Physical Fitness During a Pandemic – PediaCast 459

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  • Physical activity and exercise are important, even during a pandemic. Our sports medicine team visits as we explore family activities, physical fitness, sports conditioning and connecting with coaches, athletic trainers and teammates… while staying home. We hope you can join us!

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  • Physical Fitness
  • Activity and Exercise
  • Sports Conditioning
  • COVID-19 Pandemic 

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Announcer 1: This is PediaCast.

[Music]

Announcer 1: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone. And welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the basement of my house, because I am social distancing just like all of you are doing at this time. 

We have listeners in all 50 US states, over 80 countries and all of us right now are in this together and staying at home so that we can flatten the curve and protect the most vulnerable among us from becoming sick and perhaps dying from COVID-19 during this unprecedented worldwide pandemic. 

0:01:11

And if I have just a little bit more upbeatness to my tone this week, I think it's because we're kind of settling in. The first two or three weeks of this, it's like, "What, I have to work from home?" Here I am in the basement of my house in what used to be my exercise room. Now, the treadmill and the elliptical are both overlaid with blankets as a sound deadening technique so that there's no cavernous echo in this room.

And the reason I picked this one in the basement is it is the quietest room in the house, kind of separated from everything else. And also, the cats cannot get in here and chew cords, which they are prone to doing, little things I didn't have to worry about a month ago. But here I am, and it's not lost upon me the ironicness of being in an exercise room that equipment is draped over with blankets as we talk about physical fitness during a pandemic. 

0:02:16

If you want to know what that looks like, the blanket-strewn exercise room, now studio, I did put a picture of it on Instagram. So, you can find it easily there. But anyway, this has become really the new normal. And I think there is a little bit more upbeatness to my tone because we're settling in. And even though there is uncertainty, and we don't know how long this is going to last, it really does sort of become the new normal. 

And I've also found it really interesting how businesses, many of them are doing one of two things, either they're closing the doors and laying off all their employees, and that's really sad. But we also have several businesses around us that is adjusting, and they're changing their business model and continuing to keep their employees and finding ways to be helpful and useful to families.

0:03:10

And one of those businesses, a couple of miles down from my house is Texas Roadhouse. And I'm going to say right here upfront I am not getting any kickback, no paid promotion from Texas Roadhouse. I was just really impressed with how they have changed their model. 

And what they've done is on certain nights, they have a family meal deal. And basically, they precook lots of the same thing, so there's not a ton of choice. But you can go and you order ahead of time, you park in the parking lot, you don't even have to go inside. And their employees are in basically in PPE, they have face masks, they have goggles, they have gloves.

And they are coming out and bringing the food in a protected way so that their employees are protected. And it's a way that we can still maintain social distancing and be able to get a meal out. 

And they're even having a farm market on the weekends with box of vegetables and box of fruits. There are some other businesses around that have offered their wholesale pricing on things like milk and eggs. Even though they're usually a restaurant, they're providing groceries now. 

0:04:14

So, I find it interesting how despite this unprecedented worldwide pandemic, at least in our lifetimes, just the way that the world is beginning to adapt to this new normal. That's happening out in the community. It's happening here, it's like I get used to being in this exercise room instead of my nice studio on the campus of Nationwide Children's Hospital. And I'm hoping to some degree that it's also happening in your household. 

Now, we have spent the last several weeks really exploring this COVID-19 pandemic. It started with Episode 455, where we covered really the nuts and bolts of the SARS-CoV-2 virus and the disease that it causes, COVID-19. Really, what you need to know about the science of the virus and the disease, at least as we know it now, which is certainly not complete. And we knew even less when I recorded that episode a month ago, but that's where we started.

0:05:11

And then, in 456, we talked about social distancing and the importance, what that looks like, which we all really know now. And why that's important to flatten the curve, we talked about that. 

457, our new routine which wasn't really quiet a routine yet, but I feel now that we're a few weeks out, it is really becoming more of a routine.

And then, our last time together, 458, we talked about mental fitness during a pandemic. We're going to talk about physical fitness this week, and then next week, we're going to cover schooling and academic fitness as we're all staying at home. 

And all of these COVID-19 episodes, we're bundling together into a playlist on SoundCloud so you can find them all in one spot. And we'll put a link to that in the show notes for this episode, 459, over at pediacast.org you can find them easily.

So, on tap today, we are talking about physical fitness during a pandemic. Why is physical activity and exercise important even during a pandemic? Perhaps it's even more important during a pandemic. We'll explain and provide tips for accomplishing physical fitness at home. 

0:06:16

We have lots of ideas for you on keeping your kids physically active, which it's not always difficult to do. In fact, there may be time when you'd like to see your kids a little less active, right? Especially those young ones that are running around all over the place and you're just worried, like "Hey, be careful, you're going to get hurt." 

And then, we're going to have to go into an urgent care and emergency room. And then, there's the stress and anxiety of are we going to expose them to this virus if we have to do that. But it is important for kids to be physically active and yet safe. So, we'll talk about ways to accomplish that. 

Other kids aren't as physically active, they need motivation. So, we'll share some ideas with you. In particular, older kids and teenagers, some of them will definitely need some polite yet effective motivation to get them moving and exercising on a regular basis. So, we'll have some ideas for your older kids.

0:07:06

Other kids and teenagers are going to be frustrated at their limited set of options for staying active. Especially as I think about the sports season, conditioning and training -- what does the future hold, how do I stay fit and ready for when things do often back up? And we'll have ideas for them as well.

And then, students are, of course, keeping in touch with the teachers and their classmates online as the schoolwork moves to the digital realm. But what about teammates and coaches and athletic trainers? Should student athletes stay in touch with them? Of course, they should. We'll talk about how that can best be accomplished. 

And then we'll wrap things up by considering physical fitness for parents and families as a whole -- some ways that we can improve physical fitness together. It does not involve spreading blankets over your exercise equipment, I can tell you that. I'm going to have to do something about that.

0:08:02

My guest this week are Dr. Amy Valasek, she is a sports medicine physician at Nationwide Children's Hospital, and Sara Breidigan, she is an athletic trainer with our Sports Medicine program. 

Before we get to them, I want to remind you, you can find this podcast on all sorts of places. We are in the Apple Podcasts app, Google Podcast, iHeart Radio, Spotify, SoundCloud and most mobile podcast apps for iOS and Android.

We love when you subscribe to the podcast and keep in touch with us that way. Reviews are helpful wherever you listen to PediaCast. We always appreciate when you take a moment to share your thoughts about the show.

And we love connecting with you on social media. You will find us on Facebook, Twitter, LinkedIn and Instagram. Simply search for PediaCast. 

We also have a contact link, if you would like to suggest a topic for an upcoming episode of the podcast or you have a comment or a question that you would like, please do feel free to connect through the contact link over at pediacast.org. 

Also, the information presented in every episode of PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individual. So if you have a concern about your child's health, be sure to call or contact your child's doctor.
 
0:09:14

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement which you can find at pediacast.org. 

So, let's take a quick break. We'll get our sports medicine experts connected with the studio and then we will be back to talk about physical fitness during a pandemic. That's coming up right after this.

[Music]

0:10:03
 
Dr. Mike Patrick: Dr. Amy Valasek is a sports medicine physician at Nationwide Children's Hospital and an assistant professor of Pediatrics at the Ohio State University College of Medicine. And Sara Breidigan is an athletic trainer with the Sports Medicine Program at Nationwide Children's.

They're here to talk about staying active, exercise and physical fitness in the context of staying home in the COVID-19 pandemic. Thanks so much to both of you for joining us today.

Dr. Amy Valasek: No problem.

Sara Breidigan: Thanks for having us.

Dr. Mike Patrick: I really appreciate you taking time to join us. How are you guys doing? Let's just start with a little bit of a check-in with yourself and your family? Dr. Valasek, how are things going at home?

Dr. Amy Valasek: I think, I would say for the Valaseks, we're taking each challenge day by day. Staying positive with both school and activities and whatever we can foster at home.

Dr. Mike Patrick: Yeah, I mean this is really been tough on all of us. And I think that's an important message for parents. That you, not only are you not in it alone because other families are going through this, but all of your medical providers, their families are also going through all of this too, right?

0:11:04

Dr. Amy Valasek: Yes. We're all in this together.

Dr. Mike Patrick: Yeah, absolutely. How about you, Sara?

Sara Breidigan: It's going pretty well, so far. My husband and I are both working from home. And I have a one-and-half-year-old and she's still able to attend the daycare. So, she allows us to get some solid work done during the daytime. 

And then, when we are with her, we try to spend as much time outside as possible. Just try to keep doing normal routine. I think that's important just to keep the stress levels down and just still have fun throughout the day.

Dr. Mike Patrick: Absolutely. Now, you mentioned that you and your husband are both working from home. You are an athletic trainer, what does that look like in terms of being an athletic trainer working from home? Because like three months ago... Well, I'm sorry, maybe two months ago or about a half ago, would you have even thought that was possible?

Sara Breidigan: No, but it's been a really interesting experience and all my patients are responding really positively to it. I have set up one of our spare bedrooms into my office and my husband has the other room for his office. And we're just making the best of it and trying to give my patients the best experience possible despite us all being at home.

0:12:13

Dr. Mike Patrick: And Dr. Valasek, you're a sports medicine physician. Are you working from home as well?

Dr. Amy Valasek: No. Not necessarily. We still have clinics and during my clinic time, I'm either seeing patients in the office still that have urgent needs or urgent follow-up needs versus phone calls visit or telehealth visit. So, we're doing that. 

And I do have a little bit of extra time to kind of do academic work at home, which I'm kind of molding into helping the kids with school as well at the same time. But right now, it's kind of we're in the office, seeing patients. 

Dr. Mike Patrick: So, when you're doing telehealth visits, you're going to the office to do those? You're not doing calls from home. 

Dr. Amy Valasek: Correct.

Dr. Mike Patrick: I know it's a little bit of hit and miss, like some divisions are doing it from home, some are going into the office. 

0:13:07

But then, it's nice if you do have someone who actually needs hands-on in terms of physical exam and evaluation, that you are able to get them in safely because you guys aren't seeing sick folks, anyway. Although, you can have mild symptoms with this. I'm sure you still taking precautions, right?

Dr. Amy Valasek: We're taking all the precautions. And I would say what we're doing with molding either telehealth, or phone calls, or in-person visits, you're trying to just make the best of the situation for the patient. And good judgement and figuring out who needs to come in or what could we talk about over telehealth video, it's really required a lot of flexibility, But I think we're all adapting as well as we can, truthfully. I think it's going well.

Dr. Mike Patrick: Absolutely. Let's talk about the importance of physical activity and exercise, whether you're a student athlete or not. Just give me an idea why should we get our bodies moving even though we are staying home? Why is that important, Sara?
	
0:14:09

Sara Breidigan: Well, I think for all of us, like you said, young and old, regular physical activity remains an important strategy for staying healthy. There are endless health benefits to staying active, especially mentally and physically. It helps keep our immune system in check so that way, we can fight off diseases. 

It's associated with lower levels of anxiety and precedes stress. So, it helps keep our mental health in check as well.

Dr. Mike Patrick: Dr. Amy?

Dr. Amy Valasek: So just to add to Sara's comment, the pandemic has changed everything. However, the recommendations for activity haven't changed. And so, for pediatrics, it's 60 minutes a day, seven days a week is what's recommended for every healthy kid over the age 5 through 18. 

0:15:02

And then, everyone 18 and up, the recommendations are minimum of 115 minutes of exercise. Both kind of recommendations still suggest two to three time a week of vigorous activities. So, that's like breathlessness and really working the heart and the body as well as strength and conditioning for more bone health.

So even though our outside world, everything has changed, I think those solid exercise recommendations have not changed. 

Dr. Mike Patrick: When you say 60 minutes of vigorous exercise for kids a day, does it have to all be at one time?

Dr. Amy Valasek: Absolutely not. So, vigorous, it's 60 minutes a day, seven days a week of moderate to vigorous activity, so moderate to vigorous. And two to three days a week should be vigorous. 

However, for kids like take a five-year-old for example, they might do bursts of five minutes, ten minutes, and that accumulates throughout the day. Whereas a high school athlete, might do a one-hour workout all within that same structured period of time. So, it's more additive.

0:16:13

Dr. Mike Patrick: And I love, Sara, that you mentioned not only do you get physical benefit from it, but it may really improve energy and concentration and mood, and even your immune system. Really, there's a lot of benefits to physical exercise. 

I did see one study that showed that high intensity exercise, like for prolonged periods when someone is not used to it, you can kind of overdo things too, right? 

Sara Breidigan: You definitely can and that can almost slightly weaken your immune system for a short period of time. So, it's important that if you're not ready for vigorous exercise yet, that's okay. Take baby steps to get there. Make it part of your regular routine and set small goals each week to gradually increase your physical activity levels. 

Dr. Mike Patrick: And part and parcel with exercise, sleep and diet are also going to be important things to consider, right? I see Dr. Valasek like shaking her head, yes.

[Laughter]

0:17:08

Dr. Amy Valasek: Honestly, Dr. Mike, it is hand and hand and everything coalesces into one. It's not just exercise. I think in order to help yourself and body maintain its best, it's fueling the body in a very healthy manner with all of the right fuels and not restricting or just focusing on a certain subset of eating habits. It's really well rounded and just consistent sleep for recovery.

Dr. Mike Patrick: So, as we think active and getting a move on, there are a lot of barriers right now for families to exercising. What sort of barriers can we expect? And then, how can we overcome those?

Dr. Amy Valasek: I would say some of the barriers that even my family and myself have encountered, I teach group fitness lessons at the local gym. And so, the gym is closed. And so, for me to be able to do that, it's now, the barriers are equipment, space, having safe space within that house. I think time. I think many things are chaotic right now. 

0:18:26

And then, safety in the sense of do you go outside and exercise? When is the best time to exercise? Is it safe? So, I think those, equipment, space, time, and safety have been pretty prominent for myself and for my family as well. 

Dr. Mike Patrick: How do you overcome these barriers, then?

Dr. Amy Valasek: I think taking it day by day. As a fitness instructor, we've set up a private webpage where we can reach our audience. So, I think many coaches, teens, instructors are doing things like that, reach that broader audience. 

I think also, it's just setting time for yourself. Sara mentioned it, of keeping a schedule. Right now, things are chaotic, but schedules are so important too to be able to dedicate 60 minutes of activity in some form.

0:19:22

Dr. Mike Patrick: The last couple of episodes and the folks I've talked about really have been pushing how important schedules are. And really, even to the point of maybe writing down, "Hey, from this time, we're going to get up at this time. We're going to do schoolwork during this time. We're going to have this time for exercise."

It's just so easy since we don't have accountability to go somewhere to just sort of let things slide. But if you don't make physical and exercise a part of that written out schedule, it's a little less likely to happen for sure. 

And then, the other thing I wanted to mention is there's a lot of anxiety and disappointment and sadness and like the whole gamut of feelings. And sometimes, you don't just feel like moving because of those feelings. But I would encourage folks that if you just give it a chance, a lot of times, even though you're feeling kind of sad and down, if you push yourself to exercise, you really do get a rise up, right, your endorphins. And you get your heart pumping and you really feel better sometimes, or a lot of times even, after your exercise, right? What do you think, Sara?

0:20:25

Sara Breidigan: Yeah, I couldn't agree more. And when you're feeling like that, see if you can reach out to someone. Have an accountability partner who's also maybe working towards the same goals. 

You don't always have to work out by yourself. Even though we're in this isolation period, you can Skype or Zoom with someone and do the same workout at the same time. 

There's lots of Facebook groups out there, active moms, active dads, running groups, dance groups. I encourage people to join those and talk to those people. And see what they're doing for their workouts for the day or their activity and get really good ideas to connect to other people. So you may not feel so alone.

0:21:01

Dr. Mike Patrick: Yeah, really important to stay connected and social for sure even in the midst of exercise. 

What about our young kids? So, kids have different personalities and there are some kids who they are going to get that 60 minutes of vigorous exercise every day. Even if you told them "Hey, you have to sit down," they're up and running and up and down the stairs, and it's not a problem. 

For other kids, it can be a little bit of motivational issue to get them up and active. So, for those younger kids, what are some ideas, Sara, on how we can keep our youngest of kids active during the day? 

Sara Breidigan: Right, so like you said, free play is definitely ideal for our kids. But sometimes, it just doesn't come naturally to them. And that's okay, so encourage them to get outside, walk, ride their bike. 

One idea that I've seen floating around, which I think is great, is do a backyard nature scavenger hunt. So, make them a list, see if they can go find these things. You can have them try to take photos of items starting with A through Z. Have them get 26 photos of items they can find there in the house or outside. Have them do some homemade obstacle courses, Simon Says, relay races. 

0:22:12

I've been seeing a lot on Facebook; the sidewalk chalk is really popular these days. So, get that out. And then, you don't always have to color, but maybe draw a dot from the ground. Have them pop from dot to dot or make some type of relay race that way. 

Creativity is great for kids. You really want them to embrace that and see what other objects you can find around the house whether it's jump ropes of hula-hoops. We all have some kinds of tucked in closets places. See if you can find those items to encourage your kids to be active.

Dr. Mike Patrick: Yeah, and dance parties. 

Sara Breidigan: Yeah, absolutely. For those younger kids, Go Noodle is a great website for dancing. PE with Joe is another good YouTube channel that's been putting out some good active things that the kids can follow along, too. And then Cosmic Kids Yoga as well, kids have been taking to that as well.

0:23:03

Dr. Mike Patrick: Great resources and we'll put links to those things in the show notes so folks can find them easily.

My background is, of course, I'm a general pediatrician but now I work in our emergency department and our urgent care centers. I would say, in particular now, as your kids are active. You still really want to use bike helmets and do everything you can to prevent injuries because an injury may mean that you have to put social distancing on pause to go into an emergency room, where there's also sick kids. And so, really, this is probably not the time to be climbing trees and doing things where you can get significantly injured. 

How about our older kids and teenagers? Again, some of them are going to be motivated on their own to be active. Others aren't going to be so motivated. What are some ways, Sara, that we can encourage older kids and teenagers to stay active?

Sara Breidigan: Well, there is, again, a lot of online resources that it can be overwhelming sometimes. But maybe they should try something new each day. I think it's a great goal to try something new each day whether it's yoga or CrossFit or hit workouts. There are lots of workout apps out there as well that are offering free trials during this pandemic. 

0:24:18

For our student outlets, staying connected with their friends and teammates through Skype or Zoom, doing workouts together is a great way to be active. I was thinking earlier, it'd be cool if you're a basketball player and you could play a game of H-O-R-S-E virtually with your teammates,0 just like if they were there. 

So just keep in mind that though you may be stuck at home, technology is so awesome these days and used in creativity to make the best of it. 

Dr. Mike Patrick: Yeah, that definitely does make a huge difference. And competitions within family members can be fun, too. Like, okay, let's actually start a chart and who got their minutes in? Or you can even come up with a system of you get these, and this is probably more for your middle-aged kids, to say "Hey, you get this many credits if you do activity and then you can spend your credits on something else." 

0:25:06

I mean, it's an opportunity to really get creative in terms of how you can motivate kids depending on what their motivation currency is, right? 

Sara Breidigan: Exactly, and it's a great way to bond together as a family. Rather than seeing this as a chore or something you have to do, look at it as a really good opportunity to develop an improved relationship with you child, something that may live and flourish long past the current crisis. It could be something that continues for years to come. 

Dr. Mike Patrick: And video games, as much as we say, "Hey, let's have less screen time," there are some really active video games like Dance, Dance Revolution and Sports Party, and Zumba Burn It, Fitness Boxing. There are other ways to incorporate, so you're doing something a little bit different from one day to another. 

Let's talk more about student athletes. You mentioned, Sara, you continue to connect with your teammates and with your friends at school as you think about exercising. 

Dr. Amy, in what ways should student athletes be thinking about continuing the conditioning and training for their particular sport? Are there still things that they ought to be doing during this time? 

0:26:14

Dr. Amy Valasek: I think that is a great question. Yes is the short answer. I think the structure and the training for any athlete, whether it's recreational or teen-based or competitive athlete, it's important to have consistency. By taking a break, let's say they stopped training for 30 days in this quarantine, it really takes time to build up that conditioning you've already established.

So yes, basically, their schedules in a way, although they might not be together as a team or in a gym or studio should continue and mimic at home. And then, I would say Sara brought up a really great point, is vigorous training. So, people have more time on their hands. And they're working harder than they should be and not getting enough sleep, and not fueling, it really can have a negative effect on the body and immune system. 

0:27:19

So right now, training I think is really important to stay steady and incorporate the typical patterns that the coaches or their  teams have set out for them in a healthy meaningful way. 

Dr. Mike Patrick: And Sara you worked with a lot of schools and student athletes in your job as an athletic trainer. Are teams, to your knowledge, are people, like with the schools, teachers are sending emails and packets and some having Zoom meetings depending on the school district. Are coaches and teams keeping in touch with one another as well in your experience? 

Sara Breidigan: Yeah, from what I know coaches are still reaching out to their teams and giving them different ways to be active and giving them programs to keep them busy at home, and making it tailored to what they have at home and really giving them solid guidance on how to maintain their levels of fitness and skill while being at home. 

0:28:19

Dr. Mike Patrick: And that's something, if your particular school maybe that's not been a priority, student athletes can still reach out to their coaches and athletic trainers, right? Just say "Hey, what should I be doing right now?" 

Sara Breidigan: Yeah, absolutely. Use your resources. Parents, encourage your kids to use their resources. We're out there, we want to help, we are natural helpers. It's in our blood. So just let us know what you need, and coaches and athletic trainers would be happy to help you, guys. 

Dr. Mike Patrick: And Dr. Amy, have you talked to some student athletes in terms of what their schools may be doing? Are there different opportunities?

Dr. Amy Valasek: I think, yes. I've heard from a couple different forums and it seems to be a variety for each school system. But I think the best resource is, as Sara said, are their direct coaches, athletic directors. 

0:29:15

These private teams, the private companies, so like your studio or your gym directors, they're often making plans and strategizing how to still reach the kids in this time. Because at the end of the day, we're still all in this together. And I just seen some creative workouts and exercise forums just kind of impromptu started because of this. It's been actually really cool. 

And at the end of the day, I think exercise is one of the best medicines that we have for our health and wellness. There's nothing that beats it in the sense of all these positive side effects. So, I do feel that many people are trying to expand their audience and trying to incorporate all age groups in this. 

0:30:09

Dr. Mike Patrick: Yeah, really important. And this must be really hard for you, Sara, because athletic trainers just have such close connected relationships with the student athletes that they serve. Has this affected you personally in terms of not being able to physically connect with them?

Sara Breidigan: I mean, yeah, it's definitely hard. But this is a situation we're in and there's lots of other ways we can connect right now and still make it work and make it happen. So just engaging those people in that way is what we have to do right now.?

Dr. Mike Patrick: Are you engaging with your fellow athletic trainers in terms of maybe sharing ideas and getting together and supporting each other as a group as well?

Sara Breidigan: Yeah, I mean, athletic trainers right now feel like they don't have any normal work to do. So, I'm just checking in on them. Some athletic trainers are personally free of load right now which is really hard. We're just making sure that they're staying mentally well. And then, when we are working, what creative ideas do we have out there? What are other people doing? I think it's really important to share those ideas. 

0:31:19

Dr. Mike Patrick: Absolutely. Now, it's not only important for young kids and older kids and student athletes to stay active. It's also important for parents, too, right? I mean, we all need to stay active. Sara, just kind of give us an idea of the importance for parents to be active as well as their kids. 

Sara Breidigan: It's amazing. So, parents are, we're the role model for our kids. So, I really encourage parents not to be a spectator when it comes to physical activity. Put down the electronics for bed, take a break from work, and chores, and all the other things that we have going on. 

Exercise is going to keep our minds sharp and focused and it will help us remain patient when things do get stressful. It's a great stress reliever. So, it keeps us strong. Like you said, it helps us sleep better and gives us more energy throughout the day. So now is a great time for us as parents to work on new fitness schools and set a good example for others.

0:32:15

Dr. Mike Patrick: So all of those benefits that we've talked about for kids, those same benefits can be grasp by parents as well. And then, all those practical ways that we talked about staying active, jump in and join with your kids in doing those activities, right?

Sara Breidigan: Yes, be a kid again. Play a game of tag with them, it's still fun, trust me. I've done it with them, my patients, before.

Dr. Mike Patrick: Absolutely. And we've talked about a lot of, in addition to exercise, diet and sleep also play a role. Yoga and mindfulness can also be an important part of this, right? I see you shaking your head there. Dr. Valasek, in what way? 

Dr. Amy Valasek: This setting, I would say this pandemic in a way has made us all slow down a little bit, to take a deep breath whether we want to or not. And I think it's been a great time to hit the reset button in the mindfulness category of practices aren't three hours anymore, right? You're on your own to set your own schedule and get your training in. 

0:33:21

Often, it is hard to fill that time because it's not the same. But one thing we often leave out in our busy lives is the mindfulness, the time to kind of take a step back whether yoga is your release or meditation or just closing your eyes for ten minutes and kind of taking some deep breaths. I think it's really, really important. And I would say that has been one of the positives out of this for our family. 

My family is what I'm talking about, to kind of we're not running from practices and work and games and this and that. We now have a little bit more of time to kind of see the forest through the trees a little bit. 

0:34:04

Dr. Mike Patrick: Absolutely, it's so important. In our previous episode on mental fitness, I mentioned a couple of resources for folks if mindfulness is sort of something new to you, a new concept. One is Ten Percent Happier. Another one is Headspace and both of these sites are offering discounted or even free services during this pandemic. And I know Ten Percent Happier, I think, is free for healthcare workers in general. So, this would be a great time to look into that if it's not something that you've explored in the past. 

Another thing that I've heard about is something called a virtual marathon. Tell us more about that. 

Dr. Amy Valasek: Sure, I'd be happy to. Healthy New Albany, Dr. Philip Heit created a marathon for kids, essentially five and up to complete in the next two months, 26.2 miles. This is to be done with family, so the intent is you're sticking with your immediate family and still following all of the COVID-19 restrictions. 

0:35:12

But over the course of two months, children can download the form. Registration is free, and on that form, they record no more than three miles a day. It's the limit, whether you walk it, run it, jog it, walk your dog, ride your skateboard with your helmet, whatever you would like. And basically, this is to encourage exercise spread out over the next two months. 

Once it's complete, you email in or upload your form and all the kids who had registered win a little prize at the end. And it is just a fantastic way to really encourage families in this difficult time to stick together and get outside when they feel comfortable to do it and get a little exercise in. 

That length is real, it's 26.2 miles, but spread out over the course of two months. 

Dr. Mike Patrick: Okay, got you. 

Sara Breidigan: So instead of completing it in a day or in a morning, you're completing it over the next two months. We can send you the link to that.

0:36:19

Dr. Mike Patrick: Yeah, that is terrific. And I'll share that in the show notes so folks can find it as well, Episode 459, over at pediacast.org.

Dr. Valasek, one of the things that you've mentioned, a phrase was "Exercise is Medicine." Tell us a little bit more about that concept.

Dr. Amy Valasek: I would say Exercise is Medicine is a concept developed by the American College of Sports Medicine. And it's been around, I would say for the last ten years or so in my kind of forum. And what we know is that delay exercise on a consistent basis, essentially sitting less and moving more has numerous health benefits, too many to even count. 

0:37:08

And at the end of the day, whether you're at age 5 or your age 95, sitting less and moving more whatever your cup of tea of moving is helps lower chronic health conditions, numerous forms of cancer. It boosts your immune system if you don't too much vigorous activity. Mental health, it has improvements of so many benefits of mental health, cognition, attention, focus. 

One thing that I work on was we incorporated about a year and a half ago in one of the local systems, brain breaks. I have gotten a grant from the AAP and we created a five-minute, eight-minute, ten-minute exercise videos for them to incorporate for kindergarteners, first graders. Kind of just to get them up and moving. 

0:38:07

And we look at attention to tasks. So, the more often they got up and move could they sit and then focus and complete their writing or their reading. The results, it was easy to see. It just kind of naturally, yes, it helps all of us.

So, at the end of the day, Exercise is Medicine is a phrase I often use. And it's not the only medicine, but it's one of the best forms of medicine that are just when you look at the side effect profile, it's very minimal compared to the positive effects that it has, if you do it correctly. 

Dr. Mike Patrick: There's a website that's exerciseismedicine.org. And it has just a ton of resources for student athletes, for families, for parents, for providers with lots more information about this concept of Exercise is Medicine. 

And they put together one resource in particular. It's called Staying Active During the Coronavirus Pandemic. And it really has some terrific ideas for staying active while we have to be home. And I'll put links to both of those sites. Well, it's all at exerciseismedicine.org. But the main site and then this particular thing that relates to the pandemic, I'll put links to those in the show notes for this episode, 459.

0:39:28

But a few highlights, they have some ideas for aerobic activities but also strength training. You may not have access to the gym or to the usual weights that you have. But they have some great ideas for seven-minute workouts that do not require any equipment and doing squats and push-ups and lunges. And they have the directions for how to do all those things. And of course, the aerobic activities, a lot of the things that we mentioned indoor and outdoor ideas are all there. 

And then, one thing that I love from that site that I'll share here is that if you are watching TV, and the advertisers won't like this, but get up during the commercials and move around. Do a lap around the house, do an active chore in that few minute period. Throw some clothes in the laundry, do the dishes, take out the garbage,

0:40:18

And even after just a couple of shows, those commercial breaks add up and you at least feel a little bit more productive. I haven't really thought about that.

Dr. Amy Valasek: Yeah, and honestly, I think, Mike, that goes to the sit less, move more as we're isolated. Whether you're really doing burpees and lunges versus taking off the trash or I'm going to clean out this closet in the next 15 minutes, some version of movement is better than no movement at all. 

Dr. Mike Patrick: So, binge Tiger King or whatever it is that you want to it is that you want to binge, but then get up and move.

[Laughter]

Dr. Mike Patrick: That doesn't have commercials but pause it. 

[Laughter]

Dr. Mike Patrick: That's what Netflix or any of these streaming services, they ought to have like an auto pause after so many minutes. You know what I mean? And then, okay, we don't have commercial breaks but to encourage activity. I don't know, I don't think they'll go for that. 

[Laughter]

0:41:12

Dr. Mike Patrick: Tell our listeners more about the Sports Medicine Program at Nationwide Children's Hospital during normal times. What sort of things do you guys do other than encourage kids and support student athletes?

Sara Breidigan: So, we have our functional rehab program which we work with injured athletes and people who are still trying to be active to rehab them back to their sport or their activity. Normally, we do that in person, at our facilities, but right now, we are using telemedicine to continue to rehab our athletes. 

Our Play Strong Program which is a physical activity program for patients who are looking to increase their physical activity levels and change their habits. That program is still going on through telehealth. I'm seeing all the patients for Play Strong and I'm doing workouts at home with them and instructing them how to play games together as a family, making it super fun. 

0:42:09

It's been an eye-opening experience, so we're still keeping patients healthy that way. We have our performing arts medicine program that is still going on, one of our athletic trainers is still checking in with our dancers and performing athletes. And then, sports performance as well, they are normally out of the school's training. They're athletes but I do know that they are getting programs outdoor student athletes so they can continue to train on their own. 

Dr. Mike Patrick: Really important work, not only during the pandemic and with all the challenges of telehealth in trying to provide sports medicine services. But this will end at some point, and certainly, those great things that you do for student athletes in our community are so appreciated and will continue. 

And I'll put a link to the Sports Medicine Program at Nationwide Children's Hospital in the show notes, so you can check out all the things that they're involved in. 

0:43:01

I also love that your practice is multidisciplinary. So, when student athletes see sports medicine, they're not only seeing sports medicine doctors and athletic trainers, but we have sports nutrition and psychology and physical therapy. And really, you have the whole wealth of services at Nationwide Children's Hospital that can be integrated into a holistic program for student athletes.

Sara Breidigan: Yep.

Dr. Amy Valasek: It is a diverse program, but we just want to have all the services available for whatever our athletes need. 

Dr. Mike Patrick: We will have lots of resources in the show notes for folks that's available at pediacast.org, Episode 459. And so, all the things that we've talked about during the course of our conversation if you'd like to learn more information about those things, just head over to the website and you can find them there. 

So, Dr. Amy Valasek, sports medicine physician in Nationwide Children's and Sara Breidigan, athletic trainer, once again, thanks so much to both of you for joining us today. 

Dr. Amy Valasek: Thank you.

Sara Breidigan: Thank you for having us. 

[Music]

0:44:28

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out  of your day and making PediaCast a part of it. Really do appreciate that. 

Also, thanks to our guests this week, Dr. Amy Valasek, sports medicine physician at Nationwide Children's and Sara Breidigan, athletic trainer with our Sports Medicine Program.

Once again, you can find PediaCast in all sorts of places. You can subscribe in Apple Podcasts, Google Podcast, iHeart Radio, Spotify, SoundCloud, and most mobile podcast apps for iOS and Android.

Don't forget that landing site where you can find our entire archive of past programs. And those include all the show notes, transcripts, we have written transcripts of many of the episodes, also our Terms of Use Agreement, and that handy contact page if you would like to suggest a topic for a future episode of the program or if you have a comment or a question that you would like to share with all of us. And again, that landing site is pediacast.org. 

0:45:19

Reviews are helpful wherever you listen to PediaCast. We always appreciate when you take a moment to share your thoughts about the show. And, we love connecting with you on social media. You'll find us on Facebook, Twitter, LinkedIn and Instagram. Simply search for PediaCast.

Hey, when you have those telehealth visits with your primary care physician, please let them know about PediaCast so they can share this content with their other families and patients.

And let them know we have a show for them as well. It's called PediaCast CME. It is similar to this program. We turn up the science a couple of notches and offer no cost ad-free Category 1 Continuing Medical Education Credit for those who listen. Shows and details are available at the landing site for that program, pediacastcme.org.

And those shows are also available in Apple Podcast and all the other various places where you can find podcast, simple search for PediaCast CME. 

Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, stay home, and stay involved with your kids. So long, everybody.

[Music]

Announcer 1: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.
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