Physiotherapy

To progress your physical exercise, strength and endurance we have produced a set of tiered exercise videos. Whatever your physical level of activity we have a video to suit from gentle level 1 for those just starting on their recovery journey to more intensive level 3 for those who are feeling more able to build their strength. Watch the introduction video first and then try one of the workouts.

Introduction

Beginner level 1

Intermediate level 2

Advanced level 3

Breathing positions

The muscles you use to breathe are the same muscles that support your shoulders and neck. These positions help to support your shoulders so that your muscles can be used solely for breathing:

• Leaning forwards whilst sitting on a chair
• Leaning forwards supported by a table or wall
• Stand with hands on hips and head slightly dropped

Breathing Techniques

Over-Breathing/Hyperventilation is a perfectly normal reaction to any stressful situation. Generally when this has passed your breathing will return to a normal rate.

You may experience:

• Feeling breathless, even after relatively mild exercise
• Difficulty co-ordinating breathing and talking and/ or eating
• Breathless when anxious or upset
• Pins and needles in hands / arms / around mouth
• Palpitations
• Feeling exhausted or unable to concentrate
• Light headedness

When we over-breathe we eliminate large quantities of carbon dioxide on every out breath. This causes a chemical imbalance affecting many of the body’s systems. This can be frightening causing us to become anxious which could further upset your breathing pattern.

Breathing Techniques:

1. Lie or sit comfortably. Place one hand on your stomach and the other relaxed by your side.
2. Close your mouth lips together and keep your jaw loose.
3. Breathe in gently through your nose, feeling your tummy rise and expand ‘like a balloon’
4. Breathe out lightly through your nose if possible, keeping your stomach relaxed
5. Make sure you are relaxed, pausing at the end of each breath. Your upper chest should not be moving.
6. As you repeat this sequence be aware of any areas of tension in your body and concentrate on ‘letting go’ particularly jaw, neck, shoulders and hands.

Practise this little and often. Progress this to practising whilst standing or walking. As your body adapts to this way of breathing it will require less time and energy and is more relaxing.

Modified Breathlessness Scale

Use this scale to monitor your breathlessness during any activity or exercise:

• 0 - Nothing at all
• 0.5 - Very,very slight
• 1 - Very slight
• 2 - Slight
• 3 - Moderate
• 4 - Somewhat severe
• 5 - Severe
• 6
• 7 - Very severe
• 8
• 9 - Very,very severe
• 10 - Maximal

You should be aiming to work at a score of 3-4

It is normal to feel breathless when you exercise. It is not harmful or dangerous.

Gradually building your fitness can help you to become less breathless.

Exercises

You may feel tired but even some basic exercises will be beneficial to your recovery. Start with 6-8 repetitions of each activity; gradually increase up to 12 repetitions. Getting out into a chair will greatly benefit your lungs, muscles, circulation and digestive system.

To be done in bed:

Move your ankles up and down

Push knee into towel and lift your heel off the bed

Slide your heel along the bed towards your bottom

Push your knee down into the bed

Bend your knees and lift your bottom off the bed.

Pull up your toes and slide your leg out to the side.

To be done in a chair:

March your legs while sitting

Straighten one knee at a time and hold

Cross your arms and turn your head and body left and right.

Bend your arm to touch your shoulder, and then straighten.

Lift your arm up above your head then lower.

Keep your elbows tucked in, move your arms in and out.

To be done whilst standing:

Hold onto a firm surface for all standing exercises, for example, a kitchen work surface. Not all exercises need to be done at once so break them down into manageable sessions.

Lift the leg out to the side, and back to the centre

Lift the leg out behind you, and back to the centre

Stand up on your toes and gently back down

Squat down as able and then stand up tall

Marching on the spot

Sit to stand. Push up from chair (push up with hands if you need to)