Connecting Virtually in a COVID World
In this episode of Ask The Dance Docs, Dr. Davenport and myself cover information on Telehealth and the rapid transition made by many health care practitioners. We discuss what a telehealth session may look like with a health care practitioner, some of the benefits telemedicine has to offer and how to get the most out of your session. We answer some questions regarding virtual classes and concerns about jumping and floor surfaces as well as staying in shape with limited space
Covid-19 update
While COVID-19 continues to spread, everyone is doing their best to adapt to this new normal. It seems more and more every day that we are in this for the long haul. I recently read an article on 3 main things we can do to help during this time and I feel that they are worth sharing.
Do your best to support the front line workers and to figure out how to sustain this new normal for the next few weeks.
Do your part to help bend the curve with social distancing.
The areas in the US such as northern California and Seattle, who jumped in on implementing shelter in place, are showing that they are flattening the curve.
This allows the health care system to provide services to those most in need instead of becoming overwhelmed, it also slows the rate of transmission
Check in regularly with your local government on new practices being put into place (wearing masks etc)
give the scientists time, most labs have converted to COVID-19 and are working on the:
Development of more rapid testing
Development of vaccines (12-18 months)
Development of therapies, and clinical testing of current medications on the market
Remain optimistic- there is light at the end of the tunnel, things are dark now but we will get through this!
Telehealth
What is telehealth-
Telehealth is connecting with a health professional through telecommunication technologies (facetime, zoom, skype ect)
It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions.
Just about every practitioner I know has switched to treating via telehealth
Follow-up MD visits
PT visits
Sports psych visits
Conditioning classes
Nutrition consults
Dr. Davenport’s insight on telehealth from the MD perspective
Why haven’t we heard about telehealth before now and all of a sudden everyone is doing it?
Has been around but not widely used due to many reason
Policy and reimbursement has changed allowing for improved access through telehealth
Originally for just follow-up visits, has now expanded to cover initial visits as well
What does a normal telehealth visit with you look like right now?
Visits can be conducted by a clinician in office or at home
Can download professional background
Recommended for non emergent cases
Initial or follow-up visits
To schedule a visit call your practitioners office, and schedule a time
Make sure to have the appropriate technology (zoom, skype) on computer or phone
Would be similar to regular office visit
Can still order medications, physical therapy scripts, durable medical equipment
If the doctor feels that you need to be seen in clinic for further diagnosis such as x-rays etc many are still offering limited office hours for healthy patients.
What are you enjoying or not right now?
Many patients are enjoying the ease of scheduling and not having to come into the office
Sometimes patients who want to see a specialist have to travel for over an hour, telehealth is allowing for them to complete the visits without the travel time
It has been easier on some of the medical professionals because visits are being scheduled and completed quickly instead of playing phone tag
improve the speed to which patients can receive results for medical tests such as MRI results
Are your visit length the same or do you have more time?
Currently have a little more time, due to there being more cushion room in the schedule to get call’s set up
Visits have been mostly medical but there has been time for some social check in allowing for improved personal connection with patients
Dr. Kat’s PT perspective on telehealth
Most PT’s that I have reached out to are really enjoying working with patients via telehealth
Many PT’s in the dance medicine world spend increased time on manual therapy so we don’t always get to do the parts of this profession that we love. Many individuals have said that switching to telehealth has allowed for:
More in-depth movement assessment/analysis
Improving upon ther-ex skills that are not used in a heavy manual workload
Having to find ways to develop cueing skills since we can no longer use tactile cues
Has been nice to spend some time really program planning.
Individual program plans for patients
General strengthening plans/ cross-training ideas for dancers
Getting back into teaching movement classes
More time to read literature
Review the most up to date literature on best practices
Just have to get over my fear of putting myself out there
Videos
Blog posts
PT know that you are continuing to make an impact in people’s lives during this time even though we may not have the 1:1 contact that we are used to.
***Side note- There is no clear answer if blue light glasses help but many people report that they help reduce your eye strain and enhance your focus allowing your eyes to feel less strained. I also find them helpful if I am going to be on my computer later in the evening, I am able to fall asleep regularly instead of feeling wired awake.**
Current benefits of telehealth visits?
Now might be the best time to do a virtual consult with a dance medicine specialist
Multidisciplinary collaborations or visits may be available right now
Non-operate sports/ dance medicine doctor
Medical specialist (example: foot and ankle specialist)
Physical Therapists
Dancer/ Patient
May open up access to dance medicine practitioners for those not in major metropolitan area
Many restrictions have been lifted for telehealth
Now being reimbursed by most insurance companies
What restrictions are still in place
You need to find a practitioner who is licensed in your state
Need to follow-up with your own insurance company to understand what will be covered, and what will be out of pocket
Most clinicians will do their best to work with dancers due to financial constraints
Information for the dancer regarding telehealth visits
Please answer phone calls from unlisted numbers - it might be your doctor calling from a blocked/unlisted number
Some doctors are making phone calls from home with a cell phone and will block the number
Make sure to block off some extra time, and be ready to start your appointment when scheduled
Make sure if you are scheduling appointments with doctors or PT that you have the appropriate space set up.
Want to be able to demonstrate to the doctor what is bothering you the most
Want to have full body view so we can see what is really going on
Make sure the lighting is good, not too washed out or too dark
Make sure that you are wearing appropriate clothing to we can see the affected body part, alignment etc
Want clear space for PT
Area where you can lay down, can still see whole body
Try to avoid bumping into furniture
Let your PT know what equipment you may have available
Both clinicians and patients be flexible, and stay patient- we are all on a learning curve together!
Virtual Dance classes
Importance of taking the time to branch out
If you primarily do ballet, think about Indian dance, Ballroom dance, tap, Gaga
Can also learn a new skill/technique that may help you improve without feeling upset that you cannot do a full ballet class
Helps to create a more balanced body physically
May provide emotional benefit in learning new skill and being successful
Can also try contemporary ballet classes, Taylor modern classes
Make sure to pick a class that is appropriate for your level of dance
Younger dancers need to be careful taking more advanced classes,
If a teacher is doing a skill that you have not learned yet it may be best to rest or do a slightly easier exercise, or end the class early.
Want to avoid developing a new injury
Instructors have had difficulty with:
Music delay
This delay is normal due to you hearing the music and your dancer hearing it on their end.
For group classes this is normal, just do your best
Use feed back after exercises is completed not during the combination
Focus on group cues for multi-person classes
If a dancers wants more specific technique related information ask them to schedule 1:1 sessions
For 1:1 give the dancers the music for them to play on their side to combat delay
You may want to connect your laptop to your TV screen, or airplay to your TV so you have a better view
Stay in front of TV to watch, switch to be in front of the camera to demonstrate
I have been receiving a lot of questions on floors from dancers, and teachers and clinicians
In particular as it relates to jumping
Many dancers are used to jumping on sprung floors which help to cushion the landing
Most homes especially here in south Florida have tile which has no give, and is very slippery
Space is very limited
Ideas from The Dance Docs
Tennis shoes to increase cushioned landing on hard surfaces
Many times this is how we progress someone back from an injury- offers more support and cushion
Place a yoga mat down if you have to do jumps
Gives a little bit of cushion
Or even yoga mat on low cut rug
Many of us remember dancing on hard surfaces like linoleum floors-
if a hard surface is your only option stick to simple jumps on 2 feet- more even weight distribution
Slowly build up to jumping on a hard surface, allow your body to adapt, don’t have to kill it on day 1
If you are dancing straight on concrete or slab floors only in tennis shoes
Try not to combine multiple of these
Example jumping on a yoga mat in tennis shoes
Jumping is for impact not for overall dance
What is good to jumping is not good for turning
Now may not be the time to specifically focus on advancing certain areas of your technique, but maintaining your current level.
Cross conditioning ideas to maintain impact for return to jumps
Plyometrics
Running —> check out the blog post A dancers Guide to Running
High Intensity Interval Training (HIIT)
Single leg relevé
pool jumps (private pools)
Take a longer barre
Work on adagio, and controlled movements and balance instead of jumps and turns
Take class 3-4 days a week and substitute other days with cross training
Want to maintain some volume so that you are ready to ramp up about 2 weeks prior to returning to work or regular class schedule
Cross training can help to build overall strength and stability to keep you healthy
This may also help if your company is doing very diverse rep
Helps your body to more easily adapt to new movements
Ex ballet company that is now doing more contemporary work
Will be focusing a whole episode coming up on cross training
Ok to take a break mentally, physically and emotionally. Don’t have to make it happen every day!
May need to take some time now as a vacation
Have the plan set on how to ramp up and return to work strong
We are here to help, contact us at thedancedocs@gmail.com or through the contact page
In Health,
The Dance Docs