1 Min In OTC
Bookmark
Record learning outcomes
According to the Office for Health Improvement and Disparities (OHID) in March 2022, physical inactivity was associated with one in six deaths in the UK
The Physical activity: applying All Our Health guidance revealed that the population is around 20 per cent less active than in the 1960s and, if current trends continue, will be 35 per cent less active by 2030.
Around one in three men and one in two women in the UK aren’t active enough for good health. People tend to get less energetic as they get older, and people with disabilities or long-term conditions are twice as likely not to be active enough. However, one in four people would be more active if advised by a healthcare professional, presenting the ideal opportunity for community pharmacy teams to support and advise customers.
The benefits
According to the OHID guidance, physical activity reduces dementia by 30 per cent, hip fractures by up to 68 per cent, cardiovascular disease by up to 35 per cent, type 2 diabetes by up to 40 per cent, depression by up to 30 per cent, colon cancer by 30 per cent, and breast cancer by 20 per cent. Despite this, many people don’t realise that being physically active benefits both their mental and physical health and can help to prevent and manage over 20 chronic conditions and diseases.
"Being more active can lift your mood, make you more resilient to serious illness and improve your quality of life," says Dr Liz Durden-Myers, educational consultant and senior lecturer in physical education at the University of Gloucestershire & Bath Spa University. "For many, the challenge, social interaction and enjoyment of sport and physical activity brings significant personal reward. Engaging in sport, recreation and physical activity also benefits society because it promotes social and community cohesion, helps people to develop skills and confidence, and can reduce crime and anti-social behaviour."
According to the Mental Health Foundation, regular physical activity can also increase self-esteem and reduce stress and anxiety – even a short burst of 10 minutes’ brisk walking increases mental alertness, energy and positive mood.
"When we exercise, the body releases natural feel-good hormones which make us feel happier or content," says Lucy Macdonald, director and lead physiotherapist at Octopus Clinic, London. "We are able to deal with the stresses of life more easily which, in turn, has a positive effect on our relationships. When we exercise, we will also be more likely to make the right choices about the food we eat which will result in a healthier body and mind. Physical activity also improves sleep quality, which has further positive effects on our mental health and physical recovery."
How much, how often
The UK chief medical officers’ guidelines on physical activity (January 2020) recommend that people are active every day, and any activity is better than none. The guidelines recommend that adults aged 18-64 do the following each week:
- At least 150 minutes moderate intensity cardio activity (such as brisk walking or cycling), 75 minutes’ vigorous activity (such as running), or a mixture of both. Even shorter durations of sprinting or stair climbing can be beneficial
- Strengthening activities on two days
- Reducing extended periods of sitting.
Older adults (65 years and over) should aim for 150 minutes of moderate intensity aerobic activity, building up gradually from current levels. If they are already regularly active, they should aim for 75 minutes of vigorous activity, or a combination of moderate and vigorous activity, to achieve greater benefits. Weight-bearing activities can help to maintain bone health.
In 2020, the World Health Organization (WHO) recommended slightly higher levels of activity – that all adults (whatever their age) should do at least 150-300 minutes of moderate aerobic activity; or at least 75-150 minutes of vigorous aerobic activity; or an equivalent combination of moderate and vigorous activity throughout the week, for substantial health benefits. All adults should also do muscle-strengthening activities (at moderate or greater intensity) that involve all major muscle groups on two or more days a week, as these provide further health benefits. In addition to this, as part of their weekly physical activity, older adults should do varied balance and strength training at moderate or greater intensity, on three or more days a week.
“Around one in three men and one in two women in the UK aren't active enough”
Types of activity
Cardiovascular activity, or aerobic activity, is relative to a person’s fitness. So light intensity for a fit and active, or younger individual may be moderate to vigorous activity for someone who is inactive and unfit, or older. If customers aren’t sure how active they’re being, they can try the 'talk test': being able to talk but not sing indicates moderate intensity activity, while having difficulty talking without pausing is a sign of vigorous activity.
"Cardiovascular exercise benefits the heart and lungs," says Helen O’Leary, physiotherapist and director of Complete Pilates in London. "It will also help with weight loss so can combat obesity and will naturally increase energy levels which mean you feel you can do more. With cardio in your workout, you will also feel more tired at the end of the day, which will help you sleep better!"
Muscle strength, bone health and good balance are particularly important as people get older, especially for everyday tasks, such as getting dressed and carrying shopping.
"Increased lower body strength makes it less likely that we will suffer falls or breaks as a result of falling in our older years," says Chris McCann, strength and conditioning coach at Pure Sports Medicine. "Even if we do fall, greater lower body strength makes it more likely we can pick ourselves up, unassisted, than if we were weaker."
Preparation is key
If customers have never been physically active before and are over 45 or have pre-existing medical conditions, they should seek medical advice from a GP or physiotherapist before they take up exercise. It’s important that they build up slowly and take some precautions to prevent injuries – making sure the activity is right for them.
Lucy recommends setting realistic goals. "It’s best not to do static stretches before exercise as this may increase your chance of injury, but it’s a good idea to warm up before doing strenuous exercise," she says. "The key to a warmup is to take the body through all the movements that it’s going to do during the work out but at much lower intensity. For example, do a brisk walk before building to a jog, or do some dynamic hamstring stretches – swinging the leg back and forth – before playing football."
Chris suggests planning sessions into the week. "Make sure you give yourself days off to recover; it can be easy to think you have to train every day, but you certainly don’t," he says. "You can then gradually build the volume and intensity of your training over an extended period, which will prevent any overuse injuries from occurring."
Injury management
Musculoskeletal injuries are more common during high-impact exercise, especially in people who aren’t regularly active, are older or frail, or have a chronic health condition.
"Make sure you have the right equipment for the job, including shoes and sports bras, as this will help prevent lots of injuries," says Helen. "Keep drinking water to replace your fluids. Most importantly, if you get any sharp pains, continuing discomfort, irregular heartbeat or extended breathlessness after activity, seek advice from a medical professional including a GP or physio first – working through the pain is normally not the answer, and we can tailor the exercise better for you if we know there is a problem."
Common types of sports injuries:
Many sports injuries are caused by sprains and strains and can be treated at home. A sprain happens when one or more ligaments are stretched, twisted or torn, while a muscle strain happens when the same happens to muscle tissues or fibres. Common symptoms include pain, swelling, bruising and tenderness around a joint or in a muscle, and sometimes difficulty moving the affected body part.
The best way to treat a sprain or strain is to follow PRICE:
- Protection from further injury (e.g. using a support)
- Rest – avoiding exercise, and using crutches, a walking stick or sling
- Ice – apply an ice pack (or bag of frozen peas) for 15-20 minutes every two to three hours – wrap the ice pack in a towel so it doesn’t directly touch the skin
- Compression – use elastic compression bandages during the day to limit swelling
- Elevation – keep the injured body part raised above the level of the heart whenever possible, to try to reduce swelling.
Customers can take painkillers (e.g. paracetamol or ibuprofen) to ease any pain, as long as these are suitable for them. "Cold can help pain but, contrary to popular belief, there’s no conclusive evidence that it helps reduce swelling," says Lucy. "Warmth can be helpful to relieve muscle spasm. Sometimes alternating heat and cold can be beneficial – the way to choose is just to do whichever feels best – just be careful not to create a skin burn with ice or heat."
Shin splints usually get better within a few weeks and are often caused by running. They cause pain and tenderness along the front of the lower leg. They can usually be treated with painkillers and ice packs and switching to more gentle exercise. However, it’s important to get any severe or persistent pain checked out by an expert.
"Some common injuries such as shin splints can be the early stages of serious injuries like stress fractures," says Lucy. "So, you need to get them assessed by healthcare professional such as a chartered physiotherapist."
Blisters are common minor injuries caused by ill-fitting or tight footwear rubbing against the skin. These pockets of clear fluid often heal within a week. Blood blisters look red or black (because blood vessels have been damaged), while an infected blister may look hot and filled with yellow or green pus. A hydrocolloid dressing can protect a blister, reduce pain and speed up healing. If a blister bursts, it’s important to allow any fluid to drain before covering it with a plaster or dressing. An infected blister needs to be assessed by a GP as it may need antibiotics. To prevent blisters, customers should be advised to wear comfortable, well-fitting shoes, wear thick socks during exercise, and dust talcum powder in socks if they get sweaty feet.
Athlete’s foot is often associated with exercise that causes the feet to get hot and sweaty. It can also be picked up on contaminated floors or shared towels or clothing. This common fungal infection causes itchy white patches between the toes. It may spread around the foot and infect the nail as well if left untreated.
Athlete’s foot can usually be managed with antifungal creams, sprays or powders, but these can take a few weeks to work, and the infection can keep coming back. It’s important to keep the feet dry and clean, especially between the toes. Wear clean cotton socks, changing these every day, and avoid wearing shoes that make the feet hot and sweaty. If pharmacy treatments don’t work, the customer is in a lot of pain or the foot is red, they should speak to their GP. They should also speak to their GP if they have diabetes or a weakened immune system due to, for example, having chemotherapy.
Keeping active
Being more active during day-to-day life can support weight loss – and help to prevent weight gain – by ensuring people are using up more energy than they’re taking in when they eat and drink. For the activity to benefit their health and weight, it needs to be strenuous enough to raise their heart rate and make them breathe faster and feel warmer.
Keeping active also reduces the health risks from being too sedentary (sitting, reclining or lying down) for long periods during the day. According to the World Health Organization (WHO), highly sedentary behaviour is associated with various long-term health problems, including an increased risk of heart disease, cancer and type-2 diabetes.
According to the UK Government’s guidelines last updated in January 2020, adults should, when physically possible, break up long periods of inactivity (e.g., working at a desk, or sitting watching TV) with light physical activity for at least a couple of minutes at a time. Keeping more physically active is particularly important for people with chronic health conditions, as long as they stay within their physical capabilities.
If customers want to know more about being physically active, they can visit the NHS website and the NHS’s Better Health website. They can use apps such as Better Health’s Active10 (which encourages 10 minutes of brisk walking every day) and Couch to 5K (which helps people take up running).
Walking for Health has information on over 360 active walking schemes around the country. Customers can also be directed to local services (e.g., walking or cycling schemes), recreational groups (e.g., walking groups) and exercise/activity referral schemes through their GP surgery. The Chartered Society of Physiotherapy has information on strengthening exercises and preventing and treating sports injuries.
OTC
In OTC