Why exercise is vital during lockdown

Running postIf you dare to look at your local Facebook group, or the rants on Next Door forums you would find there is a new ‘enemy of the people’. Not a politician, or someone failing to deliver PPE, but ‘joggers’. Who knew someone exercising could be so vilified? The walkers dislike anyone running near them, the runners get annoyed that people are ambling all over the place, the cyclists breeze on by. Frustratingly my usual run route has been completely closed off to runners and cyclists so walkers can use it. We are all in this together but somehow still find our tribe and our enemies. And can get very grumpy about it in the process (and as a runner get grumpier still when I’m labelled a jogger!)

We’ve got at least another 3 weeks of lockdown and increasingly confusing interpretations of what is and isn’t allowed with some wondering why anyone is exercising at all, suggesting it is downright dangerous. A comment on twitter from cyclist Julie Elliott really highlighted this…

Juliet Elliott tweet

So why is walking, running and cycling still allowed?

It is allowed because although it creates logistical challenges, it will maintain the nation’s physical health, improve mental wellbeing and also makes economic sense. In short it will keep people healthier for longer and that is just what the NHS needs right now.

We know what in many parts of the world over two thirds of adults are not active enough. This has led to insufficient physical activity being one of the leading risk factors of global mortality. World Health Organisation studies have found that those who are insufficiently active increase their risk of death by up to 30% and put massive pressures and additional costs onto health care systems. Even if we have a chronic health condition we can still find strong value in exercise, in fact, especially when we have a chronic health condition, there is a huge amount of benefit to exercising.

Physically, exercise improves muscular and cardio-respiratory fitness, improves bone and functional health, reduces the risk of hypertension, coronary heart disease, stroke, diabetes, cancer and lowers the likelihood of falls and fractures.

Mentally, it reduces the symptoms of anxiety and depression, boosts mood and quality of life and cuts down loneliness.

It is also thought exercise plays a large part in enhancing our cognitive functions (these are the different aspects of our mental functioning such as our thought processing, memory, attention, concentration and creativity), meaning we become better at controlling our behaviour and regulating our emotions. Pretty helpful when we are dealing with things we’ve never dealt with before.

Together this shows that exercise has tremendous powers which, when taken regularly and with the right intensity, can make a huge difference to our mental, cognitive and physical health. So, what counts as exercise.

It isn’t just physical activity. Exercise is purposeful, with the intention of improving fitness and with at least a slight elevation in your heart rate. Going for a very slow walk while eating an ice-cream or smoking a cigarette (which seems rather common on my local route) might be great for your feeling of wellbeing but isn’t going to do much to improve your fitness. Walking quite briskly, but still being able to chat is the minimum of what we need for both physical and mental benefit. I love this piece from New Scientist explaining it. When we are looking to improve cognitive function the studies suggest we need to be more active – into the vigorous activity level; running, cycling, circuit training, football or rowing types of sports.

And the message is clearly getting through. Sport England commissioned some research which ran at the beginning of April (3rd-6th) and found 63% of adults feel it is more important to be exercising now than they did before Coronavirus. Really interestingly it suggests that the mental health benefits described above aren’t just in research papers, they are being felt, with 67% saying the exercise they are doing is helping them with their mental health during the outbreak. Here is the full release.

So who is right? The walkers, the runners or those staying home?

My view is it is all of them. As long as there is about 30 minutes of purposeful exercise each day where your heart rate rises quite a bit and you get at least a little out of breath then you are doing a good thing for yourself and society. Carry on.

Podcasts for Sport Psych geeks

I love listening to podcasts to hear the stories of other sport psychs, to learn new techniques and skills, to build knowledge of new research and just for opening up my world. Here are a selection for those interested in sport psychology. If you have any other suggestions would love to hear about them on twitter: @josephineperry

Sport and Performance Psychology

Finding Mastery (Dr Michael Gervais) – A huge number of followers listen in to hear from some of the most accomplished performers in the world talk about what makes them masters of their own universes.

The Sport Psych Show (Dan Abrahams) – Dan is a qualified sports psych and over his 84 (to date) episodes has chatted with some phenomenal people who work in high sports performance. He focuses on motivation and applied tools so really helpful for those looking for activities to try. 

A Slice of PIE (Hosted by Pete Jackson) – A new podcast exploring Psychologically Informed Environments (PIE) in sport, business and other performance fields. Although very new I include because I love Pete’s approach to high performance psychology and trying to understand where what is used in one sector can be really effectively repurposed in another so I’m looking forward to more coming out.

Working in sport

Supporting Champions (Steve Ingham) – I’m a bit biased because I’ve been a guest on Steve’s podcast but it is one I listen to regularly – especially when I feel like a bit of insight into how others might be dealing with their sporting careers. Steve has worked in high performance sport forever (sorry Steve) and it seems like he knows everyone so he has some brilliant guests. He is really focused on their stories and their journeys through their careers so brilliant advice (whether you are just starting out or been going for years) is interwoven throughout.

The Private Practice Startup Podcast (Kate & Katie) – If you are an applied sports psych then although the basis for the chat is America and focused on clinical psychology (so they are in a different ‘system’ to us) the interviewees have great insight and ideas to make private practice really professional and valuable. And the chemistry between the hosts makes you feel like you are listening in to the two of them chatting over a class of wine.

Wider psychology

How did we get here (Claudia Winkleman & Professor Tanya Byron) – Discusses emotions and every day issues using the insight of a clinical psychologist. 

Choiceology (Katy Milkman) – Covers the questions we’ve often wondered (one of my favourites was around why we love specific numbers in sport such as the 4 minute mile or the 2 hour marathon). So if you have questioned it Choiceology has probably considered it. The idea (and why it is sponsored by a finance company) is to expose psychological traps that push us into poor decision making.

General Sport

Don’t tell me the Score (Simon Mundie) – Simon has some fantastic interviewees so although he is focused on sport in general there is lots of psychology interwoven.

Clean Sport Collective – I just adore these interviews – It is American focused but lots of female athletes are profiled and you feel like you privileged to listen into a friendly chat. Full of people who deserve more profile and these guys are helping to achieve that.

Science of Sport Podcast (Ross Tucker & Mike Finch) – If a journalist wants to get a quote from a world-renowned sports scientist they go to Professor Ross Tucker. He fronts up this podcast with sports journalist Mike Finch to break down the myths, practices and controversies in sport. Their episodes on doping and ‘The Shoe that broke running’ are musts if you want to be informed of all the perspectives on these contentious issues. They also include interviews with some of the world’s leading sporting experts. For those who love sport.

Tough Girl Podcast (Sarah Williams) – Sarah has a passion to give female adventurers the exposure they deserve. She knows if you can’t see it you can’t be it so profiling female athletes and explorers is vital and she has set up a brilliant podcast to platform these women and their stories.

Endurance Sport specific podcasts

Marathon Talk (Tom Williams, Martin Yelling, Holly Rush, Tony Audenshaw) – – Love all these guys for their relentless positivity, weekly running updates and fascinating interviewees.

Mind over Muscle (Ant Middleton) –  – I am definitely biased on this one as I’m the resident Sport Psychologist on it but I genuinely think we come up with some good stuff so I’m including it! Ant Middleton (the SAS guy), Mara Yamauchi (two time Olympian and super speedy marathon runner) and I take 5 first time marathon runners towards their first London Marathon in April. Of course (Spoiler alert) we don’t get there as the marathon has been postponed till the Autumn but we have some fun and some tears on the way.

Runners World (Rick Pearson & Ben Hobson) – Has interesting runners on for short chats that are easy to listen to on a shortish run.

The Tripod (Annie Emmerson & Louise Minchin) – – This was a 7 part series last year taking three newbie athletes on their first triathlon. Annie and Louise have lots of superstar friends – they got cycling advice from Chris Hoy, Swimming advice from Rebecca Adlington and some top tips from Vicky Holland. Really relaxed and lots of fun – all while soothing the nerves of the triathletes.

Free Weekly Timed (Vassos Alexander & Helen Williams) – – For anyone with a love of parkrun (which is most people!) this is a great listen hearing from different parkruns, people from parkrun HQ and a weekly quiz.

Others that have been recommended by fellow Sport Psychologists:

Free courses in sport, exercise & psychology

Courses logos

When I was a trainee I was also a new mum. I needed to do as much of my learning and development as I could online while my daughter slept. I found some really valuable courses which were completely free. With the lockdown meaning work is quieter than normal I’ve been using the time to top up my professional development and have really enjoyed it so thought I should share some of the great courses out there for those interested in Sport and Exercise and Psychology. They all come from either Open University, Future Learn, Coursera or Class Central so each are worth checking out if you are looking to do some free learning.

Sport Psychology specific

Exploring sport coaching and psychology
Open University
Course explores the influence of coaching and psychology through the lens of sports people and teams who have been successful. Focuses on coaching practices used with young people and adults, including research and advice of leaders in their fields.

Exploring communication and working relationships in sport
Open University
Covers skills required to boost your ability to vary your communication approach according to the situation and the needs of the people involved.

Exploring the psychological aspects of sport injury
Open University
This course examines the relationship between injury and psychological factors, looking at the link between injury and psychology at two distinct points – before an injury has occurred and then following an injury.

Learning from burnout and overtraining
Open University
A course looking at those sports people who have thrived and those who have experienced burnout. By exploring burnout you will gain a deeper understanding of the physical and mental aspects of sport such as athletic identity, overtraining and perfectionism.

Motivation and factors effecting motivation
Open University
This course explores the term ‘motivation’ and factors affecting motivation. This includes looking at the most influential theories of motivation that contribute to understanding the causes of motivation. The motivation of sports people and people working in sport and fitness environments are used to help understand the theories presented.

Working with client skills

Developing Clinical Empathy: Making a Difference in Patient Care 
St George’s, University of London
To learn skills to help you understand a client’s situation. Helps to develop relationship-building skills such as compassion and empathy. Covers different types of empathy, explores non-verbal cues, and understanding key opportunities for showing empathy in clinical care.

Psychology

Introduction to Psychology
Yale
Provides a comprehensive overview of the scientific study of thought and behaviour by exploring topics such as perception, communication, learning, memory, decision-making, persuasion, emotions, and social behaviour.

Science of Wellbeing
Yale
Challenges designed to increase happiness and build more productive habits. Covers the misconceptions about happiness, annoying features of the mind that lead us to think the way we do, and the research that can help us change.

Learning how to learn: Powerful mental tools to help you master tough subjects
University of California, San Diego
Provides access to learning techniques used by experts in art, music, literature, maths, science and sports. Covers illusions of learning, memory techniques, dealing with procrastination, and best practices shown by research to be most effective in helping you master tough subjects.

Wider Sport Science

Science of Endurance Training and Performance
University of Kent
Learn about the science behind endurance sports training and performance, including effective preparation and rehabilitation.
(NB: Course not running right now but you can sign up to get an email when it does).

Managing your health – the role of physical therapy and exercise
University of Toronto
Course covers the concepts and benefits of physical therapy and exercise.

The Science of Exercise
University of Colorado, Boulder
Helps you to have an improved physiological understanding of how your body responds to exercise, and will be able to identify behaviours, choices, and environments that impact your health and training.

Introductory Human Physiology
Duke University
Learn to recognize and to apply the basic concepts that govern integrated body function (as an intact organism) in the body’s nine organ systems.

Lifestyle medicine

Essentials of Lifestyle Medicine and Population Health 
Doane University
Covers the foundations of population health and lifestyle medicine and makes the argument for why healthcare delivery models based on these foundational principles are essential to addressing global healthcare crises.

Introduction to Lifestyle Medicine 
Doane University
Lifestyle Medicine is the science and application of 49 healthy lifestyles as interventions for the prevention and treatment of lifestyle-related diseases such as heart disease, diabetes, stroke, obesity, some neurological conditions and some cancers. It is bridges the science of physical activity, nutrition, stress management and resilience; sleep hygiene and other healthy habits to individuals through clinical practice in healthcare.

Two weeks in… Interview with Counselling Psychologist Dr Natalie Raiher

When we know athletes are about to have a tricky time; a training camp they need to go on with team mates they dislike, a really hard period of training focusing on a skill they are currently weak in, the biggest competition of their year that is fuelled with pressure, we often discuss how they can suck it up. We all know we can cope with tough stuff for a few days or weeks. It helps to put the period in context and see light at the end of the tunnel.

But we are now two weeks into the COVID-19 lockdown. And while every athlete knows they can cope with three weeks of something (as the original period was given from the Prime Minister) we mostly know it will be longer. But none of us know how much longer. It is that uncertainty that is so tricky to deal with. The novelty of isolation has worn off and we’ve probably tried lots of things to keep us busy, entertained and fit but now is the time to ensure we have some coping strategies and routines in place to keep us mentally fit.

I chatted to Chartered Counselling Psychologist, Dr Natalie Raiher, from The Practice at 322 in West Hampstead (where I sometimes also see athletes in clinic). She is still seeing her regular clients for video sessions but is also volunteering using her skills to support NHS staff. We talked about how she is helping all these people deal with this period. She offered some great advice that will be valuable for athletes and performers both now and when things return to normality.

What are the main worries you are finding people have about Coronavirus?

“The worries tend to vary depending on what part of their lives has been impacted the most. People whose businesses have had a sudden downturn, such as those in travel or hospitality or those who are in debt, their main worry is money and livelihood and what to do. For some people it is the loneliness if they live alone or are estranged from loved ones, some people it is the chaos and the lack of access to their usual coping resources like sport or hanging out with their favourite people. We are used to having support structures in place but they just don’t exist in the same way right now.”

It is changing at all?

“The profile of worry does seem to be changing as the virus is getting more virulent. In the beginning people were worried about lockdown and food and trying to organise things. Now people are more worried about their own health and more emphatically worried about others; their health and how they are coping.”

How are people coping?

PyramidSome aren’t. We are seeing a rise in domestic and child abuse statistics – people are finding it very hard to function in small places under stress. Substance abuse is going up too with people reaching for unhealthy coping mechanisms. When I work with people we use a coping mechanism pyramid [I’ve added a picture of one here – it was created by Dr Alice Boyes – http://www.aliceboyes.com] – the behaviours at the top are ones you use sparingly and those are the bottom are those you can use liberally. All coping mechanisms serve a purpose but there can be a fine line between healthier ones and unhealthier ones. You don’t want to take away the coping mechanism they have but we do want more alternatives for people.”

“We must remember most of the worries and anxieties people are experiencing right now are completely normal. From a mental health perspective it is entirely appropriate not to feel great right now. Lots of people have lost jobs and structures so it is fine not to be feeling ok. Some people have responded to this by fleeing from the reality of this using denial and this is a solid way of coping but it can come under many guises. So some people have developed things like over-productivity or OCD. They are denying what is happening, which is perfectly understandable – it is bloody scary. It is perfectly normal to be grieving our normal lives and feel the loss around it. It is ok to feel the fear.”

Athletes are often used to high levels of routine and structure in their lives. How can they cope without this?

“Even if you are someone who likes the freedom not to be too structured, during times like this everybody needs some structure. The degree is dependent on personality. Some people need a lot of structure to feel safe – others need less. But everybody needs some type of routine as it regulates our limbic system and things like our appetite and body clock. Routine can be quite soothing and a gentle structure is beneficial.”

“For athletes used to a high level of structure in their training to go to none is very distressing so they need to find gentle structure in their day. It can be unique to each athlete but a few elements which create a routine will help them.”

Many of the coping techniques that athletes rely upon; such as exercise or focusing on a goal are either not possible now or only possible a different way. Are there any good coping mechanisms you can suggest athletes could try instead? 

  1. Focus on function. Again this will be personalised but you can think about the function of what each thing in your normal routine does for you. What is the function of yoga class, or work or taking the train? When you drill down into this then you can write your own prescription to replicate that function within the constraints of your life right now. Whatever you get out of that activity that is a good way to translate it. Replicating the same function within our new constraints.
  2. Stay goal driven. Keep the idea of being goal driven but focus on the soft skills which will help your performance down the line, such as learning to tolerate pressure or stress better. If you can use this time to practice tolerating higher levels of anxiety and uncertainty or using a different approach to unhelpful thoughts then that you will have developed some really positive cognitive skills that will help you in the future.

Are there any specific cognitive skills that athletes could work on? 

“Meditation is really good. We know from neuro-imaging that meditation turns off the fear part of our brain. When there is over-activation in our fear brain we can turn the volume down when we meditate. Meditation also turns up the impact on the self-soothing centres of our brain so cortisol [our stress chemical] release goes down and we are better able to reflect and to be present. Apps like Calm and Headspace can help these.”

If we are used to being very active, always in and out of home and often at work or the gym what should we look out for to spot if our mental health might be becoming fragile?

“It is completely to be expected that everyone’s mental health will be a bit wobbly right now. Angry, moody, feeling helplessness is completely normal when everything has changed in the way it has.  But if these feelings persist and don’t vary throughout day or they start to get in the way of you functioning then you need to keep an eye on yourself and ask for help. If you find yourself starting to use unhealthy coping mechanisms such as gambling, drugs or withdrawing from others these are also signs need to seek help.”

We realise that being anxious or feeling some grief during this period is a very natural and rational response – but that doesn’t mean we can’t try to feel better. Have you found any ‘pick me up’ techniques which are helping people when they are having a down moment? 

“Yes. We follow a two pronged approach.

Coping cardsFirstly, we have to feel our feelings. It is like digesting food. If we don’t do it then it gets stuck and we get panic attacks and will have angry outbursts or become obsessive about things. So if you are feeling down acknowledge that feeling and only then focus on comforting yourself. Some people will make a ‘coping card’ with a message to themselves or a quote that they love. They can keep it with them – or have a photo of it on their phone and look at it when they need comfort or strength.

Grounding techniques

The second prong (if it is anxiety you are feeling) is to use a grounding technique which can use your five senses and pull your body down.

 

 

 

 

Another second prong (if it is low mood you are feeling) is to focus on ACE. This stands for Accomplishment, Connectedness and Enjoyment.

  • Accomplishment – When our mood drops over a period of time we withdraw so we need to increase our sense of accomplishment. These can be any small tasks; baking a cake, having a shower, something on our to do list.
  • Connectedness – when we withdraw the only way to come out of it is to get back to connecting with other people. We have to force ourselves to connect with another person – even if that is a text or a phone call to someone else that day.
  • Enjoyment – This is the biggy in this is many people are depriving themselves of enjoyment and pleasure. People are getting on with the task at hand but not factoring in any pleasure and that really effects our mood so got to look for some enjoyment and pleasure in the day – this is your prescription for better mental health.”