Daniela Ciurea, a Digital Clinics physiotherapist with experience in the field of medical recovery, answered a series of questions related to pulmonary recovery after COVID, joint health, and posture.

Physiotherapy is known as a method of recovery after accidents or conditions, but the prophylactic role of physiotherapy is less well known. What can you tell us about prophylactic physiotherapy, how can it help us?

Prophylactic physiotherapy aims to maintain and improve an optimal functional level of the body, such as preventing neurological, rheumatological, and cardiovascular conditions, as well as preventing injuries in high-performance athletes and the elderly, whom we try to maintain at a functionally independent level.

By maintaining the health of myoarthrokinetic structures, neurological problems such as: herniated discs, discopathy, lumbosciatica, or other spinal conditions can be avoided.

Why is joint health important?

Joint health is essential for the comfort of easily performing daily activities and for any movement not to become an additional stress. A joint can be kept healthy through movement because it lubricates itself, through well-toned muscles, through healthy and strong bones. All of this can be achieved through adequate physical exercise.

There is a quote that I really like: You are the age of your spine, in other words you are the age of your joints. So, the healthier the joints, the better the quality of life of that person.

Does posture influence our health and quality of life?

Posture is what we transmit to others about ourselves, before we even speak and it is also our perception of ourselves. Through posture we deliver information about our physical and mental state. In fact, good posture positively influences many aspects that we do not realize: better support of the spine, activation of the abdominal corset, better breathing, proper digestion and indirectly reducing stress and increasing the body's energy.

Why is it important to tone the abdominal area?

A toned abdomen is, of course, attractive, but above all, it also has the quality of protecting and supporting the spine. We can imagine the muscles around the spine, the abdominal, paravertebral, and gluteal muscles as a corset that support our spine. So, the more stable and tight the corset is, the more it will take on more of the body weight and thus, the pressure placed on the intervertebral discs. The tight corset is what keeps us upright, lifts us and elevates us. The more toned the abdominal muscles, the more they take on of the physical and mechanical forces to which we are subjected.

By toning the abdominal corset, some back pain that occurs from prolonged standing or sitting can be treated. In chairs with a backrest, we put our weight on our back and no longer maintain our back muscles. Fitness balls that replaced chairs were very popular at one time, and the lack of support at the back taught you to maintain your position with your back muscles. With these chairs that we use for hours every day, we practically do nothing but weaken our muscles because we do not let them maintain our posture.

What are the most common discomforts caused by excessive sitting at the office, what side effects can they have and how can physiotherapy help?

Sitting is not a problem as long as it does not accumulate for most of the day and as long as the position is not kyphotic, a bent one. But excessive sitting without breaks every one or two hours will lead to pain, fatigue, a tense back and muscles, impaired blood and lymphatic circulation and a decrease in respiratory function. Practically all our vital functions will function at minimum capacity, and yet we expect our brain to function at its maximum, which is impossible under the given conditions.

The solution would be to have a chair without a backrest or not to lean on the backrest when we are at the office and to get up every hour or two, during which time to take a few steps, stretching. Including physical therapy in one's lifestyle will improve the condition of the entire body by acting on these systems that are slowed down: the muscular, articular, circulatory, lymphatic, respiratory system.

Can the tension between the shoulders that appears so frequently disappear through physical therapy exercises?

The tension in the upper chest area is caused by weak and tense muscles. Because it is weak, it cannot maintain the correct position of the body, or not for a long time and ends up tensing up. Also, this area is the seat of emotional charge and reflections and sometimes that is why it is tense. That is, it is the area with a great connection to our state of mind, and of course they influence each other. For example, if I actively work on de-tensioning this area, the emotional state will involuntarily balance itself. It is an area that is emotionally charged and when we are more anxious, stressed, tired, we tend to keep our shoulders and chest more closed, looking down; we do not have that open and hopeful posture.

What can you tell us about pulmonary recovery exercises after COVID?

If we are talking about people who have been left with reduced lung capacity after contracting the virus, if they get tired much faster after climbing stairs, if they get tired much more easily in daily activities that they used to do without effort, these symptoms can be improved through specific breathing and cardiovascular exercises. These exercises can be done online: they are specific exercises that will put the lungs into action and the affected person will easily notice the results after a few sessions.

Also, lung capacity is a predictive factor for health and longevity and should not be ignored. That is why people who have impaired lung capacity post-COVID should remedy these symptoms.

What exercise do you consider to be very useful for people who do not do enough sports?

An exercise of will first of all, because we must be aware of the fact that before wearing a beautiful garment, it is more important that they cover a healthy, functional body and, understanding this, to mobilize ourselves to exercise.

The exercise program must be adapted to the needs of each person because each person has different activities: there are people who stand a lot, others who sit a lot, others who are very active, which is why, depending on the activities, the program must be personalized.

What can be worked on in an online physiotherapy session?

An online session could focus on prophylactic work to improve one's general condition. The objective is to teach people to take care of themselves by acquiring knowledge that will help them maintain physical health. In other words, through prophylactic physiotherapy we work to reduce and, as much as possible, avoid a life restricted by pain and physical limitations.

My objective is not to keep people tied to a medical system or physiotherapy classes, but to teach them how to take care of themselves in specific situations and in everyday activities.

I believe that we are made up of body, mind and soul, all three being interdependent. As a result, whichever of these systems is improved will influence the other two. And, most of the time, starting by improving your quality of life by cultivating a healthy body is the easiest.