Upper Extremity Strengthening Using Household Items

by Elizabeth McCarthy, LPTA

If you are wanting to get back in shape and strengthen your arms but do not feel comfortable returning to your local gym yet, there are plenty of household items you can use to achieve your goal. Simple items around your home that you may never have thought twice about can easily be used to improve arm strength, stability, and mobility!

Let’s Get Pumped-UP!

Weighted items you can use around your home (with each item you will find an example of exercises you can do with each). We suggest starting with 2 sets of 10.

  • 1 gallon milk jug (a full gallon typically weighs around 8.5 pounds)

  • Laundry detergent bottle


  • Any canned goods/soup cans

  • Broom or mop

  • Water bottles

  • Backpack full of books

  • Flour/rice/sugar bag
  • Bike air pump
  • Towels

Disclaimer: Weights vary for each of these items. If you cannot lift any of these items without causing injury or pain, or have a condition that limits you from completing these exercises, you should seek medical advice from a professional, such as a physical therapist.

Self-Assessing Your Physical Fitness Level

by Nicole Somers, DPT

Your physical fitness is your state of health and well-being that not only impacts your ability to participate in sports and recreational activities but also when performing occupational activities and normal day-to-day tasks. Research suggests that most Americans do not perform enough physical activity which can have negative side effects on one’s overall health.

Physical activity recommendations for adults from the US Dept of Health and Human Services include:

  • “At least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity;”
  • “Should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week;” and
  • Older adults, in particular, should have multiple components including strength, aerobic, and balance, as part of their physical activity program.

Take the Test!

Ready to take this 6 Step Self Physical Fitness Assessment?

The goal of this at-home self-assessment is to get you thinking about your level of fitness. It features six exercises to gauge your flexibility, balance, strength, and cardiovascular capacity. These exercises are inspired by evidence-based testing used by physical therapists. Just click on the link above in orange, Ready? Go!

Did you not perform as well as you had hoped? A physical therapist can perform a comprehensive evaluation to help get you started on a physical fitness program or guide you in your current one.

Disclaimer: A self-assessment is not meant to replace medical treatment for an injury, pain, or condition that limits you from completing the self-assessment, and you should seek medical advice from a professional, such as a physical therapist.


Getting the Most Out of Physical Therapy

by: Crystal Bondurant-Salisbury, LPTA 

You can arrive at PT for the first time for a number of reasons, whether it be an injury, a surgery,  general issues like balance training, or even more severe, chronic issues like fibromyalgia or Parkinson’s Disease (PD), and for most people going to physical therapy for the first time, there are a lot of questions. You will want to know what to expect from your therapist and what they expect from you. No matter the reason that brought you into our clinic, there are a few things that can help you make the most out of the time you spend with us.

When arriving on the first day there are a few things that we will need from you including your prescription from your doctor. It is important to make sure that if your doctor is not sending it directly to us that you arrive with it and any pertinent insurance and identification you may need for your paperwork. Like most medical offices there will be some paperwork for you to fill out, so it is important to be on time to do so. Our office staff will be happy to help walk you through it and will be providing you a welcome letter and copies of our policies for you to keep and review.  So being prepared on your first day is very important.

On your first day, you will meet with your evaluating therapist. The two of you will spend time first talking about what brought you to therapy and then going through an evaluation process to determine what you will specifically need. Being a good historian is important during this process. You can do this by writing a list of your previous medical history and making a list of any symptoms or problems you’ve experienced recently.  It is good to be prepared for your first day by understanding why your doctor sent you and bringing anything with you provided by your physician. If you have had surgery there might include a protocol or instructions from the surgeon. This will allow your therapist to choose appropriate tests and to help identify any areas that require special attention.

Prepare yourself by getting S.M.A.R.T.

Setting goals is an important part of physical therapy. Your therapy team will help you set goals that are both measurable and functional. For example, if there is a balance component to your sessions your measurable goal may be to stand on one leg for greater than 30 seconds, but a functional goal will be to walk through a wooded area without tripping over small obstacles. Take time to express goals to the evaluating therapist that are important to you personally. Goal setting is a great way to keep your mind focused on what you need to accomplish and to provide you with the best outcomes possible.

Can you Commit?

The most effective way to achieve the goals you established with your team is to commit to your appointments and do your homework. Each appointment should be seen as a stepping stone towards your goal completion and independence. No matter why you are coming, your referring physician will expect your attendance as well in order to achieve the goals that they too have set for you. Your skilled program will be carried out by a skilled therapist guiding you through educational and physical components that will require continuing alterations in your care depending upon your personal progress. These personalized programs are developed in conjunction with your participation as a key component, so doing the homework is as important as each one-on-one session.

Time is Money!

Keeping in mind all these components to getting the most out of your therapy sessions, it is most important to communicate openly with your team. Ask questions to improve your understanding of your diagnosis or surgery. Your therapy team will be happy to answer them for you. Is your homework too hard or too easy? Let your therapist know. Communication will help your team continue to develop a personalized program that will fit with your home needs. Having difficulty sticking to a routine? Your therapist along with other clinical staff can help you problem-solve scheduling difficulties and provide options to increase your adherence to your home program. Open communication will help you be the biggest part of your care team.

Return on Your Investment (ROI).

Our number one goal is your independence and successful goal completion. We will help you work towards your discharge, or as we like to call it “graduation day.” As a team, we will reach your goals and form a plan to help you maintain the progress you have achieved during your time with us. Each patient leaves our care with a personalized program and education that will help them to be successful, as well as with the understanding that your therapy team will always be here for you.


Living with Lymphedema

Lymphedema is a relatively unknown condition for most people.  The lymphatic system is part of the immune system and is really a “sewer system” for our bodies.  If the lymphatic system is not working properly to rid the body of waste, one is more susceptible to infection or development of lymphedema which is an excess accumulation of fluid in the body (usually a limb).  Lymphedema is commonly known as a complication of breast cancer but can be anywhere in the body.

Types of Lymphedema

There are 2 types of lymphedema: primary and secondary.

Primary Lymphedema….

Sometimes people develop primary lymphedema or have always had some problems with intermittent swelling in their legs typically referring to it as their “bad veins”.  True primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in your body.  Primary lymphedema can also have a late-onset – lymphedema tarda (a congenital disease characterized by underdevelopment of lymphatic pathways). It manifests commonly after the third decade as an accumulation of lymph in the interstitial spaces of the skin. Wound healing is significantly impaired.

Sometimes can be a combination of lymph problem and venous return problem – phlebolymphedma. Phlebolymphedema is the most common form of lymphedema in the Western world. It is a combined lymphatic and vascular condition that causes inflammation and lymphedema in the feet and lower legs.

Secondary Lymphedema….


Is caused by another health problem. It happens when a blockage or another problem changes the flow of lymph fluid through your body’s network of lymph vessels and nodes.  Secondary lymphedema is typically the result of a surgery in which lymph vessels are removed.  It is a common debilitating complication of breast cancer therapy/surgery and affects more than 1 in 5 breast cancer survivors. Patient-reported outcomes may be more important in predicting long-term health-related quality of life (HRQoL) than clinician-measured outcomes.

The key to treating lymphedema is early identification. Typically wearing compression garments, and regular completion of specific exercises can prevent or reverse swelling and help you keep it at bay in early stages.  When this is not enough, manual lymphatic drainage (MLD) taught by a certified lymphedema therapist or physical therapist is the next step in managing lymphedema.  Physical Therapists will teach specific manual technique interventions to stimulate the flow of lymphatic fluid which is then followed by wearing compression garments.      MLD along with compression and exercise is one of the best ways people can manage their lymphedema.

Skincare for Lymphedema

A regular skincare routine is extremely important when living with lymphedema.  Any injury or infection can make the swelling worse. This is because injury or infection can cause more damage to the lymphatic system in the area.

You can do a number of things to help protect your skin and lower your risk of infection or injury:

  • Keep your skin clean and dry – cleanse daily using a soap substitute, such as aqueous cream, Oilatum or Neutrogena soap bars, or an E45 wash.
  • Moisturize your skin at least once a day.
  • Clean cuts or grazes straight away with clean water, then put antiseptic cream on and cover the area.
  • Protect your skin from the sun by wearing a high factor sun cream or cover up with clothes.
  • Use an insect repellent containing at least 50% DEET– if you’re bitten or stung, try not to scratch and use antihistamine cream.
  • Avoid hot baths, saunas, and steam rooms because this can increase swelling.
  • Avoid extremes of temperature that can dry your skin – including hot, cold, or windy weather.
  • Don’t wear tight clothing or jewelry.
  • Avoid sitting or standing for long periods of time if you have leg swelling.
  • Don’t have injections, blood taken, or your blood pressure checked on the affected arm.

Any skin breaks can make you more likely to get an infection. Keeping your skin healthy, unbroken, and well moisturized helps to prevent this. There are different types of emollients, including bath oils, soap substitutes, and moisturizers. Avoid perfumed body lotions because they can dry your skin. You need to moisturize your skin every day. How you do this and what you use depends on the condition of your skin. Apply moisturizing cream with downward strokes. This way cream will not clog your hair follicles.

Remember, Knowledge is Power!

No matter the cause, lymphedema can be difficult to live with whether it is primary or secondary lymphedema, the key to lymphedema is early detection and getting the right treatment so it does not become a larger problem. MLD along with compression and exercise is one of the best ways people can manage their lymphedema. With regards to quality of life, the presence of metastasis and age are good predictors in how well a person can live with or control their lymphedema.


Reap The Benefits of Exercise Two-Fold

An essential component of lifestyle modification is EXERCISE.


  1. activity requiring physical effort, carried out to sustain or improve health and fitness.

But, evidence has suggested that exercise may be an often neglected intervention in mental health care. How can that be when aerobic exercises, including jogging, swimming, cycling, walking, gardening, and dancing, have been proved to reduce anxiety and depression. These improvements in mood are proposed to be caused by exercise-induced increase in blood circulation to the brain and by an influence on the hypothalamic-pituitary-adrenal (HPA) axis and, thus, on the physiologic reactivity to stress. This physiologic influence is probably mediated by the communication of the HPA axis with several regions of the brain, including the limbic system, which controls motivation and mood; the amygdala, which generates fear in response to stress; and the hippocampus, which plays an important part in memory formation as well as in mood and motivation.

Exercise has also been found to alleviate symptoms such as low self-esteem and social withdrawal. So by staying active exercise can help you manage symptoms of depression, stress, and anxiety. Physical activity can also counteract the effects of some psychiatric medications that may cause weight gain. Consider walking, swimming, or gardening. Even light physical activity can make a difference like cleaning the house, doing laundry, or raking leaves now that fall has arrived.

What Will I Gain?

The other benefits from regular exercise that should be emphasized and reinforced by every mental health professional to their patients include:

  1. Improved sleep
  2. Increased interest in sex
  3. Better endurance
  4. Stress relief
  5. Improvement in mood
  6. Increased energy and stamina
  7. Reduced tiredness that can increase mental alertness
  8. Weight reduction
  9. Reduced cholesterol and improved cardiovascular fitness

The 5% Rule

DON’T start out too hard in a new exercise program no matter what it is –listed above or otherwise. Walking for instance is GREAT exercise, but you don’t have to walk 20 miles in a week. Start out low and slow..follow the 5% rule, which might look like this:

Week 1: 3000 steps (1.5 miles)

Week 2: 3150 steps

Week 3: 3300 steps

Week 4: 3500 steps (1.75 miles)

Week 5: 3750 steps

Week 6: 4000 steps (2 miles)

The immediate effects of exercise are empowering and rewarding! Your body is the only house you have to live in so take care of it.

Eliminate Stress by Staying in the Know, NOT the Don’t Know!

Without trying to adhere to the phrase coined the ‘new normal,’ unfortunately, it is just that and we have to adapt to it—for now anyway. Therefore, our stress levels are like a roller coaster ride right now; it can be physical, emotional, or financial…one at a time – or unfortunately all at once. Even for us!

Depending on who you ask, stress is defined differently. When you are charged with handling more than you anticipate, stress rules! To some, stress is simply a fact of life while others struggle to anticipate or identify stress, inhibiting their ability to react productively. Understanding what stresses you is key to being able to identify and manage your response.

Either way, people are still getting back and neck pain, overuse injuries and hurt while at work, or are deconditioned from being under active during isolation and/or quarantine. At Carousel, we are consistently having round table discussions about how we can keep you in the know on how – now more than ever – physical therapy should be an important part of your healthcare team. Matter-of-fact physical therapy came in at #3 in the 5 kinds of health appointments you should consider keeping despite the pandemic July 2020 Washington Post article that we shared on social media. Physical therapist and spokesman for the American Physical Therapy Association, Robert Gillanders was quoted in saying “when you treat injuries in the early stages, the outcomes are always better.”

Naturally, we will expand on injuries to include other treatments such as:

Gait & Balance*
Pre- & Post-Surgical*
Stroke/Cardiac Rehabilitation
…and many other conditions and specialty conditions as outlined on our website.

(*) indicates home safety checks for fall risks and post-op home navigation staging can be requested with your treatment.

We Adapt to Keep Our Clinics Safe; We Are Trained to Handle It!

Many of you who would benefit from seeing our physical therapists are reluctant because of concerns over COVID-19 that our clinics are busy places with people coming and going. That’s understandable, but we have made changes to allow us to continue to serve you while keeping you and our staff safe.

Physical therapists are medical professionals who were trained to deal with infectious diseases and keep people safe long before COVID-19 existed. By making changes throughout our workflows and patient experiences, Carousel Physical Therapy continues to reduce the risk of spreading COVID among their staff and patient populations, while continuing to deliver needed services to the public. If you are in need of PT treatment but are hesitant to go into the clinic, give our clinics a call and talk about what policies and procedures we have in place. To reduce or eliminate going into the clinic, ask about using telehealth either exclusively or in combination with in-person treatment.

This is a time of uncertainty, but people are reacting with flexibility and creativity. Don’t let concerns over COVID keep you in pain or from the treatment you need. So Remember to….

Stay in the Know, NOT the don’t know!


How to Pick Shoes for Flat Feet

By: Crystal Bondurant Salisbury, LPTA

I always hear people comment about having “flat” feet, use it synonymously with “bad” feet. Your flat feet aren’t any better or worse than your friend with those lovely, high arches. It all comes down to how to dress your feet, and it’s important to dress for success.

When it comes to flatter feet or feet that fall flat while walking, it helps to give a little support. Studies found that the further a person would run the more force came through the plantar or bottom surface of the medial or middle foot. Studies further showed that it was even more important the more a person would overpronate or “fall in” to provide support from a motion control shoe.

Does that mean that you need a motion control shoe if you’ve been told you have flat feet, or you think your feet are falling flat while walking or running? No, not necessarily, but there are a few things to keep in mind while shopping to address each one of the three parts of your foot; Forefoot, Midfoot, and Rearfoot

Foot Facts:

Forefoot: It is important to keep in mind your forefoot, or the ball of your foot including your toes needs enough room to spread out as you push off while walking. A foot can spread up to 5 mm when striking the ground, so your shoe must accommodate this spread comfortably from the arch up to the toes. Restricting your foot’s ability to comfortably spread can create circulation problems, impinge tendons and nerves, and bend joints in odd directions.

Midfoot: Generally, when talking about this part of the foot we want to keep in mind a goal of supporting the midfoot or the region of the foot where your arch is. With most issues stemming from this region the arch responds well to controlling the excessive motion of the arch dropping to the floor while walking. You want to pick a shoe that slows or reduces this drop, so pick a shoe that comfortably rests into your arch. The arch of a shoe should not be so high as to be painful or push you onto the outside of your foot (pronate).

An arch should allow you to rest comfortably in standing and respond well to you while walking. It could be uncomfortable to have support for the first 2-3 days but should get progressively more comfortable as you get moving in your new shoes.

Rearfoot: The heel of your shoe controls your rearfoot. A traditional shoe, running or walking, has a heel-toe drop of 12 mm, but a minimalist tennis shoe could have as low as 4 mm. The elevation is intended to relieve stress on the Achilles tendon and calf musculature and was intended to make it easier to progress through a normal walking pattern. Also, the cushion in the heel of the shoe also helps with shock absorption with walking and running.

Picking the Shoe:

When picking shoes, we have a lot to consider, from these three parts of your foot to the materials and the brands you’re thinking about purchasing. Motion-control shoes are a popular type of shoe used to address flat feet while running and walking. They are a little heavier than average shoes and improve a person’s ability to heel strike while walking, promoting a more normalized gait. Trail shoes can also be a good option for that may be a little more versatile, offering stability but also allowing more mobility in the ankle and foot laterally.

Keep Track of Mileage:

It is also good to keep in mind the life of a shoe ranges between three hundred and five hundred miles, and they tend to start breaking down around a year. So, just remember, your shoes should be comfortable and accommodating to your foot allowing a snug but not a too-tight fit and supporting your arch while you run, walk, or play.


Meditation IS Good Medicine

There is a legit reason you feel so drained right now, and feeling a little ‘over it’.

The psychological reason for this has something to do with ‘surge capacity’.  What is ‘surge capacity’?

“It’s a collection of adaptive systems – mental and physical – that humans draw on for short-term survival in acutely stressful situations, such as natural disasters.”

The issue is that our surge capacity only allows us to adapt to major disasters if they are temporary.

However with the pandemic, the disaster stretches out indefinitely.

Many have had preplanned and pre-paid travel or events canceled, to find out it’s non-refundable because of this epidemic. This hits the wallet pretty hard!  The unknown of the future including the inability to plan. Social connections that provide support are missing – no hugs, limited physical closeness even laughter, and dancing.

Not- to- mention, your pain doesn’t stop or is suddenly onset because you have taken the opportunity to catch up on the ‘honey-do’s’, and overexerting yourself with exercises. Or, just deconditioning in general due to lack of energy caused by stress and anxiety.

Even the ones who are coming for physical therapy feel that the current state of the world is affecting their progress with PT.

Therefore, because this pandemic is going on, and on, and on…..your surge capacity is depleted and it needs to be renewed. Which now means the emergency phase has become chronic.

Even our own anxieties have increased dealing with work/life balance, so some have started using a guided meditation app in the recent past. And, as some of our patients expressed, they too had reached their limits, so we recommended meditation to them and have had really positive feedback.

So, here are some links providing evidenced-based research on the benefits of meditation, as well as some meditation apps that can promote resilience and help you cope better during these unprecedented times.





Do You Have Osteoarthritis (OA) or Rheumatoid Arthritis (RA)? There is a Difference Between the Two.

“Arthritis” is a term used to describe inflammation of the joints.

Osteoarthritis (OA) is the most common form of arthritis and usually is caused by the deterioration of a joint. Typically, the weight-bearing joints are affected, with the knee and the hip being the most common.

Rheumatoid arthritis (RA) is a chronic inflammatory disease. It affects about 1% of the population. RA often results in pain and inflammation in joints on both sides of the body. In some people, it can become disabling due to its effect on the immune system.

What is Osteoarthritis?

Your bones are connected at joints such as the hip and knee. A rubbery substance called cartilage coats the bones at these joints and helps reduce friction when you move. A protective oily substance called synovial fluid is also contained within the joint, helping to ease movement. When these protective coverings break down, the bones begin to rub together during movement. This can cause pain, and the process itself can lead to more damage in the remaining cartilage and the bones themselves.

The cause of OA is unknown. Current research points to aging as the main cause. Factors that may increase your risk for OA include:

  • Age. Growing older increases your risk for developing OA because degeneration and aging of the cartilage and synovial fluid increases over time.
  • Genetics. Research indicates that some people’s bodies have difficulty forming cartilage. Individuals can pass this problem on to their children.
  • Past injury. Individuals with prior injury to a specific joint, especially a weight-bearing joint (such as the hip or knee), are at increased risk for developing OA.
  • Occupation. Jobs that require repetitive squatting, bending, and twisting (eg, construction, landscaping, childcare) are risk factors for OA. People who perform jobs that require prolonged kneeling (eg, miners, flooring specialists) also are at high risk.
  • Sports. Athletes who repeatedly use a specific joint in extreme ways (eg, pitchers, football linemen, ballet dancers, runners) and those who engage in high-impact joint loading done in a repetitive manner (eg, running, jumping, landing on hard surfaces) may increase their risk for developing OA later in life.
  • Obesity. Being overweight causes increased stress to the weight-bearing joints (such as knees), increasing the risk for development of OA.

How Does It Feel?

Typically, OA causes pain and stiffness in the affected joint. Common symptoms include:

  • Stiffness in the joint, especially in the morning, which eases in less than 30 minutes
  • Stiffness in the joint after sitting or lying down for long periods
  • Pain during activity that is relieved by rest
  • Cracking, creaking, crunching, or other types of joint noise
  • Pain when you press on the joint
  • Increased bone growth around the joint that you may be able to feel

Caution: Swelling and warmth around the joint is not usually seen with OA and may indicate a different condition or signs of inflammation. Please consult a doctor if you have swelling, redness, and warmth in or around a joint.

What Is Rheumatoid Arthritis?

RA is an autoimmune disease — a condition where the body’s immune system attacks its own tissues. It affects the soft tissues around joints. Fluid builds up in the affected joints, causing pain, stiffness, and inflammation. The exact cause of RA is unknown. RA may be related to a combination of genetics and environmental or hormonal factors.

Women are more likely to develop the disease and are diagnosed with RA three times more often than men. Although RA may begin at any age, most research suggests it usually occurs in midlife.

How Does It Feel?

Rheumatoid Arithritis

RA symptoms can flare up and then quiet down (go into remission). Research shows that early diagnosis and treatment is important for easing symptoms and flare-ups.

People with RA may experience:

  • Stiff joints that feel worse in the morning.
  • Painful and swollen joints on both sides of the body. Symptoms often start with smaller joints like those in the fingers. Over time, larger joints, such as knees and ankles, also can be affected.
  • Bouts of fatigue and general discomfort.
  • Low-grade fever.
  • Loss of joint function or range of motion (movement).
  • Redness, warmth, and tenderness in the joint areas.




Manual therapy: Helping a post COVID-19 doctor breathe easier during recovery.

A special type of physical therapy is helping some patients with the novel coronavirus breathe more easily. The type of physical therapy, called manual therapy, is a bit different from the typical physical therapy and has helped some COVID-19 patients.

Dieterich, a hepatologist at Mount Sinai Hospital in New York City, was infected with the novel coronavirus in March and spent over three weeks in the ICU and hospital.

“Physical therapy for me before COVID was common for orthopedic injuries. This was different,” Dieterich said of manual therapy. “After I got home, my physical therapist was also certified in manual therapy so she addressed how my joints in the rib cage worked.”

The physician explained how they dealt with social distancing during treatments.

“Since COVID exposure was a concern for her, we did virtual PT and she taught me self-massage techniques for the muscles between my ribs,” he said.

“The act of breathing is automatic but the depth of breath is dependent on the muscles functioning and the rib cage working efficiently,” Valerie Harris, who practices manual physical therapy at Thrive Integrated Physical Therapy in New York City, told Fox News.

The physical therapist said incorporating breathing exercises during and after these techniques allows for greater lung expansion and may help with a greater diffusion of oxygen throughout the body.

The novel coronavirus creates inflammation and attacks the lung tissue, according to health experts. Breathing becomes compromised and the patients typically become generally weak.

“The muscles were so tight and deconditioned from weeks in the hospital. It was difficult to take a deep breath in; the manual physical therapy really got in there and helped get the ribs to actually separate as I took a deep breath,” Dieterich said.

“When I first got out of the hospital in late April, I could not even sit up for 30 minutes. My oxygen saturation rate on the pulse oximeter would plummet to the 80s when I tried to stand and move around to cook in the kitchen, even with 6 liters of oxygen.”

— Dr. Douglas Dieterich 

Besides addressing the rib mobility, the physician said treatment also focused on the diaphragm, the muscle just under your rib cage.

“The diaphragm is the primary muscle of respiration and during inspiration, it contracts and pulls downward,” said Harris.

She explained how the muscles between the ribs, which are known as the intercostals muscles, work with the diaphragm to expand the chest to allow air to fill the lungs. When they are tight, the chest can’t expand as efficiently, according to the physical therapist.

“ICU-acquired weakness occurs in 33 percent of all patients on ventilators and up to 50 percent of patients who are in the ICU for greater than one week,” Amitay, the owner of Thrive PT, added.

Physical therapists say the muscles compensate for the weakness in many COVID-19 patients and many muscles no longer contract properly, which can contribute to inefficient breathing patterns.

“Patients who have been in respiratory distress may use their accessory muscles of respiration versus their diaphragm,” said Amitay. “This increases the work of breathing.”

Both physical therapists say when these muscles are tight, these manual techniques along with stretching and breathing exercises can really help patients recovering from COVID-19. Dieterich said the virtual sessions appear to be helping him in his recovery.

Although he has a long road to full recovery ahead, he noted that he can now “walk 2 miles on 2 liters [of oxygen], although I get tired and have to rest afterward.”

source: https://www.foxnews.com/health/coronavirus-patients-recovery-physical-therapy-breathing