Attention Magazine June 2020

For an extroverted physical therapist with ADHD, this quarantine is hard!

You may be in the same boat, whether you’re working from home, supervising a child or teen while they attend school from home, dealing with a college student sent home, living alone, or coping with social distancing in any of a dozen other scenarios.

Ironically, under these highly unusual circumstances, we need to be calm, relaxed, patient, healthy, and able to focus.

Yeah, right… cue more stress for trying to be what may not be natural for us.

Research indicates that exercise is one of our best allies at any time. We know that it benefits every cell in our bodies, including our brains. Simply google “Exercise and Executive Function” or “Exercise and Brain Function” or “Exercise and ADHD” and prepare for a plethora of research articles and information.

Here’s the dilemma: Now more than ever we need to exercise, but now more than ever it may be hard to find the time, method, equipment, and space. The great news is that exercising under stay-at-home conditions is not only possible, but it might be an excellent time to explore options and develop new healthy routines. In the sidebars that accompany this article, you’ll find numerous references and websites to assist you in this endeavor.

For those new to exercise, here’s a quick review.

ADAPTATION TO IMPOSED DEMAND

Your body is designed to adapt to the degree of activity you demand of it. If you are inactive (minimal demand), it will become deconditioned, weaker, and stiffer. Your energy level, general mood, and ability to focus may decline. If you regularly provide your body an appropriate challenge with activity (“overload”), it will adapt in a multitude of positive ways, including mental health and brain function.

THREE TYPES OF EXERCISE

The three major types of exercise are those that challenge and benefit your heart and lungs (cardiopulmonary/endurance), musculoskeletal power (strength), and overall flexibility (stretching). An ideal exercise program would incorporate all three types.

If you only have room or time for one, that’s better than none at all. Remember that with exercise, ONE SIZE DOES NOT FIT ALL. Always follow your healthcare provider’s advice. Find what works for you, your interests, your health and fitness level, and your goals. Many workout programs incorporate one or all three types of exercise and provide an efficient, effective workout. Examples are Pilates, Yoga, Tai Chi, Zumba®, Kick Boxing, HIIT (high intensity interval training), Silver Sneakers®, and line dancing. If you don’t already have DVDs of programs led by certified instructors, you can purchase them or stream online workouts that fit your needs.

Suggestions for cardiopulmonary (cardio) exercise: Get your heart pumping and break out in a sweat. Set goals, starting with a comfortable challenge, and follow reliable published guidelines such as those from the American Heart Association, American College of Sports Medicine, CDC, and Health and Human Services. (See the sidebar of Resources on Physical Activity and Exercise.) Wear good, sturdy shoes; drink water to stay hydrated; and have fun.

• Get out of the house and walk, jog, or run—either alone, with the dog, or with your quarantine mates. Be sure to keep a distance between yourself and others of at least six to nine feet.
• Bike outside or in the house on a stationary bike or on a “trainer” that you attach to your regular bike.
• Swim laps or enjoy water aerobics if you have access to a pool.
• Do aerobics workouts like Zumba®, Cardio Fit, or Silver Sneakers® Aerobics.

Suggestions for strengthening exercise: Strengthening requires regularly challenging your muscles to hold or move against enough resistance to promote the growth of stronger, healthier muscles (adaptation). A fully equipped fitness gym is enjoyable but not necessary. You can use weights, elastic exercise bands or tubing, homemade weights such as a gallon (9-10 lbs.) or half gallon (4-5 lbs.) jug of water, soup cans, or easiest of all, your own body weight. (See the sidebar to find resources you can consult for strengthening guidelines.)

Suggestions for flexibility exercise: Muscles, tendons, and ligaments will adapt by being gently stretched. You will be amazed at how much better you feel, easier you move, and less often you feel aches and pain. Maintaining flexibility as we age is extremely important to our health and function. Remember that flexibility is not a competition and that some websites promote excessive flexibility in postures or movements (like doing the splits or pressing your foot to the back of your head) that are not functional for everyday life. In fact, some excessive flexibility causes instability and pain. Work for healthy improvements, not impressive party tricks! (See the sidebar of Resources on Physical Activity and Exercise.)

OTHER SUGGESTIONS AND RESOURCES

Physical activity—such as gardening, mowing the yard, vacuuming, going up and down your stairs several times or washing your car—counts as exercise. Get out with your friends or kids and throw a frisbee, kick a soccer ball, play tennis, badminton, volleyball, tag, crank up some music and dance “like nobody is watching.”

The American Heart Association and several other organizations have websites that provide excellent overviews of exercise along with recommendations of specific exercises. Getting the recommended 150 minutes of moderate physical activity a week, or 20 to 30 minutes a day, may not be easy. Just 10 minutes once or several times a day is better than none and can be incorporated into your schedule. Stretch while waiting for the coffee to brew. Stand up from your chair and do 5-10 squats while waiting for the video conference to begin or every time a commercial comes on, practice deep breathing while folding clothes, do a modified yoga Warrior Pose while brushing your teeth. You get the picture.

In the sidebars to this article, you’ll find online resources for achieving fitness at home. These references are for different levels of fitness, many of which are too hard for me. Beware of extreme exercise sites that are impressive but limited to experienced, elite fitness levels. Follow your doctor’s or healthcare provider’s recommendations for your level of fitness. Select from the beginner, moderate, or challenging (intense) levels. Please do NOT attempt to do exercises that are too hard. Stop exercise if you experience pain, dizziness, nausea, or overheating. Initially, expect to experience some muscle soreness 24-72 hours (delayed onset muscle soreness) after a challenging workout. This soreness will subside with gentle muscle movement, rest, and exercise. With all exercise, have water nearby and stay hydrated.

These are difficult times. Lean in. Give and receive help. Give up on perfection. Just do the best that you can, and pat yourself on the back as you go to bed each night. We will get through this.

Ruth Mulvany, PT, DPT, MS, is a physical therapist and retired associate professor from the program in physical therapy at the University of Tennessee.