Dr. Burrascano's Lyme Rehabilitation

Despite Lyme treatments, you will not return to normal unless you exercise!

Those with outstanding Lyme end up in poor physical comdition. In late stage disease, many degative effects to the body are occurring:the muscles are shrinking, weakening, and are being replaced by scar tissue and fat.

To some degree, the heart muscle also suffers. The lungs, ribs, and muscles of respiration are also affected, as are joints, nerves, liver,etc.

Besides these physical effects, chemical changes occur. The percent fat content of the body as a whole rises, the cholesterol rises, and the balance between the "good" and "bad" cholesterols (HDL and LDL, respectively) becomes less favorable. Also, in at least 80% of the patients, significant weight gain occurs.

To make matters worse, because of extreme fatigue and body pain, many Lyme sufferers end up spending inordinate amounts of time in bed, and get far less exercise than they had before they became ill.

As a result of all this, Lyme patients are stiff, weak, tired, have poor stamina, and are at increased risk for cardiovascular disease and diabetes.

Therefore, a vital part of any plan for recovery must include various forms of physical therapy, the extent of which depends on an individual patient's condition, followed by an exercise program.

The physical therapy should involve massage, heat packs and pads, and simple range of motion exercises to relieve discomfort, promote better sleep and flexibility.

This then evolves into an exercise program that starts with stretching and mild muscular strengthening, to lessen joint pain and increase mobility and stamina.

Finally, the program must include a specific program of no-aerobic conditioning to reverse the negative effects on the heart, lungs, and circulation, and to help with correting the chemical imbalances described above.

Diet also plays an important role. This is the time for the very best of health habits. I recommend light, low fat food, with high quality nutritional value, absolute abstention from alcohol, elimination of caffeine, a decrease in sugar and starch intake, and if applicable, a serious committent to weight loss. Smoking is completely out!!!

Professional guidance will be needed, from therapists of various types and from dietary counselors. Written orders for therapy may be obtained from my office in order to initiate the program.

It is indeed a difficult task to regain your health after a serious bout with Lyme Disease. By following this advice, your physical and emotional well being will dramatically improve. After what you've been through, you deserve nothing less.

EXERCISE AS A FORM OF THERAPY FOR LYME DISEASE

I encourage all Lyme patients to go through a formal rehabilitation program. Generally, this involves progressing from simple physical therapy modalities, then to stetching and mobility training, and finally to formal strengthening exercices supervised either by the physical therapist, or by a qualified, credentialed exercise coach.

A surprising thing happened which none of us expected-when Lyme patients went further with their rehab, to include a whole-body conditioning program, the lyme seemed to go away!

I have seen this occur repeatedly, including in some patients who did not even go on antiobiotics!

Although the scientific basis for this is not known, there are several reasonable theories. It is known that the Lyme spirochete,Borrelia burgdorferi, will die if exposed to all but the tiniest oxygen concentrations. If an aggressive exercise program can increase tissue perfusion and oxygen levels, then this may play a role in what is being seen.

Also, during aggressive exercise, the core body temperature can rise above 102 degrees; it is known that B. burgdorferi is very heat sensitive. Perhaps it is the added tissue oxygenation, or higher body temperature, or the combination, that weakens the Lyme Borrelia, and allows the antibiotics and our defenses to be more effective.

In addition, there is now evidence that a carefully structured exercise program may benefit T-cell function in the immune system, an obvious potential benefit in an illness like Lyme that is known to weaken immune resonses.

As you progress through rehab, you must make it your goal to participate in a one-hour aggressive exercise class every other day(at least three times per week). BUT- you must be patient! It takes at least six weeks of regular physical therapy to be able to join a light conditioning and stretching program, and six more weeks are usually needed before heavier exercises can begin.

Finally, only after several weeks of this level of physical training will you be able to say that you have made a major dent in your illness. Please note that the program consists of condititioning and strengthening, and not aerobics.

Because high body temperatures may play a role in this phenomenon, I advise against using swimming as the choosen exercise.

A few final few words of caution: do not jump into an aggressive program until you are ready for it and your physical therapist agrees. Do not try any aerobics until you are ready for it and your physical therapist agrees. Do not try any aerobics until your Lyme is no longer active, and your physician okays it.

You may need a cardiac stress test first to ensure safety. And finally, please join a program run by a trained professional with proper credentials.

Best wishes working out your Lyme!

Physical therapy (if needed):

1. Relieve pain and muscle spasms utilizing multiple modalities as available and as indicated: massage, heat, ultrasound,TENS, "micro amp", etc

2. Increase mobility while protecting damaged and weakened joints, tendons, and ligaments, to increase range of motion and relieve stiffness.

3. The role of physical therapy is to prepare for the required, preferably gymbased, exercise program outlined below.
EXERCISE Begin with a private trainer for careful direction and education.

PATIENT EDUCATION AND MANAGEMENT (to be done during the initial one-on-one sessions and reinforced at all visits thereafter):

1. Instruct patients on correct exercise technique, including warm-up, breathing, joint protection, proper body positioning during the exercise, and how to cool-down and stretch afterwards.

2. Please work one muscle group at a time and perform extensive and extended stretching to each muscle group immediately after each one is exercised, before moving onto the next muscle group.

3. A careful interview should be performed at the start of each session to make apparent effects, both good and bad, from the prior visit's therapy, and adjust therapy accordingly.

PROGRAM

1. Aerobic exercises are NOT allowed, not even low impact variety, until your stamina improves.

2. Conditioning: Follow a "Body Sculpting" program-This consists of light calisthenics and weight lifting, using very low resistance(small weights) and many repetitions., and must involve the whole-body. This can be accomplished in exercise classes, with exercise machines, or carefully with free weights.

3. Each session should last one hour. If the patient is unable to continue for the whole hour, then modify the program to decrease the intensity to allow him/her to do so.

4. Exercise no more than every other day. You may need to start by exercise every 4th or 5th day initially, and as your abilities improve, work out more often, but NEVER two days in a row. The days you do not exercise should be spent resting.

5. This whole-body program is required to achieve wellness. Simply placing the patient on a treadmill or an exercise bike is not acceptable (except briefly as a warm-up), nor is a simple walking program.

The End

I found that about six weeks into the class i could tell a real differnce in my flexibility and strength, which had started out at a pretty low level.

My instructor was very good at helping me adapt any poses that caused me trouble, and some I just sat out on till I got stronger.

I think you have to pay attention to the feedback your body is giving you. While it isn't easy to use muscles when you have lost strength, there is a line between pushing just enough to get improvement, and pushing so much that you go backwards.

Resting afterwards is VERY important.

Good luck. You CAN recover strength, flexibility, and stamina if you take it at the pace your body can tolerate.

One theraphy which did help me was water exercises! Great way of stretching the body in WARM water. I did this until my chemical sensitivity became so bad; I had to quit...couldn't breath!

Also, used the spa...that's when my rash started and hasn't quit to date 7-8 yrs. later.

As mentioned earlier, listen to your body. If it HURTS, stop immediately or you will pay the consequences. Best wishes on becoming healthier. Betty G., Iowa

My muscles get incredibly tight. When I started therapy, I was in constant pain from knots in my upper back. I couldn't physically relax my shoulder blades. I couldn't use my hands, because I had spent almost a year in wrist braces.

I started with myofascial release. This is hands on work by the therapist, and mine specialized in it. The aim is to relax the muscles. It didn't work for me until I started taking Flexeril, and then I saw progress. I also had stretches to do at home. Once the muscles were more relaxed, we moved onto very light strengthening.