who's already walking 10 minutes a day or 15 minutes a day? What is your current level of aerobic conditioning and what's your current level of of strength? So RDA is like, let's preserve what you're already doing and then build on that.

00:04:09:16 - 00:04:25:08
Speaker 1
And that's going to be a little bit different for everyone. So think of kind of what can I already do that feels manageable and that's where we're going to start. So let's make a couple of choices together. We're going to choose your aerobic exercise and your strength program so you know exactly where to start and what to do.

00:04:26:21 - 00:04:49:23
Speaker 1
So in your workbook, you're going to see on page three, we're going to write down what kind of aerobic exercise you'd like to start with. Now, since you're not experiencing any dis autonomy, like with the Arctic stand test or exercise intolerance with the concussion treadmill test, that means you're open to any type of exercise. With that said, we know you're also recovering from a concussion.

00:04:49:23 - 00:05:11:17
Speaker 1
And our goal for this for this module is to get you moving aerobics again. Right? So we want to pick an activity that's going to help you move aerobically again, but it's not going to be too provoking for the other concussion symptom systems like your neck and your vision and vestibular so that you really can spend your time conditioning rather than battling these other symptoms.

00:05:12:01 - 00:05:33:12
Speaker 1
And so there's a couple of things to think about when choosing that. Typically, something that's stationary, like a stationary bike or a treadmill is a good choice because we're controlling the environment. So if we're doing something outside, maybe there's noise, maybe there's a certain amount of sunlight, maybe it's freezing outside. It helps us control the environment a little better there, and it helps us to control the speed.

00:05:33:12 - 00:05:54:24
Speaker 1
So you're able to get kind of more consistent anaerobic capacity going. So that can be a great place to start. And then when we think of that, we think, okay, someone who might be best for the bike would be someone who has like some pretty significant like next stop, like your neck gets pretty cranky pretty easily or you get like dizzy or have vision or vestibular stuff.

00:05:54:24 - 00:06:13:16
Speaker 1
You feel kind of sick, fairly easy. The bike would be a really, really great place to start any stationary bike. It could be a recumbent bike, it could be your peloton, it could be the cheap thing that's like a million years old that was in the attic. Any bike as long as it's stationary. And then the other option would be you're like, Maybe I just really enjoy walking and I want to be up on a treadmill.

00:06:13:16 - 00:06:34:19
Speaker 1
As long as you feel like your neck and your vision are similar, aren't going to be so provoked that it's going to prevent you from being able to exercise cardiovascular. Really? Then that's okay. So with those things in mind, I want you to think about how do I want to start to exercise cardio wise? I'm going to choose something stationary like the bike or the treadmill.

00:06:34:19 - 00:06:54:19
Speaker 1
And am I going to do I feel like I need something to really manage some of my other symptoms, So maybe I'm going to do the bike versus the treadmill. So I want you to choose your exercise choice here. If you're like, I don't know, just tell me what to do. I would say, just do a recumbent bike or a stationary bike, Any stationary bike, it's the easiest it's the least symptom provoking.

00:06:55:08 - 00:07:11:01
Speaker 1
Think of, though, when you're on a bike, If you have the one where you can kind of lean forward, I would just say sitting straight up for a while because sometimes a leaning forward can strain your neck and we'll get into the neck module next any bike, and then you're going to say, okay, like what can I already do?

00:07:11:02 - 00:07:29:13
Speaker 1
Remember, we're going to preserve the function you already have. So if you can already know, you already know you can by a group and going to walk for 15 minutes. Right. 15 minutes if you like. Sometimes I do. T but I feel kind of crappy. Choose what you feel confident in too. If I say do this, you're like, I know that I can do that.

00:07:29:13 - 00:07:56:23
Speaker 1
Start with that. I like to start showing the body how much it can do and start with wins and build rather than overshooting it and then scooting back. I just think it's much, much easier, especially I've been through this myself, like mentally it's just nice to get some wins. So I would say start with the number that you feel that you can do now, but you're confident with maybe you are, you know, just struggling to get up and get to the kitchen.

00:07:56:23 - 00:08:16:01
Speaker 1
So maybe you start with a couple minutes. It can be literally anything just preserved you already have. And then we're going to build there is no amount too small. And of course, if you're already close to 30 minutes, great like well will help will help build you there. The next decision you'll need to make is how you want to do your strength training.

00:08:16:01 - 00:08:39:04
Speaker 1
So with strength training we generally recommend body weight to start and then weights. But again, we're in concussion recovery, so that means doing things with our arms might strain our neck. That means, hey, I want to do squats. But that moving up and down really triggers my eyes. We have other symptoms to kind of think about. And just like with aerobic exercise, our goal is strength.

00:08:39:04 - 00:09:02:16
Speaker 1
So we want to choose to strength, train in a way that is going to be the least provoking for our other systems. Remember, eyes, ears, neck, all that stuff, so that we can actually get the strength gains that we're we're looking for in a way that's not provoking our symptoms. So if you have something with your physical therapist you're already doing or you have like a YouTube video that you're like, I know what I feel great with that I just want to build.

00:09:03:06 - 00:09:23:06
Speaker 1
Fantastic. If you're like, I'm not sure what that would be. We have exercise classes for you so you can find them in your bonus section under movement classes, or you can simply scan that QR code below and it will take you there. But you're going to see a series of classes and they'll say pots friendly in parentheses. Those are the ones I want you to do.

00:09:23:16 - 00:09:42:20
Speaker 1
And you'll see they're laying down recumbent or laying down, seated, standing, and then a combination, I would say start with the seated, because we know again, we tested so we don't have any, you know, difficulties with upright position. So start with seated. But if you're like, I can already tell that's too easy for me, then you can go to standing.

00:09:43:03 - 00:10:00:22
Speaker 1
The goal is just overall strength. You can choose your position. So I would say one of you choose what class you're going to start with. Again, if you're on the fence, start lower and then if you do it and it's too easy, great. You can just increase either the intensity or go to the next class. So those will be your strength days.

00:10:02:21 - 00:10:28:09
Speaker 1
And then once you've decided your days, you can use this tracker to track progress. So I made a really simple weekly tracker, put a couple of them in there. You can make as many copies as you want for the weeks, but you can pick, okay, like Monday, maybe start small, maybe say Monday, Wednesday, Friday. I'm going to do aerobic exercise and you check this aerobic exercise box and then maybe Tuesday, Thursday, I'm going to do strength training because we always look at one day in between strength training.

00:10:28:09 - 00:10:49:11
Speaker 1
So So your strength train Tuesday, Thursday or maybe Tuesday, Saturday, you could check those boxes. And then once you've done the exercise, you can tabulate the your time for your aerobic exercise in this little box below because we're working up to 150 minutes per week. So that's kind of an easy way to do it. Maybe you want to start with the five days and you feel like you're there.

00:10:49:11 - 00:11:05:22
Speaker 1
So you're going to exercise Monday through Friday and maybe you're going to add in some strength training on Wednesday and Saturday, you know, whatever it may be. You can just use that planner to decide how you're going to do it. So every day you're not making the decision, make the decisions ahead of time, set up a plan for yourself.

00:11:05:22 - 00:11:37:15
Speaker 1
We can adapt as you go. If you're like for the love of God to make any more decisions, someone tell me what to do. I'm going to say, get a stationary bike exercise aerobically to start Monday, Wednesday, Friday. Add in Tuesday, Thursday as you can take Sundays off and then strength train twice a week. Tuesday, Thursday. Start with the sitting class kick bike exercise three days a week.

00:11:37:15 - 00:11:59:12
Speaker 1
Monday or Monday, Wednesday, Friday strength Tuesday, Thursday with your sitting class build from there. Okay, so if you're like just pick one or those are probably going to be the most successful for everyone. So once you have all those things, you're not like, okay, I understand what's happening. I understand my goals. I know what aerobics stuff I'm going to do.

00:11:59:12 - 00:12:20:21
Speaker 1
I know what strength stuff I'm going to do. And I know roughly like the days I'm going to try and how much I'm going to try to start to try with. Let's talk about what you actually do in each of those sessions. So what you would do for, say, anaerobic exercise session is you would start with, you know, when you're ready to exercise, you would say, okay, what are my symptoms right now on a scale of 0 to 10?

00:12:21:06 - 00:12:38:21
Speaker 1
And you just pick General, you don't need to overthink it. Let's say you're starting at a four, you're at a four in a ten. So then we want you to do a warmup. If you can complete a few minutes. Warmup, great. If it's not accessible to you yet, that's all right. If you need to start with 2 minutes of a warmup, that's okay.

00:12:39:07 - 00:13:06:20
Speaker 1
But your warmup is basically doing the movement. So say you chose the bike, you'd get on the bike and you do the movement very easy. So if I were to ask you how easy it was on a ten point scale, you'd say like, this is one or two, like it's super slow, super easy, just getting your body warm, then what you'll do is you'll begin to increase your speed or intensity till you feel like you're exercising at like a moderate pace, and you'll continue that until your symptoms increase more than two points on a ten point scale.

00:13:06:20 - 00:13:23:10
Speaker 1
So say I started with a four out of ten. That means once my symptoms get to seven out of ten, I stop and then I'm going to do a little cooldown. So you're going to slow down the speed to a cooldown, anywhere from 2 to 5 minutes up to 5 minutes if you can. And then you're going to record your workout for the day on the handle.

00:13:24:06 - 00:13:48:09
Speaker 1
So how many minutes did you get for that aerobic exercise for strength? It's going to be very similar. We guide you through this in the strength exercise videos, but essentially you're going to the same thing. Pick a number, do a warm up, do your strength exercises. Once you start increasing more than two points on a ten point scale, do your cooldown and then you can mark off your strength day.

00:13:48:11 - 00:14:07:04
Speaker 1
If you want to record how long you can do the strength stuff, you can do that too. But we strength is less about time as cardiovascular. So really the only one we really need the time on is the aerobic exercise. And then it's like, okay, I've got that and I've got that going. When do I actually progress? Like, when do I progress?

00:14:07:04 - 00:14:27:05
Speaker 1
How do I progress? How long do I keep progressing? So you'll also see this in your workbook on page eight. So typically what we would do if someone came into me and they had no concussion and they were just air conditioned, we'd say, okay, let's preserve what you have. And then each week we're going to build the amount of minutes or the amount of challenging of strength exercises that you're doing.

00:14:27:21 - 00:14:48:23
Speaker 1
Now. Like we said, with concussion, we have other symptoms to keep in mind, and we have general guidelines for post concussion symptoms when we're in recovery. And so we typically use the two point rule. You can do whatever you're able as long as your symptoms aren't increasing more than two points. That would be when you would take a break, calm it down, and then you could go back to what you're doing if you're able.

00:14:48:23 - 00:15:08:05
Speaker 1
So you have a couple options. That means for how to progress your aerobic exercise or your reconditioning program here. The first is, I think is best for people who maybe are a little hyper focused. Maybe you're a little anxious and we just want to get you out of your head and start movement again. If that's you, I would just use option one, which is the 2.0.

00:15:08:05 - 00:15:30:16
Speaker 1
So basically you'll do the amount of exercise you can wear, we just talked about and you'll use a two point rule, one that basically will look like every day you might exercise at a little different time. So maybe one day you get 8 minutes, the next day you get five and 67, so on and so forth. But overall, we should see you progressing because you're putting in consistent exercise.

00:15:32:11 - 00:15:51:17
Speaker 1
So that's option one. Option two is time based. Typically what we do with a more standard reconditioning program, which you absolutely can do for concussion too. But the here again, you'd set your starting time like we already talked about. Let's use for example, say it was 10 minutes you would begin your exercising. So start with your warmup and then begin into your exercise.

00:15:52:11 - 00:16:10:00
Speaker 1
Once you hit two points, you would stop from there and your goal would be just to get to that consistently 10 minutes every day for that week. Once you can get to 10 minutes every day that week, great, then you would increase it. If it's someone who's, you know, really struggling, we might do 3 minutes. If it's someone who's feeling pretty robust, we might increase that by 10 minutes.

00:16:10:11 - 00:16:43:02
Speaker 1
And so that's so that might be 13 to 20 minutes the next week for your goal. And we would increase it that way. Either one is okay, I would say do what feels most freeing and most most like it gets you to the kind of goals you want in a way that the experience feels okay, So a way that you're not like overanalyzing it constantly and you'll continue that until you get to the end goal, which is basically being able to exercise aerobically for 150 minutes a week and then strength training for 2 to 3 days.

00:16:43:02 - 00:17:02:14
Speaker 1
So that's the end goal. If by the time you get there, you're like, You know what? My desired level of fitness is way higher than this. I was super active. I want to do more than you could continue to increase until your desired level of function right? So simple and sweet. I mean, you got this. So again, to two parts.

00:17:02:19 - 00:17:24:09
Speaker 1
Aerobic and strength. Start where you already have your function and build from there you have your all your worksheets to tell you kind of what to do each day. You're going to use your two point rule and you're going to gradually build until you get to the level of fitness that you would like to be at, sweet and simple.

00:17:24:09 - 00:17:48:14
Speaker 1
And then of course, in the models after this, we're going to be addressing your neck and your vision and her vestibular issues, any cognitive issues. So we'll get those covered as well. But getting moving is just if there's one magic pill, it would be exercise. So if you're not able to get to these levels already getting to those, prioritize that because it's just going to help you so much with everything that you do in your concussion recovery as well.

00:17:48:18 - 00:18:05:17
Speaker 1
So thank you for being here. I know this is hard, but I'm really glad that you you showed up for yourself. You have this program. I'm with you alongside you in the community every step of the way. Please feel free to ask me any of your questions. I am here and I'm really looking forward to you getting moving again.

00:18:05:17 - 00:18:31:02
Speaker 1
So congratulations. And again, we learned what was happening. Why the condition? Why deconditioning happens new met your reconditioning program and we talked about the steps to effectively and safely recondition after concussion. You still have questions. Head over to the community for support again. I'm here. I've got you. We are here every step of the way and I'm very, very excited for you.

00:18:31:05 - 00:18:32:09
Speaker 1
So good luck.