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Help Your Clients Return to the Gym Post Quarantine

    Author by Elyssa Hartman, MA

 

As fitness instructors, we need to understand the impact COVID-19 quarantine could have had on our psyches and physical bodies, even at an unconscious level, to help ourselves and our clients adjust to post-quarantine life.

Post-traumatic stress disorder (PTSD) is a common and insidious mental health issue the world is facing today. How we process several important issues like the stress and trauma of a world pandemic, quarantine living, and the ever-present reality that anyone at any time can be infected, impacts how we are able to return to our activities of daily life. Let’s examine some of the symptoms and stages of PTSD, how we may have adapted to the unprecedented stress, and how to facilitate a gentle reintegration to gym life for our patrons.

Researcher Kanwar Hamza Shuja (2020), claims that, “although as of yet the effects of COVID-19 on mental health have not been studied systematically, it is expected to have significant effects based on recent public reaction.” While not everyone will have full-blown PTSD, there is no denying the higher levels of stress and anxiety are impacting more people more profoundly. We need only scroll Facebook or Instagram to see how the masses are spending this time in quarantine. For example, any random day scroll reveals the gamut from organizing the garage to Netflix binging, showing a frenetic energy we don’t quite know how to lasso.

It’s not surprising that there appears to be a systematic reaction to having been suddenly quarantined. A theory of stress response developed by Dr. Hans Seyle explains the progression as General Adaptation Syndrome (GAS). The first phase consists of Alarm Reaction where cortisol is spiked, the fight or flight response is ignited, and there is a surge of energy (Higuera 2017). Indeed, at the beginning of quarantine, many people had this urge to clean, organize and take on new tasks. The swell of energy brought on a buzz of excitement for some, an imagining of all that could be caught up on while putting some of our typical daily activities aside, not the least of which is commuting. For others, the sudden quarantine created panic and anxiety, exhibited by hoarding toilet paper and hand sanitizer; the uncertainty of what was to come causing them to connect with their basic survival instincts and escalating cortisol levels.

As quarantine continued, the second or Resistance Phase kicked in. Cortisol levels hopefully lowered but our bodies remained vigilant looking for reasons to flee. While we may have felt as if we were handling the stress better during this phase it is marked by irritability, frustration, and poor concentration (Higuera 2017). The notion that we have come to terms with this new lifestyle is undermined by behaviors that exhibit our edginess. Perhaps there is no better example of this phase than the vitriol flung at the government, the defense of health care workers, and the daily postings of which political parties or countries are to blame. Furthermore, and closer to home, incidence of domestic abuse began rising during the second month of quarantine revealing the heightened tension (Taub 2020).

The final phase of GAS is Exhaustion and is associated with fatigue, burnout, depression, anxiety, and decreased stress tolerance. It’s at this phase where the fallout of the protracted stress becomes dangerous as the immune system is taxed, and we become more at risk for illness (Higuera 2017). The pleas from many to be able to return to their jobs, to visit friends and family, to feel normal again have risen as Governors devise ways to open their states safely.

Reimagining Life at the Gym

Avoidance is an unhealthy but common PTSD behavior (Anxiety and Depression Association of America, [ADAA]). Survivors of trauma are fearful of returning to any place that reminds them of the traumatic events. Unfortunately, that may mean anywhere outside of home these days. Walking into the gym and seeing people in masks, equipment shut down to increase physical distancing, and space demarcations on the group ex floor may keep many from returning to their regimens for a long time.

Another pandemic also caused by a coronavirus, Severe Acute Respiratory Syndrome known as SARS, occurred in 2003 and mostly affected Asia but managed to traverse 12 countries in less than 2 months and kill 10% of the 8,000 people it infected (CDC 2004). The rampant spread required home quarantine of those infected and initially caused hysteria until it rather suddenly disappeared in a few weeks. A study of people after the SARS quarantine noted that “many participants continued to engage in avoidance behaviors...54% avoided people who were coughing or sneezing, 26% avoided crowded enclosed places, and 21% avoided all public spaces in the weeks following the quarantine period” (Brooks 2020). Considering the more extensive infection rate and death toll of Covid-19, what this will mean to in-person participation in our classes is yet to be seen and will take exceptional adeptness by instructors to ensure a relaxed environment.

While reintegration of clients into the social realm of gym life is the goal, the fear of infection may be too much for some to overcome quickly. Continuing to offer online classes can help ease this stress and give those suffering from PTSD a familiar face to workout with in the safety of their home. Furthermore, live-streaming or a video library can be another revenue stream for both the instructors and the gym. For those willing to come back to the gym, offering one-on-one personal training in a specified restricted area can allow the hesitant to become more comfortable in the setting and may facilitate the speed of their return.

Creating a Reduced Stress Environment

Instructors can make several quick but far-reaching adjustments to class to reduce their participants’ stress and to recover from the trauma brought on by COVID-19.

  • VOLUME: To make group fitness classes more welcoming, instructors can reduce music volume as loud sounds can trigger those with PTSD (ADAA).
  • LIGHTING: Keep the lights slightly dimmed and remember to smile more frequently to increase feelings of comfort and connection with participants.
  • PRE-SHOW: Instructors can help more by offering the class some extra time to chat during the warm-up thereby reigniting the sense of community we all have been missing.
  • CONTENT: Additionally, some members may not have worked out at all during quarantine. The lack of movement, along with the stress and uncertainty during quarantine can cause fatigue and achiness as well as tension throughout our bodies making movement more difficult in the beginning. Including gentler and longer warm-ups will help everyone re-enter the “groove” more readily and help participants re-engage with their bodies.
  • COMPLEXITY: Keep the choreography simple for a few weeks to help everyone feel more successful as our brains may feel foggy and confused from weeks of inactivity and stress.
  • CLOSING: Consider using classical music for the last few minutes of class to end the on a calm and peaceful note.

 

Add More Stress Reduction Techniques

While stress reduction is a natural byproduct of fitness, everyone can benefit from learning breathing exercises to relax their nervous system and those with PTSD especially so. G.K. Pal et. al (2004) explain how the “Regular practice of breathing exercise is shown to improve autonomic functions by decreasing sympathetic activity or by increasing vagal tone” (115). Take an extra few minutes at the end of class to calm your student’s nervous systems through breathing exercises. For example, teach 1:2 ratio breathing with exhales twice as long as inhales to effectively soothe the fight or flight response. You can also increase the recommended stretch time to include static stretches 60-90 seconds.

Undoubtedly, ending classes with mindfulness breathing and luxuriating stretches will help everyone decrease cortisol levels, feel calmer, and reduce blood pressure, all of which are helpful in counteracting the effects of the long-term stress associated with quarantine.

As we all ease out of isolation, bringing more kindness, compassion, and stress relief to our students will be needed to overcome these challenging circumstances. Those of us with mental health issues are looking to our fitness instructors to help us attain the relief we crave from our overactive brain and hypersensitive nervous systems. We appreciate you more than you know.

 

REFERENCES

Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. ​Lancet​. 2020;395(10227):912-920. doi:10.1016/S0140-6736(20)30460-8

CDC. Basic Fact Sheet on SARS. ​https://www.cdc.gov/sars/about/fs-SARS.pdf​ 2004

G.K. Pal, S. Velkumary & Madanmohan. 2004. Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. ​Indian J Med Res 1​20, August 2004, pp 115-121.

Higuera, Valencia, Medically reviewed by​ ​Timothy J. Legg, PhD, CRNP​ on May 1, 2017 — https://www.healthline.com/health/general-adaptation-syndrome

Shuja, Kanwar Hamza, Aqeel, Muhammad, Abbas Jaffar, and Ammar Ahmed. 2020. ​Psychiatria Danubina. Vol. 32, No. 1, pp 32-35 https://doi.org/10.24869/psyd.2020.32

Taub, Amanda. 2020. ​A New Covid-19 Crisis: Domestic Abuse Rises Worldwide. ​The New York Times​. April 14, 2020.​ ​https://www.nytimes.com/2020/04/06/world/coronavirus-domestic-violence.html

 

AUTHOR

Elyssa Hartman is an active aging specialist with over 20 years of experience in the fitness industry. Having suffered from PTSD and depression for most of her life, she strives to share the strategies she’s learned in her 10+ years of therapy to combat the urges to isolate and vegetate. ACSM, PT; NASM, Group Ex.; CYT. Elyssa can be reached at her website,  www.seasonedfitness.com, and on Facebook at https://www.facebook.com/elyssa.hartman

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