Training in hot weather!

Let's talk about the factors to be considered while training in hot weather! 

Before putting some guidelines out there, we will try to understand what happens to the human body when exposed to hot environment. 

All primates including humans, generate heat either by increasing muscle activity or by reacting to the hot environment which exceeds the body temperature. 

How do humans differ from other primates?

Firstly, humans have the advantage of losing heat via perspiration (sweat). In addition, humans can cope up with their maximal potentials in terms of exercise for prolonged duration in temperatures ranging not more than 41 degree C (106 degree F). Having said that, there are different modes of heat transfer. Do you know what is the easiest way for humans to do so? 

What could possibly go wrong if you are not careful enough to interpret those symptoms?

The common possibilities are heatstroke, exercise associated collapse/ heat syncope and cramps. 

1) Heatstroke - Heatstroke is a life-threatening emergency condition that occurs when your body temperature is greater than 104 F (40 C). You may develop confusion, irritability, headache, heart rhythm problems, etc. You need immediate medical attention to prevent brain damage, organ failure or even death

2) Exercise associated collapse/ heat syncope - Exercise-associated collapse is feeling lightheaded or fainting immediately after exercising, and it can occur especially if you immediately stop running and stand after a race or a long run. Heat syncope is a feeling of lightheadedness or fainting caused after standing for a long period of time, or standing quickly after sitting for a long period of time in high temperatures. 

3) Cramps - Cramps occur due to fatigue. It's a presumption that "Oh, cramps are just an electrolyte imbalance. Load him/her with Oral Rehydrating Solution and it'll be gone like it never existed in first place." That's not always true! Cramps occur due to spinal neural reflex which in turn is a result of fatigue. Too much to grab, don't worry; just stretch the muscle along with application of ice and Poof ! You're cramp free! 

Pay attention to these symptoms as it affects the training. 

If you ignore these symptoms, your condition can worsen, resulting in a medical emergency. Signs and symptoms may include:

• Muscle cramps
• Nausea or vomiting
• Weakness
• Fatigue
• Headache
• Excessive sweating
• Visual problems
• Confusion
• Irritability
• Low blood pressure
• Increased heart rate
• Dizziness or lightheadedness

How can one avoid such problems? Well , here are some measures to be taken when not feeling "okay"!

1) Stop exercising immediately and get out of the hot environment. If possible, have someone accompany you who can help monitor your condition.

2) The most effective way of rapid cooling is immersion of your body in a cold- or ice-water tub.

3) In cases of heat exhaustion, remove extra clothing or sports equipment. This will help cool your body faster.

4) In running events, there are 'Flag' warnings that correspond to the degree of heat and humidity. For example, a yellow flag requires careful monitoring, and races are canceled in black flag conditions.

5) If you're used to exercising indoors or in cooler weather, take it easy at first when you exercise in the heat. It can take at least one to two weeks to adapt to the heat. As your body adapts to the heat over time, gradually increase the length and intensity of your workouts

6)  Reduce your exercise intensity and take frequent breaks.

7) Dehydration is a key factor in heat illness. Help your body sweat and cool down by staying well-hydrated with water. Don't wait until you're thirsty to drink fluids.

8) Lightweight, loose fitting clothing helps sweat evaporate and keeps you cooler. Avoid dark colors, which can absorb heat. If possible, wear a light-colored, wide-brimmed hat.

9) Exercise in the morning or evening, when it's likely to be cooler outdoors. If possible, exercise in shady areas, or do a water workout in a pool

10) Apply sunscreen as a sunburn decreases your body's ability to cool itself and increases the risk of skin cancer

Heat-related illnesses are largely preventable. Take some basic precautions and your exercise routine doesn't have to be sidelined when the heat is on!!

Physiotherapy after TKR (Total Knee replacement) Surgery

 

Physiotherapy after TKR (Total Knee replacement) Surgery:

Some Facts

Before TKR or knee replacement surgery

1.       A person, who is suffering from severe pain in the knee joints, avoids activities like climbing up and down the stairs, running, cycling, sitting on the ground, squatting, sitting cross legged or even walking.               

As the activity slows down, strength of thigh muscles, muscles around knee joint, calf and foot muscles reduces.

2.       If a person is suffering from osteoarthritis or rheumatoid arthritis, a deformity is developed in the knee joint.

Due to this deformity, wrong style of walking leading to wrong posture or “Gait Pattern” is developed.

After TKR or knee replacement surgery

1.       Pain in the knee joint reduces.

2.       Deformity of the knee joint is corrected.

But still there is some nagging pain in the knee!!!

Many a times this pain is unbearable and is troublesome physically and mentally.

This is due to lack of muscle strength.

Due to lack of muscle strength in legs, person even after a successful surgery, is not confident to walk or to climb up and down the stairs.

Statistical data tells that 25-30% of patients who have undergone the TKR surgery are unhappy with the results!!

The most common complaints are,

“I can’t tell you what is wrong.  I am not comfortable with my knee joint. I still don’t feel like doing any physical activity”.

“I have spent so much of money and got my knees replaced but the pain is still there.  I am not sure about success of this surgery.”

This happens because during (Robotic or Conventional) TKR surgery

1)      Muscles are dissected or cut to reach up to the bones.  After the replacement of knee joint, these muscles are sutured or stitched.

2)      Two major ligaments of the knee joint (ACL-anterior cruciate ligament and PCL- posterior cruciate ligament) are totally cut off and removed. Necessary design features are incorporated in the knee joint implant to take care of loss of these ligaments.

3)      To correct the deformity of the joint, ligaments, tendons and muscles are partially ‘released’ from the bone attachment. Because of this coordination between signal from the brain and   joint movement is disturbed.

4)      This signals sent by the brain to the muscles and ligaments to do a movement, known as Proprioception’, may not be still accurate, after the surgery.

5)      Till the time these dissected/cut muscles do not get functional, some pain or limitation on joint movement remains.

Therefore, physiotherapy plays a very important role in total recovery of the TKR patient.

Physiotherapy post TKR:

·         Get rid of residual pain post TKR surgery.

·         Re-educate or train the muscles around the knee joint and all muscle groups of the leg post TKR surgery.

·         Regain muscular strength

·         Correct the walking pattern and locomotion or movement of the knee joint (Correct the ‘Gait’ or posture of patient).

·         Regain ‘burst energy’ or ‘firing power’ in muscles, whenever body demands it.