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    Lisa Bywaters
    30/Jul/2020
    Health InformationMSK articles

    Put your best foot forward

    Looking after your feet

    Our feet are amazing ‘feats’ of engineering (sorry, I just couldn’t resist that one).

    Each foot has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. They support us through thick and thin – whether we’re walking, running, jumping, dancing, skipping or hopping. We cram them into ill-fitting shoes, torture them in high heels and stub them against the bedside table in the middle of the night (or is that just me?).

    As well as the many injuries and calamities that befall our feet, many musculoskeletal conditions, such as osteoarthritis, rheumatoid arthritis and gout can affect the feet.

    They’re the unsung heroes of this pandemic as we hit the streets, parks and trails for exercise. Walking has become the exercise of choice for people at the moment. Many of us can’t – or don’t feel safe to – return to gyms or exercises classes. And lots of people are walking instead of catching public transport to avoid being in close contact with others. As a result we’re all walking many more steps than we did pre-COVID.

    So we need to stop taking our feet for granted. We need to look after them so we can continue to do the things we want and need to do as pain-free as possible.

    So what can we do?

    Give your feet the TLC they deserve. It’s really important to look after your feet. Wash and dry them regularly. Inspect them for anything unusual such as cuts, blisters, changes to the nails and skin. By being aware of your feet and any changes that occur, you can seek advice sooner. And if they’re sore after a day of walking, maybe give them a warm soak in the bath, or in a bucket or a foot spa (if you have one) while you watch TV. Then dry them thoroughly and rub a moisturising foot cream into your skin. Take your time and give your feet a nice massage. Better yet, see if you can talk someone else into giving them a massage while you relax on the couch.

    Manage your condition. If you have a musculoskeletal condition that affects your feet, it’s important that you work with your doctor and healthcare team to look after your feet and manage your condition effectively. The treatments used for foot conditions will vary from person to person, depending on your condition and how it’s affecting you. And this may change over time as your condition and your feet change.

    See a podiatrist. If you have foot pain, or a condition that affects your feet, visit a podiatrist. They’re feet experts and can assess, diagnose and treat foot and lower limb problem, including skin and nail problems, foot and ankle injuries, foot complications related to medical conditions and problems with your gait or walking. Podiatrists can also give you advice on appropriate footwear, and can prescribe custom foot orthotics.

    Consider orthotics. Orthotics are corrective insoles that can help alleviate pain by redistributing pressure away from the painful area and support your arches. You can buy off-the-shelf orthotics or you can have orthotics made that are specifically fitted to your feet by a podiatrist.

    Fit your feet with appropriate footwear. With our worlds turned upside down due to COVID, and many of us having to stay home, it’s tempting to stay in our slippers all day. There’s something so comforting about warm, fluffy slippers. However our feet and ankles need proper support. Wear the right footwear for whatever you’re doing. Going for a walk? Put on your sneakers. Working at home? Wear your casual shoes/boots that support your feet and keep you warm. And lounging around in the evening? Get those slippers on.

    If you’re buying new shoes, make sure they fit properly, support your feet and are comfortable. Look for shoes that are light, flexible at the toe joints and are hard wearing. Shoes made of leather are preferable over synthetic materials as they breathe better. Avoid slip-on shoes and if laces are difficult to fasten due to arthritis in your hands, Velcro or elastic laces may be an option.

    Let them breathe. Did you know you have about 250,000 sweat glands in each foot? That’s a lot of sweat! So let your feet breathe to avoid smelly feet and fungal infections. Change your socks and shoes at least once a day. Wear shoes that allow air flow around your feet: leather, canvas, and mesh are good options, avoid nylon and plastic. And avoid wearing the same shoes two days in a row. Give your shoes time (at least a day) to dry and air out. And if the weather’s warm, set your feet free and let them go au naturale. There’s nothing better than walking barefoot on warm grass on a sunny day.

    Exercise your feet. I’m not talking about walking here…but other exercises that keep your joints moving. Try non-weight-bearing exercises such as swimming, especially if you have foot pain, as they take the pressure away from the painful areas. You can also do exercises while sitting in a chair. NHS Inform (Scotland) has some foot exercise videos you can try. If you want exercises tailored specifically for you, visit a podiatrist or physiotherapist.

    Medications might help. If you’re having a lot of foot pain, speak with your doctor about whether medications may be an option. Depending on the underlying condition causing the problem, your doctor may prescribe a short-term course of pain relievers or anti-inflammatory medications, or they may prescribe other medications, such as a cortisone injection into a joint for rheumatoid arthritis or medication for acute attacks of gout.

    Diabetes and feet. Many people with musculoskeletal conditions also have diabetes. So it’s really important if you have diabetes that you take care of your feet every day because of the increased risk of developing nerve damage, ulcers and infections. Talk with doctor about how to look after your feet properly if you have diabetes.

    Surgery may be required. For some people, surgery may be needed if other conservative treatments haven’t helped. A referral to an orthopaedic surgeon who specialises in feet is usually required.

    Contact our free national Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    16/Jul/2020
    Health InformationMSK articles

    I’m walking on sunshine

    “Whooooa, and don’t it feel good!”

    Gotta love the eighties and music from bands like Katrina and the Waves, right?

    And even though there’s only a glimmer of sunshine in Melbourne as I’m writing this and I’m a bit chilly from the quick walk I took round the block, I’m certainly feeling brighter than I did 15 minutes ago! Especially with the tune of that song stuck in my head.

    While I was out I couldn’t help but notice how many people were also out for a stroll. It seems that everyone’s rediscovered walking during the pandemic.

    This is one of the most positive things to have emerged due to COVID. People are pulling on their walking shoes and hitting the paths.

    Family groups, deliriously happy dogs with their owners, single people with their headphones on – and everyone doing the COVID smile as you pass by. It’s lovely.

    Walking is a great way to exercise. It costs nothing, it’s suitable for most people, and it gets you out and about.

    It’s a fantastic way to wind down after a long day of work. It can help you relax, especially if you’re feeling stressed or anxious because of the crazy state of the world. There are so many things we have no control over at the moment, but going for a walk? That’s something we can control.

    The fresh air, the exercise, and listening to something interesting – your family, a friend, a podcast or music – it’s a great way to boost your mood.

    If you don’t exercise much, walking might be a good way for you to build up your activity levels – though be sure to talk with your doctor first to get the all-clear. Then start slow.

    Try walking 30 minutes a day on most days of the week and you’ll really notice the health benefits. It can help you manage your pain, lose weight or maintain a healthy weight, it can lift your mood, help you get a good night’s sleep, improve your bone and joint health and increase heart and lung fitness.

    If you can’t walk 30 minutes at a time, break the walking up over your day. Three 10 minute walks, six 5 minute walks…it all adds up.

    And if 30 minutes most days isn’t achievable for you at the moment, set yourself a goal so that it becomes achievable. Think about your daily commitments, your level of fitness, your pain/fatigue levels and all of the other things that affect you day to day. Now create a SMART goal. That’s a goal that is Specific, Measurable, Achievable, Realistic and has a Time-frame that works for you. Read our blog about goal setting for more info.

    Walking tips

    • Wear comfortable, appropriate clothing and shoes. Your shoes should support your feet and have a non-slip sole. Clothes should be loose and/or stretchy enough to allow you to walk without restrictions. And don’t forget a hat on sunny days.
    • Warm up and cool down to prevent injuries or pain. While you might be eager to just get out there or you want to stay ahead of a group of people coming up behind you, it’s important that you take the time to let your muscles and joints warm up. And when you’re close to finishing your walk, take the time to slow it down and give your body the chance to cool down. Don’t forget to incorporate some basic stretches after you’ve warmed up and after you’ve cooled down. Check out these ones from the Arthritis Foundation (USA).
    • Remember to physically distance from other people when you’re out for your walk. Keep at least 1.5 metres between yourself and others. That doesn’t include members of your household.
    • Choose quieter times to walk if you live in a busy, densely populated area. Try walking early in the morning, or in the evening, as long as it’s safe to do so.
    • Avoid the really popular parks and paths. It’s just too hard to maintain that 1.5 metres when you’re surrounded on all sides by people. It can also make your walk less enjoyable if there are crowds of people and lots of noise. Find parks and walking trails that are less crowded, or go at a different time of the day/week.
    • Make it social (if you can) – walk with a friend, your family, kids, the dog.
    • Listen to music, audio books, podcasts. Going for a walk by yourself gives you space for some alone time. Listen to something that interests you and relax as you get some exercise.
    • Make walking a part of your regular routine. Go at the same time each day – e.g. before/after work, after lunch.
    • Don’t go out if you’re sick – stay home and look after yourself. This is especially important if you’re experiencing any COVID symptoms such as a fever, cough, sore throat or shortness of breath. Find out more about COVID symptoms on the Australian Government website.
    • Be mindful while you’re walking. Really take time to be in the moment and experience the walk. How do your feet feel as they connect with the ground? What can you smell? How does the wind feel on your face? This is an opportunity to really connect with what you’re doing and savour every moment.
    • Explore new places. Obviously follow the directions of the health officer in your state/territory, but if you’re able to explore new walking trails, parklands and suburbs, do it. As many of us have discovered during lockdown, walking the same paths day after day can become a little tedious. Mixing it up will make your walks more interesting. Comedian and radio host Tony Martin and his partner have spent more than 10 years exploring the streets of Melbourne, with the goal to walk every single street! While your goal doesn’t need to be this challenging, it may inspire you to pull out the old Melways or use your GPS to discover new and interesting places to walk.
    • Take a water bottle – it can be thirsty work! And depending how far you’re walking, consider taking a small backpack for your water bottle and any other supplies you think may need such as snacks, a map, band aids (just in case) and your phone.
    • Track your walking with a pedometer or fitness activity tracker. This’s a great way to see how you’ve progressed over time. And many of the walking apps allow you to challenge others, so if you can’t physically walk together, you can in spirit.
    • Increase the distance and intensity of your walks over time. To see the health benefits from your walking, you need to push yourself to go further and harder.
    • And if you catch the walking bug (that sounds a little gross but you know what I mean), consider joining a walking or bushwalking group when restrictions ease. You’ll meet other people who love walking, explore new places together and get lots of tips and advice to make your walking more enjoyable and challenging.
    • And last but not least…walk with us! At least in spirit. Our Walk in July is happening as we speak. People of all ‘walks’ of life (sorry for that), ages, conditions and locations are walking virtually whenever and wherever they want to raise awareness of musculoskeletal conditions and to raise funds for Musculoskeletal Australia. Join us and together we can make a difference to the lives of those who need it most!

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    This isn’t an exhaustive list, but just some of the sites that provide useful info about different walks and trails in Australia.

    CONTINUE READING
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    Lisa Bywaters
    16/Jul/2020
    Health InformationMSK articles

    Massage your pain and tension away

    For many of us, massage is an important tool for managing the aches, pains and muscular tension associated with having a musculoskeletal condition. It complements the other things we do to manage our condition such as exercise, medication and mindfulness.

    What is massage?

    Massage is a hands-on therapy that involves rubbing and manipulating the soft tissues of your body, especially your muscles. There are many different types of massage including relaxation, shiatsu, sports, deep tissue, hot rock and remedial.

    Massage can improve circulation, ease muscle tension and help you feel more relaxed. A massage can also help relieve stress and help you sleep.

    In this blog our focus is remedial massage and self-massage.

    What’s a remedial massage?

    Remedial massage treats muscles that are knotted, tense, stiff or damaged. (1)  In consultation with the client, a remedial therapist will assess and identify which areas of the body require treatment, and use a range of massage-based techniques to optimise muscle function.

    Remedial massage helps loosen tight muscles and ease your pain and stiffness. And for many people with musculoskeletal conditions such as arthritis or back pain, this type of massage is essential to keep you moving.

    Seeing a remedial massage therapist

    A qualified remedial massage therapist is trained to “assess and treat muscles, tendons, ligaments and connective tissue and treat injuries and soreness”.(2) 

    Seeing a massage therapist regularly can help prevent a build-up of muscle tension caused by chronic pain, inactivity and injury. They can also help you manage your pain, maintain joint flexibility and function, and provide you with exercises and stretches to do between visits.

    Questions to ask a massage therapist

    Before seeing a therapist, you should do your homework and find out as much as possible. Ask questions such as:

    • What type of massage do you provide?
    • What are your qualifications?
    • Are you accredited with the peak massage body in Australia?
    • Have you successfully treated people with my condition?
    • Do I need to take all my clothes off?
    • How long are the massage sessions?
    • What is the cost?
    • Can I claim this on my health insurance?

    When you see the therapist you should:

    • Be open with them and communicate your needs and any health issues – whether they’re ongoing or new.
    • Make sure you’re comfortable before they start massaging. They may have placed your arms in a position that aggravates a neck or back condition, or have you lie in a way that causes pain or discomfort. If this occurs, explain to the therapist that the position doesn’t work for you. They can then make changes to ensure you’re comfortable and that you get the most benefit from the massage.
    • Ask for extra support if you need it. If you need a pillow or cushion to support your neck, knees or back, let them know so they can accommodate you.
    • Let your massage therapist know if the pressure is too hard, too soft or if anything hurts. Don’t suffer in silence.
    • Ask yourself whether it matters if you see a male or female therapist. Massage therapists are professionals who want to help you. They’ve seen people of all shapes and sizes and will use towels and sheets to cover you. However you do need to be relaxed during a massage, and if you feel uncomfortable or self-conscious you won’t fully relax. So if you think this will be an issue for you, ask for a massage therapist that suits your needs.
    • Try not to feel embarrassed if you fall asleep or pass wind during your massage. It happens – especially when your body relaxes.

    After your massage

    • You may feel a little sore or tender after your remedial massage. This may last up to a day. The massage has worked and stretched your muscles, much like exercise does. If you’re not used to this or it’s been a while since your last massage, you may feel some pain. A warm shower or heat pack can help alleviate this.
    • Do some gentle stretches, as you would after exercising. This helps you maintain some of the benefits of your massage – such as increased flexibility and reduced muscle tension.

    Giving yourself a massage

    You can relieve many of your own aches and pains by giving yourself a massage. You may even find that you do this unconsciously – when you’re sitting at the computer and you rub your neck, when you have a headache and you gently rub your temples, or when you’re applying a heat rub to your sore knee.

    It’s a simple easy way to relieve pain and tension. The good thing about self-massage is you can do it almost anywhere and it’s free! Try it next time you feel tense and sore.

    Self-massage tips

    • Warm up first – ease some of your muscle tension with a warm shower or by applying a heat pack (warm not hot) to the painful area.
    • Use smooth, firm strokes. You’ll feel the difference between strokes that are relieving muscle tension, and those that are adding to it. Adjust the pressure, from hard to gentle, based on your pain.
    • Add some massage oil (or lotion) – it can help your hands move smoothly over the skin. This isn’t essential, but can add to the soothing feeling of the massage.
    • Don’t massage over bony areas. This can be painful and may cause an injury.
    • Try using massage aids – such as a foam roller, massage balls or other massage aids; e.g. use a tennis ball or a golf ball to massage the soles of the feet. Simply place the ball on the floor, place your bare foot on top of it and gently roll the ball along the length of your foot. If you’re unsteady on your feet, sit down while you do this. You can also use the shower to provide a massage, especially on your neck, shoulders and back.
    • Massage regularly – this’ll help prevent muscle pain and tension building up.

    Get help with self-massage

    Sometimes you need help when you’re giving yourself a massage. Reaching a sore spot in the middle of your back is tough. Or being able to apply firm, consistent strokes to your neck and shoulders may be impossible if you have a musculoskeletal condition that affects those areas. So ask for help. From your partner, a close friend or even the kids. Just be sure to clearly explain what you need.

    You can remain fully clothed and have them massage those areas over your clothes. Combined with using a heat pack, a home massage can provide some relief from your pain.

    Massage during COVID

    Many of us are finding our muscular aches and pains are worse at the moment and the need for a massage is even greater. Working from home and not having access to a proper desk or chair, trying to home school kids, not being as physically active as we’d like, and general stress about what’s happening in the world can all add to our pain levels and muscle tension. A massage – whether by a qualified therapist or a self-massage can help.

    The good news for people locked down due to stage 3 restrictions, is you can still access remedial massage therapists. Yay!

    Remedial massage and other allied health services like podiatry, mental health counselling and physiotherapy are essential to support health and wellbeing. So they’re not a restricted at this time. So wherever you are in Australia, you can get a remedial massage if you choose to.

    Just make sure you don’t see a massage therapist if you’re feeling unwell. If you feel at all sick, get tested for COVID-19 and stay home. Find out more about COVID symptoms on the Australian Government website or call the National Coronavirus Helpline on 1800 020 080.

    Take care, stay safe and give massage a go.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    16/Jul/2020
    Health InformationMSK articles

    Taking control in these uncertain times

    We’re used to having a certain amount of control and consistency in our lives. Before COVID our lives were fairly predictable and we generally knew what was coming. It made us feel secure and settled.

    But at the moment it’s almost impossible to know what’s coming. Things are constantly changing and there’s so much we can’t control because of this new world we find ourselves in.

    The problem is that when we feel like we have little or no control, we can start to feel more anxious and stressed. Apart from the significant impact this can have on our mental health, we know our physical health is negatively affected by periods of increased stress and anxiety. Our pain and fatigue becomes more intense, our sleep is affected, as is our concentration and blood pressure. We may also get more frequent headaches and stomach upsets.

    So if we can take back some control, we won’t feel so powerless. This can help reduce the impact of stress and anxiety on our health.

    But we’re in a pandemic – what can I control?

    I’m glad you asked. While there are lots of big picture problems we can’t change, we can focus on the small, personal things that affect ourselves, our family and friends and our community.

    Start with rituals and routines

    Work – Hands up if your working from home attire is something you couldn’t wear to work even on a casual Friday? Many of us have relaxed into trackies, slippers and other comfy clothes. Unless we’re on a video chat, in which case our top half is more presentable.

    But this has the effect of blurring the lines between work and home life; just when we really need that distinction to give us work/life balance. And while I won’t go so far as to suggest we all get dressed in our pre-COVID work clothes (though some of you may do that) making a few simple changes may help solidify the lines between work and leisure.

    In a recent article in The Age, Melissa Singer wrote that when she’s working she puts on her work shoes, even if she’s wearing comfortable, loungy clothes. At the end of the day she can kick them off. This is her signal that work is done for the day.

    You can do similar things like putting on some perfume/aftershave, lipstick, a favourite work shirt, or putting your work away in a briefcase or work bag at the end of the day. They’re things we associate with work, and when we’ve finished work, we should go through our end of work day routine.

    And if you can, put your work out of sight so it’s not in view. Even if that means putting a sheet over it. Create a new work routine that helps you put work aside so you can relax and enjoy your leisure and home time.

    Daily routines – It’s important during times of change and uncertainty to have a daily routine that you stick to. It will help you feel more in control of your life and what’s happening at the moment.

    Your routine is very specific to you and your life, and will be affected by what you need to do in your day, if you have people depending on you, if you’re working from home, have school work (or need to help others with school work) etc.

    It might help to sit down with the members of your household and create a calendar that includes everyone’s commitments and needs. Things to think about when creating your calendar:

    • Get everyone involved. It’s vital that everyone feels that their needs matter and they’re being heard.
    • Include specific time for fun stuff, exercise and connecting with family and friends.
    • Keep your weekends separate – this is really important so that you can get your chores done (sadly the laundry doesn’t stop because of a pandemic) and you have time to do creative stuff, exercise, and get a break from the workday routine.
    • Be very clear on your hours. It’s really easy to lose track of time. If you find this happening, set reminders on your phone to alert you.

    Birthdays, weddings, graduations, funerals – These are big events for us all. They make us feel connected with our people. And while there may be some restrictions depending on where you live, it’s important we continue to mark these occasions in whatever way we can. In person, via video or phone. We can send celebratory or condolence cards; we can even go the extra mile and make our own. We can write letters and actually put down on paper how much people mean to us. I can guarantee that this will mean so much to the recipient.

    Things are different, but there’s no reason we can’t still connect when it comes to the important occasions in our life. Or just on a random Tuesday.

    Our health

    We need to continue to look after ourselves. We have musculoskeletal conditions, so we need to continue to manage them as best we can. That means staying in touch with your healthcare team, alerting them to any changes or concerns, exercising, getting your regular tests done when they’re due, managing your weight and looking after your mental health.

    Many of us have other health conditions as well. So we need to manage those too. Looking after your health is a really tangible thing you can do to feel in control in an upside down world.

    The COVID three

    This would be the worst band name ever, but it’s stuck in my head from all the ads in the media. Which I guess is the point.

    We can control how we react to the pandemic and reduce our risk of becoming infected, or spreading the virus, by following what Deputy Chief Medical Officer Dr Nick Coatsworth calls the COVID 3.

    Wash your hands, physically distance yourself from others and consider downloading the COVIDsafe app. Stay home if you’re unwell and get tested. Cough and/or sneeze into your elbow. Consider wearing a mask. Use hand sanitiser when you don’t have access to soap and water. And follow the advice of the chief health officer in your state or territory. Wait, hang on, that’s 10 things.

    Oh well, just stay safe people. Stay kind. And look after yourself and others.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Reference

    • Even behind the curtain of Zoom, the show must go on
      The Age, 9 July 2020
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    Lisa Bywaters
    02/Jul/2020
    Health InformationMSK articles

    Feeling vulnerable? You’re not alone

    We’ve been noticing an increasing number of posts on social media and calls to our Help Line from people with musculoskeletal conditions, autoimmune conditions or with weakened immune systems who are feeling really anxious and vulnerable at the moment.

    In the general population there’s a giddy exhilaration about restrictions easing. Unfortunately this seems to have led many people to forget all of the good things they’ve been doing over the past few months to flatten the curve. People are gathering in large numbers and forgetting all about physical distancing and giving others plenty of space.

    That’s scary because most of us are still susceptible to the virus. And if you’re more at risk than others, it can make you feel really helpless and exposed.

    So what can you do to look after yourself?

    Acknowledge your feelings

    It’s a crappy, crazy time, so recognise that and allow yourself to feel frightened or anxious, cry, have a freak out, and then move on. Don’t bottle these feelings up or pretend everything’s fine. All of our feelings are valid and important – you don’t have to put on a happy face or turn that frown upside down. You need to acknowledge how you really feel.

    However if it feels like these feelings are taking over and they’re all you can focus on, talk to someone – your partner, a trusted family member or friend, your doctor or a mental health specialist.

    Talk to your doctor

    Make sure you keep your healthcare team up-to-date with how you’re doing – both physically and mentally. Continue to follow your treatment plan as prescribed, and if you have any issues contact your team immediately. If attending health appointments in person feels unsafe, use telehealth if you can. Obviously there are some appointments that will require you to attend in person – for example blood tests and scans – however there are many appointments you can attend from the comfort and security of your own home.

    It’s also important that you don’t change or stop your medications without talking to your doctor, regardless of what you may see online or in the news. A recent survey of more than 500 patients attending Monash Health’s Rheumatology Department found that over half were concerned that their medications would increase their risk of getting COVID-19, and more than 75% were concerned that their medications would increase the severity of the disease if they did get it. There’s a lot of misinformation floating around about medications and COVID, so if you’re worried, contact your doctor and get their expert advice.

    Stay home

    If you’re able to stay home, do it. The best way to avoid contact with someone who may have the virus is to stay at home. This is the advice of our health officers, especially if you’re in an area that has outbreaks. And quite frankly it’s so cold in parts of the country at the moment, it feels much better inside than out!

    So stay home when you can. Use telehealth to access your health professionals, go online to order your shopping and have it delivered (or have a family member/friend pick it up for you and leave it at your door), stay in touch with your people using video chat and phone calls, use exercise apps or online videos to keep active. Technology allows us to stay connected while staying home.

    Work from home if you can

    This will help reduce your risk of coming into contact with someone with COVID and other contagious illnesses like the flu. However if you can’t work from home, your workplace is required to have in place safeguards to protect you including physical distancing measures, access to soap and water and/or hand sanitisier, and clean and disinfected work spaces. For more information visit the Safe Work Australia website.

    Keep practising good hygiene

    This is just something we need to live with from now on. Wash your hands regularly and thoroughly (for at least 20 seconds), use hand sanitiser when you don’t have access to soap and water, cough or sneeze into your elbow, throw tissues into the bin after use and wash your hands immediately, clean and disinfect your surfaces with soap and water and a disinfectant. It’s important to clean before disinfecting because organic matter and dirt can reduce the ability of disinfectants to kill germs.

    Wear a mask

    When you do have to venture out, consider wearing a mask, especially if you have to catch public transport or you need to go to a location where physical distancing may be difficult. Read our updated blog about face masks for more info.

    Get vaccinated

    We’re all being urged to get the flu vaccination this year. This pandemic is overlapping with our flu season and while flu numbers in Australia are low due to our physical distancing measures, this may change. So see your doctor (if you haven’t already) and get your flu vax.

    Ask for help

    People living with health conditions are tough and resilient. We want to be able to do everything ourselves. However sometimes that’s not an option and we need to ask for help. This can be really hard and can feel like we’re giving away our independence. However this is a global pandemic – so asking for help when you need it is the smart thing to do – especially if it helps you look after your physical and mental health.

    Get support from others who understand

    There are some great peer support groups who meet online. You can chat with them, share your worries and concerns, get useful info and gain support from people who understand exactly what you’re going through. Being a part of these groups also give you the opportunity to give back and provide support to others.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING
    mask_web.jpg
    Lisa Bywaters
    02/Jul/2020
    Health InformationMSK articles

    Masks – revisited

    This article was written a week before Melbourne and Mitchell Shire in Victoria resumed Stage 3 restrictions from 11.59pm 8 July 2020.

    We’ve updated it as information has changed for different parts of Australia. Latest update 30 July 2020

    Another week, another edit.

    “The advice from the Victorian Department of Health and Human Services has been updated. People living in metropolitan Melbourne and Mitchell Shire and will now be required to wear a face covering when leaving home for one of the four reasons, following a concerning increase in coronavirus cases in recent days. To give people time to purchase or make a face covering, this new rule won’t be enforced until after 11.59pm on Wednesday 22 July – but for those who can, please start wearing yours immediately. The fine for not wearing a face covering will be $200.”(1) 

    • All people in regional Victoria will be required to wear a face covering from 11.59 Sunday 2 August 2020.
    • NSW now recommends people wear a mask when physical distancing can’t be guaranteed.(8)

     

    Just as restrictions began easing across Australia, Victoria started recording outbreaks of COVID cases. For more than two weeks the number of Victorians infected has been in the double-digits. And on Wednesday many suburbs in Victoria were locked down to stop the spread of the virus.

    So if you’re immunosuppressed and feeling really vulnerable no one can blame you. This is a scary time, and having a condition or taking medication that makes you more at risk of getting ill from any contagion or infection, adds another level to this.

    Although, we’re being advised to stay at home as much as possible, sometimes we just have to go outside the house. Some of us can’t work from home, or we have an appointment that can’t be done online or via video chat, or we have to use public transport.

    So how do we protect ourselves when we have to go out?

    Three months ago we wrote a blog about face masks. We thought it was timely to revisit this blog in light of the latest evidence, and advice from the Federal and Victorian Governments.

    The advice from the Federal Government

    This information is general advice about the use of face masks in Australia. It’s important to note that the advice from your local state or territory health department supersedes any general advice about face masks and coverings.

    “In Australia the routine use of face masks in the community is currently not recommended, while the rate of community transmission of COVID-19 is low.” (2)

    “However, some members of the public may choose to wear a mask in situations where it is not feasible to maintain physical distancing e.g. on public transport and/or if they are at increased risk of severe illness if infected (e.g. because of their age or a chronic medical condition). This may provide some additional protection in these circumstances.” (3)

    This advice takes into account the fact that restrictions are easing, and people are going out more. And with the opening up of our communities, the risk of coming into contact with people who have the virus, whether they appear to have it or not, is increased.

    The advice also reinforces the message that masks aren’t a substitute for all the other things we’ve been doing: staying at home as much as possible, physical distancing, washing/disinfecting our hands regularly, not touching our face, coughing/sneezing into our elbow and staying home when we’re sick.

    The advice from the Victorian Government

    Parts of Victoria are currently experiencing significant outbreaks of COVID-19. For that reason the recommendations about face masks have changed.

    The Victorian Premier Daniel Andrews and Chief Health Officer Brett Sutton have advised that it will be mandatory from 11.59pm on Wednesday 22 July 2020 that people living in metropolitan Melbourne and Mitchell Shire must wear a face covering when leaving home for one of the four reasons, following a concerning increase in coronavirus cases in recent days.

    People in regional Victoria will be required to wear a face covering from 11.59 Sunday 2 August 2020. That means that it will mandatory for ALL Victorians to wear a face covering when they go outside of their homes from next Monday.

    What type of face covering?
    If you haven’t been able to get a surgical or cloth mask, Premier Andrews has said: “It need not be a hospital-grade mask. It need not be one of the handmade masks … it can be a scarf, it can be a homemade mask.” He admits “nothing is perfect” and a “face covering is just as good”. (4)

    What else do you need to know? 

    • Wearing a face covering protects you and your community by providing an additional physical barrier to COVID-19.
    • Keeping 1.5 metres between yourself and others and washing your hands are still the best defences against COVID-19.
    • There will be some reasons not to wear a face covering. For example, those who have a medical reason, kids under 12 years of age, those who have a professional reason or if it’s just not practical, like when running. However you’ll still be expected to carry your face covering at all times to wear when you can.
    • The fine for not wearing a face covering will be $200.
    • Face coverings in regional Victoria continue to be recommended in situations where maintaining 1.5 metres distance is not possible – however regional Victorians will have to wear a mask when visiting metropolitan Melbourne or Mitchell Shire for one of the permitted reasons. (4)
    • Read the full Department of Health and Human Services update.

    The advice from the New South Wales Government

    The NSW Government now recommends wearing a mask if it’s difficult to stay 1.5 metres away from other people. For example, on public transport, when caring for vulnerable people or when indoors.

    Find out more on the NSW Government website.

    The evidence for using face masks

    Up until recently the evidence for the use of face masks to protect against COVID-19 has been conflicting. But over the last several months the evolving evidence has come down firmly on the side of wearing masks.

    Many people cite an article published in The Lancet in June 2020 as the turning point in the debate for wearing masks in public. It provided robust evidence for the benefits of face masks. It reported on a systematic review and meta-analysis that investigated a range of measures used to prevent person-to-person virus transmission. It looked at physical distancing, eye protection and the use of face masks.

    Researchers analysed hundreds of studies involving SARS-CoV2 (the virus that causes COVID-19), as well as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), across 16 countries in healthcare and non-healthcare settings, including more than 25,000 people.

    They conclude that “wearing face masks protects people (both healthcare workers and the general public) against infection by these coronaviruses”. (5)

    However the authors also state that “none of these interventions offers complete protection and other basic protective measures (such as hand hygiene) are essential to reduce transmission.” (6)

    While there were several limitations with this study, it does provide good evidence for the use of masks by the general public.

    So if you choose (or are required) to wear a mask there are some things to keep in mind:

    • Follow the latest guidelines from your state/territory health department. There’s no ‘one size fits all’ when it comes to face masks or coverings in Australia.
    • Don’t let wearing a mask give you a false sense of security. Masks will provide some level of protection – depending on what they’re made of, how porous the fabric is, how well you use them – but they’re not a magical, virus-repelling shield (though how cool would that be?)
    • Use masks correctly:
      • Wash or sanitise your hands thoroughly before you put a mask on and when you take it off.
      • Only touch the mask by the straps.
      • Make sure it covers your nose and mouth and fits snugly under your chin, over the bridge of your nose and against the sides of your face.
      • Don’t touch the front of the mask when you wear it. That means no pulling it down to talk to someone, to eat or drink or to smoke a cigarette.
      • And don’t touch the front of the mask when you remove it. If you do accidentally touch it, wash or sanitise your hands immediately.
        Basically imagine the front of your mask is covered in something messy or gross – like paint or a virus (!) – that you don’t want to get all over yourself and the things you touch (e.g. your phone, your kids).
    • If it’s a disposable, single use mask, only use it once and then dispose of it properly.
    • If it’s a cloth mask, wash it thoroughly in warm, soapy water and allow it to dry properly before you use it again.
    • Don’t wear a mask if you have breathing difficulties or when you’re exercising strenuously.
    • Don’t put a mask on a baby or small child.
    • Replace the mask if it gets damp or wet, or if you sneeze inside it.

    The World Health Organization (WHO) has some great videos to help you learn how to use a mask correctly.

    And finally, remember to keep doing all the other important things: stay home when you can, wash your hands regularly and thoroughly, use hand sanitiser when you don’t have access to soap and water, physically distance yourself from others, cough and sneeze into your elbow and stay at home and get tested if you feel even the slightest bit unwell.

    Stay safe and be kind.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to Explore

    References

    (1, 5)  Face coverings mandatory for Melbourne and Mitchell Shire
    Victorian Department of Health and Human Services, 19 July 2020

    (2-3) Use of masks by the public in the community
    Australian Government Department of Health, updated 11 June 2020

    (4) Face masks will be mandatory in Melbourne and Mitchell Shire to combat coronavirus. What about regional Victoria? Do children need to wear them?
    ABC News, 19 July 2020

    (6-7) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis
    The Lancet, 1 June 2020

    (8) Face masks
    NSW Government, 28 July 2020

     

    Photo by visuals on Unsplash

    CONTINUE READING
    donuts.jpg
    Lisa Bywaters
    02/Jul/2020
    Health InformationMSK articles

    Losing the COVID kilos

    An article in the news this week caught my eye and really struck a chord. I don’t know about you, but the period of isolation has seen me gain a little more weight than I’m happy with

    Having more time to cook and create, stress eating, the return of Masterchef (Go Poh!) and not being as physically active as we were before COVID…not to mention the snacking, cocktail hour and a whole bunch of other factors has caused many of us to gain weight during iso.

    Apart from the many health issues associated with being overweight (e.g. heart disease, diabetes, high blood pressure) it’s also linked to increased pain and joint damage due to the increased stress on your joints. It can also affect your ability to be as active as you’d like, which can lead to more pain, musculoskeletal issues and weight gain. We also know that fat releases molecules that increase inflammation throughout your body.

    Clearly maintaining a healthy weight is important.

    So if, like me, you want to lose some of the weight you’ve gained during the last few months, we can do it! We can turn this around. It may be a challenge and take some time, but we can lose the COVID kilos.

    • Start with a goal. It really does help if you have a clear goal in mind. Just the idea of losing weight isn’t a goal, but a specific, measurable plan – for example – losing 5 kilos in 8 weeks is. So make sure your goal is SMART – specific, measureable, achievable, realistic and has a timeframe. Read our blog on setting goals for more info. When you’ve created a goal that suits your specific wants and needs, write it down and put it somewhere prominent. It’s a great visual to help you stay on track, and remind you of why you started.
    • Keep track. It’s helpful when you’re trying to get back into a healthy routine to write down what you’re eating. You can use a simple notepad or download an app. Whatever format you choose, make sure you use it. Add every little thing you eat and drink, how much you’re consuming and when. Keeping track of your food intake really helps you see if your diet is balanced and it can help you spot any trends as far as snacking, serving sizes etc. That’ll help you adjust things if you need to.
    • Eat a balanced diet that includes a colourful variety of foods, such as fruits, vegetables, whole grains, dairy products, proteins and healthy fats. This gives your body the energy and nutrients it needs to work properly, helps you maintain a healthy weight, helps protect you against other health conditions and is vital for a healthy immune system.
    • (Re)Establish a routine. If you had a healthy diet and exercise routine pre-COVID, reestablish it. It may not be exactly the same, but if you had it once, you can do it again. Look at what’s changed for you over these last few months, how it’s affected your diet and exercise, and what things you need to do to get things working again for you in this new world. If you didn’t have a good routine before COVID, now’s the perfect time to get one. Think about your typical weekday (weekends will have a slightly different routine), what you need to fit into your day including your family, work and other commitments. Write it all down and think about how you can establish a routine that works for you. Think about when you’ll work on creating healthy meal plans, when you’ll shop for ingredients, when you’ll cook, and when you’ll exercise. If you break it down into the small tasks, it makes it easier to fit into your schedule. This may take some trial and error, but it’s worth the effort.
    • Get the family involved. Whether you have family living with you, or they’re in another location, get them involved. They’ll be your cheer squad, but they may also benefit from a little TLC when it comes to their diet and exercise. You can support each other, work through problems together, share recipes and ideas.
    • Exercise. Obviously. Make sure exercise is part of your everyday routine. It’s important to help manage your musculoskeletal condition, pain, mental health, weight, sleep – and so many others things.
    • Get a good night’s sleep. Research has shown a clear link between not getting enough sleep and weight gain. Poor sleep is also linked to difficulties losing weight. As many people with musculoskeletal conditions struggle with sleep, this is yet another reason to really look at how you can improve your sleep quality and quantity. And if you need help, talk with your doctor.
    • Eat mindfully. This involves taking the time to be aware of what you’re cooking and eating – savour the tastes, the smells, the textures. Be present while you eat, and try not to be distracted by things like the work, TV and other devices. Don’t hurry, eat small bites, take your time and enjoy.
    • Distract yourself. Sometimes we eat not because we’re hungry, but because we’re bored, sad, lonely or upset. Before you eat something outside of meal times, ask yourself why you’re reaching for that food. Do you actually feel hungry? Or is there another reason? If you’re not hungry, distract yourself with a walk, call a friend, drink a glass of water (not wine! – many of us are overdoing that too – see below).
    • Choose snacks wisely. I’m not a chocoholic, but somehow it’s been finding its way into my cupboard on a regular basis. It’s easy for this sort of thing to become a habit, so be mindful of what you’re snacking on and how often. If you’re snacking on less healthy options like high fat, high sugar or high salt treats, substitute them for healthy options such as fruit, vegetables, nuts, yoghurt. But be aware of the serving size and the frequency. You can have too much of a good thing! And save the treats for when you can really savour them. When you only eat them occasionally you’ll enjoy them even more.
    • Acknowledge that you’re not perfect and you may eat some things that aren’t part of your healthy eating plan. That’s OK, you’ll get back on track. Don’t let it trip you up, or allow the negative self-talk to sabotage your weight loss. Go back to your goal, remind yourself why you’re doing this, and move on.
    • Don’t deprive yourself but don’t ‘treat’ yourself too often either. Find that balance of enjoying your food, but don’t use it as a reward or to make yourself feel better if you’re feeling down or stressed.
    • Get help. If you’re struggling with your weight and you need professional help, talk with your doctor or dietitian. They can help you with practical information and strategies that are specifically tailored to you.
    • Be careful with alcohol. Reports are showing that many of us are drinking more during these stressful times. If that sounds familiar, cut back on your alcohol intake. Substitute other drinks that you enjoy instead of alcohol, though be careful of drinks high in sugar. Try different teas and infusions, add lemon and other fruits to your water, give kombucha a go (maybe? It can be an acquired taste), make a mocktail (again be careful of the sugar content).

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Photo by Heather Ford on Unsplash

    CONTINUE READING
    dont-panic-button.jpg
    Lisa Bywaters
    25/Jun/2020
    Health InformationMSK articles

    COVID-19 outbreaks

    The last week has seen a large number of new cases of COVID-19, particularly in Victoria. With this large increase in the number of active cases, should we be worried?

    Well – yes and no. Let’s explore some of the issues.

    We’re dropping our guard

    SARS-CoV-2 (the virus that causes COVID-19) is like a mythical beast. It’s caused so much damage and devastation – both here and globally – but most of us haven’t faced it. It’s hard to stay vigilant against something that seems so elusive.

    So we drop our guards and our standards along with them.

    It’s absolutely understandable – it’s been a long road so far, we’re sick of being isolated, we want life to go back to normal.

    “I wish it need not have happened in my time,” said Frodo.
    “So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is that to do with the time that is given us.”
    J.R.R Tolkien – The Fellowship of the Ring

    But because most of us haven’t been exposed to the virus, we’re still susceptible. And some people are more at risk than others of becoming very ill if they develop COVID-19, including people with immune issues and certain other health conditions.

    So we need to maintain our vigilance.

    Community transmission

    Most of the new cases can be linked to people returning from overseas and specific clusters where the origin of the virus transmission is known.

    However there are some cases where we have absolutely no idea how/when/where a person became infected. This is known as ‘community transmission’ – a person becomes infected with the virus but they’ve had no contact with a known case.

    They may have been in contact with someone who’s asymptomatic (infected but don’t feel unwell or show any symptoms) or someone who’s pre-symptomatic (infected but not yet showing symptoms). Or they may have come into contact with someone who thinks they have a bit of a cold, or even someone who suspects they have the virus but isn’t self-isolating.

    The issue of community transmission is why we need to remain on guard against this virus. Just because restrictions have been easing doesn’t mean we can ease up on our physical (social) distancing, washing our hands as often as possible, using hand sanitiser if there’s no access to soap and water, sneezing and coughing into the elbow, staying home when we’re sick and getting tested if/when we develop symptoms, however mild.

    Remember, symptoms of COVID-19 are:

    • fever
    • chills or sweats
    • cough
    • sore throat
    • shortness of breath
    • runny nose
    • loss of sense of smell.

    For more information about symptoms and to see if you or someone you care for may have the virus, use the healthdirect Coronavirus (COVID-19) Symptom Checker. Answer a few simple questions to find out if you need to seek medical help or be tested. Or call the National Coronavirus Helpline on 1800 020 080, 24 hours a day, seven days a week.

    Winter is here

    And for most of Australia there’s is a bit (or a lot) of chill in the air. Which means we’re staying indoors, huddling close together to stay warm, keeping the windows closed to keep the cold out and the warm in. Unfortunately all of these things make it easier for germs to spread. We’re close together and there’s little ventilation. Perfect to help the little buggers move from person to person.

    Along with the cold weather, we’re seeing more people gather together as restrictions ease and as boredom well and truly sets in. This’s a big problem. On a recent trip to the local shopping centre I was shocked by how many people I saw –most weren’t allowing 1.5 metres between themselves and others, people were hugging, coughing into their hands, not using hand sanitiser when entering stores…all of these things allow germs to spread through the community. Needless to say I hightailed it to the closest exit and went home.

    It’s cold and flu season

    This pandemic is overlapping with our flu season. Yay! Currently flu numbers in Australia are low due to our physical distancing measures. However, this may change for the same reasons we’ve seen increases in COVID-19 cases.

    There’s also the potential that people may become infected with the flu and COVID-19 at the same time, which, to put it mildly, isn’t ideal. While we don’t know if this leads to more severe cases of both infections, the immune system will be weakened by fighting two infections. And if a person’s immune system is already weak due to another health issue, this has the potential for very serious outcomes.

    Finally if flu numbers do increase as we continue through our flu season, it will have an impact on our healthcare system, which is already working overtime because of the pandemic. It seems like so long ago, but the 2019 flu season was our worst flu season on record.

    So for all of these reasons we’re being urged to get our flu vaccination this year.

    This is also a time of year when many of us succumb to colds. Coughing, a runny nose or sore throat may be symptoms of cold, allergies, the flu or COVID-19. If you experience these symptoms, don’t just assume it’s a cold or your allergies flaring up. The same goes with muscle soreness and a fever. For some people with musculoskeletal conditions, this may be a symptom of a flare. Or it may be your body displaying signs of COVID-19. The best thing you can do is stay home and contact your doctor – and if recommended – get tested.

    So should we be worried about these COVID outbreaks?

    We should be concerned because most of us are still susceptible to the virus, and some of us are at risk of becoming seriously ill if we become infected with COVID-19.

    So stay at home if you’re unwell, know the symptoms of COVID-19, wash your hands often and thoroughly, cough/sneeze into your elbow, maintain physical distancing measures and continue to follow the advice of our health officers.

    But we shouldn’t become so worried that we don’t get out (safely and responsibly), that we don’t live our lives. We were able to keep the numbers down for months. We can do it again.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

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    small-joys-bubbles.jpg
    Lisa Bywaters
    25/Jun/2020
    Health InformationMSK articles

    Rediscovering small joys

    This strange time we’re living through has forced us to live smaller. SARS-CoV-2 is going to hang around for quite some time, so our way of living will likely remain on the small scale for the foreseeable future.

    And as we’ve seen with the spike in active cases in Victoria, restrictions can be eased and they can be tightened again. Trips overseas are out and trips interstate are dependent on state borders being open. Even travelling across our own state may be subject to restrictions if outbreaks continue.

    It’s easy to feel a little despondent about the whole situation. It’s been a hard slog with no end in sight.

    So it’s important we take some time to sit back and take stock. We’ve adapted to isolation and the massive changes in our world. We’ve been creative and done things that we couldn’t even imagine we would’ve done this time last year. We should give ourselves credit for that and continue to discover the small joys in life.

    Like having a jigsaw on the go on the kitchen or coffee table that everyone adds to as they walk past. I can’t tell you how many people have told me they’ve been doing this…and how much satisfaction they get when they complete a tricky 1,000 piece puzzle.

    Or discovering the parks, paths and until now unexplored areas in our neighbourhoods. Foot power and pedal power has us discovering many hidden treasures we never knew existed before COVID.

    We’ve enjoyed cooking and creating meals together. Discovering an interesting recipe, trying new ingredients, and taking time to sit down together and talk, laugh and have fun. With the change in our routines, and the lack of social/sporting/school/work gatherings, we have a little more time to break away from the mundane meals of the past, at least occasionally. Turn the TV off, put some music on, enjoy the company and the meal.

    We’ve hauled the dusty board games out of the back of cupboards and spent hours playing and enjoying time together…unless it’s Monopoly. It always seems to start well, then ends in tears. We’re reading, planting vegie gardens, catching up on new TV shows, enjoying a cup of tea in the garden, doing the crossword together – basically living much more simply.

    We’re catching up with friends and family with long phone calls and video chats. I think this’s been one of the best things that has come out of the pandemic. Without the distractions of work, social obligations, kids sports and the busyness of pre-COVID life, we have a bit more time to catch up and really talk. This has been wonderful.

    And for those of us with a chronic condition, being able to stay home has allowed us to feel safe from the virus, but has also given us the time to reevaluate how we’re travelling. For example, how’s our pain management? Do we need to tweak something, try something new? Are we looking after our mental health? Should we try some mind-body techniques such as mindfulness or guided imagery? This pandemic has paused the world in some ways, but it’s given us an opportunity to check our health and wellbeing.

    This time will pass. It’s going to take a while, but we can adapt. We’ve been doing it for months, and we can continue to do it. And rediscovering the small joys in our world will help us get through.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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    vitamin-D-cap.jpg
    Lisa Bywaters
    18/Jun/2020
    Health InformationMSK articles

    Vitamin D for healthy bones – and for COVID-19?

    Most of us know that vitamin D is important. It’s like the other things we ‘know’ – when to use the word literally, which fork goes with which course, and what Pi is. We sort of know vitamin D is good for us, but maybe not as much as we’d like. So let’s do a quick vitamin D refresher.

    It’s important for our health. Among its many benefits vitamin D:

    • regulates the amount of calcium and phosphate in our body, necessary for healthy bones, teeth and muscles
    • helps protect us against osteoporosis, a condition that causes bones to become weak and lose their strength, making them break more easily than normal bones
    • supports our immune system
    • can reduce the risk of falls, important for all of us, but especially those with fragile bones or another musculoskeletal condition.

    There are two types of vitamin D:

    • D3 (cholecalciferol) – formed in the skin by the action of ultraviolet (UV) light
    • D2 (ergocalciferol) – produced by UV light on plants and obtained through our diet.

    In Australia our main source of vitamin D is sunlight. It’s important to expose our hands, face and arms to the sun every day. The amount of time needed to do this depends on where you live, the time of the year and the complexion of your skin. Because we also need to be careful that our sun exposure is safe and we don’t risk skin cancer, Osteoporosis Australia and the Cancer Council have developed a useful chart to help you work this out.

    Vitamin D can also be found in small quantities in foods such as fatty fish (salmon, herring, mackerel), liver, eggs and fortified foods such as low fat milks and margarine. For most us though, it’s unlikely we’ll get enough vitamin D through diet alone.

    Vitamin D – whether it’s from sunlight, food or supplements – is stored in our fat cells until it’s needed.

    Why should we care about vitamin D?

    First, for the reasons we mentioned above. And second, in case you haven’t felt it, it’s getting cold. Winter is upon us and we’re not exposing as much of our skin to the sun in most parts of Australia as we did earlier in the year – at least not without risking frostbite.

    So we need to make sure we’re doing everything we can to get enough vitamin D during these colder months.

    Most people, through every day exposure to the sun in the warmer months, will have created enough vitamin D to make it through the winter without becoming deficient. Yay!

    For others however, it may take a more concerted effort to get enough vitamin D during winter. The best way to do this is to be active outdoors – e.g. going for a walk, working in the garden. You can also include foods that contain vitamin D in your diet. A dietitian can help you with this. They can also ensure your diet is healthy so that you get all the other nutrients you need.

    Finally there are some people who aren’t able to get enough vitamin D through sunlight or diet, which puts them at risk of vitamin D deficiency. This includes:

    • elderly people – especially those who are housebound or in residential care
    • people who wear concealing clothing for religious or cultural reasons
    • people with certain health or medical conditions who need to avoid the sun
    • people with dark skin as their skin contains higher amounts of melanin, which inhibits the creation of vitamin D
    • people in occupations where they have limited exposure to natural sunlight throughout the day – e.g. taxi drivers, factory workers, office workers and nightshift workers
    • people with diseases that make it difficult to absorb enough vitamin D – e.g. cystic fibrosis, coeliac disease and renal disease.

    If you‘re concerned that you may be deficient in vitamin D, it’s important to discuss this with your doctor. They can do a simple blood test to check your vitamin D levels. If you are deficient, it may be necessary to take vitamin D supplements for a period of time.

    It’s important to note that if you’re not vitamin D deficient, there’s no reason to take vitamin D supplements. It’s possible to have too much vitamin D, so only use these supplements as prescribed by your doctor.

    What does vitamin D have to do with COVID-19?

    There have been reports that vitamin D may be useful in our fight against COVID-19, however the results of these studies haven’t been conclusive.

    We know that vitamin D plays an important role in supporting our immune system. And in some recent studies people who’ve developed COVID-19 have been found to be vitamin D deficient. However these studies involved literature searches, analysis and observational studies – which are useful and provide valuable information – but can’t say with any certainty that vitamin D can help prevent people who are vitamin D deficient from catching COVID-19.

    That’s because they can’t eliminate other important risk factors such as age, obesity and socioeconomic status (e.g. level of income, education, access to healthcare, housing).

    However when researchers looked at the data of half a million people from the UK Biobank and adjusted for variables such as age, race, socioeconomic status and obesity, they found that ‘people with lower vitamin D have a higher risk of COVID infection, but it looks like this is explained by other risk factors and not by the vitamin D itself…our findings do not support a link between vitamin D concentration and the risk of COVID-19 infection.’ (1)

    Professor Mark Morgan, Chair of the Royal Australian College of General Practitioners Expert Committee – Quality Care (REC–QC), has also been quoted as saying ‘at the moment, I’ve not seen any evidence that using vitamin D could prevent or treat COVID-19…I know that there’s a number of controlled trials that are being commenced to look into that, but we’ll have to wait for the results of those trials before we have any information.’ (2)

    So at the moment, it’s a watch and wait situation when it comes to vitamin D and COVID-19. We need more information from randomised controlled trials that are able to tell us conclusively if vitamin D can protect at risk people from catching it.

    And remember if you’re concerned about your vitamin D levels, discuss this with your doctor. Don’t start taking a supplement without their expert advice.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    References

    1. Exploring the links between coronavirus and vitamin D
      The New York Times, 10 June 2020
    2. Do vitamin D levels affect risk of infection and severity of COVID-19?
      newsGP 15 May 2020

    Photo by Michele Blackwell on Unsplash

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