On today’s podcast Dr. Jimenez DC, health coaches Adriana Caceres and Faith Arciniaga will discuss how the changes in our present lives have changed the way clinical rehabilitation is performed. Today we demonstrate the modern way to get your groove on with fitness and rehabilitation.
Dr. Alex Jimenez: All right, we’re going to talk today about fitness and how we do rehab, your doctor is now actually working on you, and many people are going to be able to ask you, “Hey, we’re going to be doing some rehab.” Your doctor prescribed rehabilitation and provided you with rehabilitation with your rehabilitation, your physical therapist, your chiropractor, and your personal trainer. We’re going to be discussing today the issue of how we do and how we perform rehabilitation in modern society in modern times. As you all know, we have the COVID dynamics that have been affecting many of us over the last year or two that have changed the way we do fitness. Now what we are doing in our office is that we are still going to fitness centers and training as everyone does. But getting a personal trainer to work with you directly sometimes becomes more of a logistics issue. So what we’re going to discuss today is how we can get into your home to see how we can do the rehabilitation. Today, we’re going to be talking to Faith Arciniaga and Adriana Caceres regarding the types of exercises we do within your home. So as I work on patients and they have a physical issue, inflammation, a joint problem, a dysfunction about mechanical imbalance, whether it may sometimes start as a physical issue, sometimes ends up physiological. But we’re finding that exercise seems to be one of the things that we, as physicians, physical therapists, or orthopedists, don’t matter where the type of physical medicine is. We typically lean heavily on exercise performance or restoration and procedures. What we’re going to talk about today is how we do it within the home. So I got here a special guest, Adriana, who will be an essential, crucial part of the new dynamics in the new issues is; we got plenty of gym space in your home. So Adriana, welcome. So tell us a bit of what you do for our patients now that we have started exercise fitness training within their home, specifically with issues that affect them and their particular dynamics.
Adriana Caceras: Thank you. Yes. So we are trying to motivate people to work out and do exercise. So as prevention and reduction of any chronic disease and any physical imbalance. The way to do this is that the easiest way to do it from home is that there’s no excuse not to do it and the space is always available. So it’s just plugging into a phone, a tablet, a computer and just popping into the link, and you’re in. And the fun part about this, or the easiest part about this, is that you never leave the house and the difference between the online and the Zoom. That is our case. What we do with our patients here is that you still feel the interaction with the trainer. So when you do an online class or an app, you don’t know that you don’t have any feedback on what you’re doing and any response. So it’s you with a TV or whatever you’re using, any electronic you’re using, and you know, it’s you tracking yourself, OK, when you do the Zoom classes, you still have that interaction you have at a gym. So the trainer is watching you and working out with you, and you can feel the energy flowing both ways. Also that the comfortable part is that there’s no clothing needed. You can wear whatever you want, whatever makes you comfortable. There’s no limitation on what normally would limit you to going to a gym. Physically, you have to hit your car keys and get in the car, which is the first barrier we always find. Like, I don’t know where my car keys are. I don’t have enough time. I’m going to have to drive. So this is just plugging into your electronics and starting the class. It’s effortless and really simple. You don’t need much equipment because of what we do with the rehabilitations we do, and all the exercise we do is focus on body weight more than anything and flexibility. So we do strength training, cardio, and flexibility to work on the three components of fitness. So we work on mobility range, and we work on muscle building and, of course, in cardiovascular, respiratory improvement.
Dr. Alex Jimenez: Mobility, flexibility, and agility are the, I think, bread and butter of fitness. So we want people to be able to move better. So in terms of people with how, say, a knee problem or a back problem? Let me ask you, how do you address or adjust the protocols to an individual, let’s say, has a knee problem or a persistent low back problem? As part of your rehab, how do you prep them in that situation when you have a group of individuals?
Adriana Caceres: So the most important part of any workout is the warm-up. You need to get your body, your joints oiled, and you want to have them prep mentally prepared and physically prepared for what’s coming? Depending on their limitations, any injury they have you modify. So, for example, if you had a back problem, you might be using a chair for squats because you need to learn how to strengthen your back by supporting it, so you would use a chair and, you know, the functional movement of sitting up and down several times. That is a squat and very safe squat, also for the knees because you don’t come lower than 90 degrees. That’s what you want to protect that knee injury from going and in over and over flexion. So you want to keep it at a ninety-degree angle, or less in a chair always helps you with those things. Also, for any shoulder injuries, you use the walls so you can use to do pushups against the wall. And if we’re doing, if you have any dizziness or any kind of migraine suffering, you don’t want to face down because that will trigger any dizziness or any migraine. So you always use a chair, something that keeps you elevated so your body will be at a certain angle, or you’re not literally on the floor or parallel to the floor, and that will help you not get those triggers.
Dr. Alex Jimenez: Let me ask Adriana in.. no, actually Faith a little bit about what we do with our patients and how we schedule those appointments. How and how do we integrate that? Because one of the things we do is we when we have them here in a patient, has gone, be through their at least their acute care, which is their beginning care where they need more rehabilitation. What’s the approach, though, that that we perform here in the office? From your point of view, to get them into the rehabilitation program.
Faith Arciniaga: Absolutely. So when a patient comes in, the doctor will typically evaluate them for ninety minutes, and he’ll see where they’re at in terms of strength. He’ll prescribe specific stretches and exercises for them that we give them at the end of their visit. They go home, work with that. Then when they come back, the doctor can reevaluate and say, OK, you need to get on board here with a Zoom class with Adriana, for example. And then he’ll say, We’re going to set you up with that to work from home. So then we can set them up at the designated time that she’s available, and they can have the exercise probe and the Zoom classes.
Dr. Alex Jimenez: That’s an excellent point. Adriana, what scheduled times do we typically work with them? Because I know we have a wide range of hours available for patients, and people have different complexities in their schedules. How do we adapt to that?
Adriana Caceres: Well, right now, we’re working Monday through… Monday, Tuesday and Wednesday at six a.m. and we have another class at four p.m. and another one at five p.m. On Fridays, we’re doing a six a.m. and then an eight a.m. So there are enough time slots for everybody to join us in this program.
Dr. Alex Jimenez: So what we’re going to do is I’m going to show a clip of kind of how the classes go and give an insight as to how the procedure goes. So it’s pretty exciting to watch because we have different videos that we can see, and we can see the dynamics of what is going on in terms of the class as it goes. So tell us a bit of what is going. We will go live here for a second.
Adriana Caceres: We got this. OK, if you give your attention to the clip and the video, you can see everybody is in the living room. These are ladies who are looking to improve their mobility and their strength. I try to focus on classes that are more of a HIIT. So it’s high-intensity interval training, meaning that you have like those bursts of energy, and then you have those short resting periods. We focus on strength. We focus on cardio, and we focus on the end and the cool down. We do the flexibility there. If you see how they’re dressed, everybody’s comfortable. You want to jump into the class and get your workout done. You want to move. Right now, we have a lot of people with very sedentary life and what you want to focus on is bringing that sedentary. We had you from eight to 10 hours a day of sedentary activities. You want to do at least one hour of movement and a high interval training, so you can have that oxygenation.
Dr. Alex Jimenez: Let me ask you now that you mentioned, and that’s pretty interesting stuff that you actually showed us there. When you have these dynamics, the privacy that an individual has, sometimes they don’t want to show themselves; how do we handle that situation?
Adriana Caceres: Yes. If you see in the video that we had posted, there’s one lady who had her camera off. You can put a picture or anything like a screensaver, and we don’t have to see you. I know that nowadays, many people have used Zoom, and for this, since the pandemic, it’s been one of the tools that we’re using more often, and a lot of people are using and know there’s an etiquette for Zoom now. But one of the things that we do want to make people comfortable is that you can turn off your camera and, you know, keep up with the activity or the other exercises we’re doing. Many people who go to the gym feel self-conscious because of this, and this is an advantage that you have doing it from Zoom because you don’t have that. I don’t feel comfortable. People are looking at me. People are judging me. Or maybe you don’t have, you know, I am awkward, and I don’t do the exercise right, and I don’t want anybody to judge, and this is a good way, safely, to start doing it and not be not feeling uncomfortable in your home. Also, when you have family behind, sometimes I have patients that have the family watching TV in the back, and they’re just working out, so they want to put their screensaver. So I don’t see what they’re watching on TV.
Dr. Alex Jimenez: It seems pretty cool because we didn’t have this particular opportunity until the advent of the post-COVID era, right? So this has been one of the things that we’ve been able to adapt. As you can see, certain people are, you know, they’re running different components of their video here. You can see other areas, and you don’t have to be seen on these things. So that’s important. Plus, you can work out outside inside anywhere that feels comfortable to you. And this is a way that we’re projecting our particular practice inside people’s homes and offering these kinds of services. So we wanted to present these kinds of things, and we wanted to present this kind of awareness for our patients. Because the times are changing, rehab, it’s never going to change. We’re always going to need some sort of exercise to recover specific pathologies. So as we do things, the body is; it’s always asking in its recovery. It’s asking a fundamental question like, what do you want me to do? So whether it’s an elbow, a joint, or a knee, it’s asking, What do we want to do? What do you want us? What do we want me the joint to do? When you move it, the body heals in the trajectory of the healing motion. So as we’ve learned, that motion becomes one of the most component healers of the body, and it’s restoring to normal homeostasis. So as we look at that, we can get into and integrate fitness inside of people’s lives. It does change the way we do things. So we wanted to present this to you today. So as we are starting and we’re part of it. I mean, we were we’re doing this around the city here and around the state and through New Mexico as well. So what we want to do is to let you know that we can reach and we can come up, which is what telemedicine does. Telemedicine offers us the ability to reach out. Through different forms of Zoom and others, they can get in there and help people using their phones and iPads, using their computers. Real simple through a little camera that you know, it doesn’t have to be anything more than just the basic stuff that’s already attached to the computer and change your life, so we look forward to it. Faith, thank you very much. Adriana, thank you for sharing. And we look forward to at least offering you these services when you’re here to be able to reach in and give you some love of mobility inside the things that you do. OK, so thank you very much, and we look forward to seeing you. Today was a really short one, so we’ll talk about the next ones in the following days. OK, thank you. Thank you.
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Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
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