Physician Athletes Promoting Physical Fitness Through Social Media During the COVID-19 Pandemic

Abstract

The COVID-19 pandemic has had an unprecedented impact on our daily lives and functioning. To reduce the potential transmission, countries throughout the world practiced social distancing. Unfortunately, this social distancing often contributed to a sense of social isolation and physical inactivity. Two physician athletes on opposite coasts of the United States sought to change this narrative by promoting physical activity among the general population with the #SocialDistancingFitnessChallenge. During the height of the COVID-19 pandemic in March and April 2020, these physicians would post exercises during the 5-day workweek—one would post yoga/flexibility exercises, while the other would post high-intensity cardio and strength exercises on two social media platforms. Some posts would amass over 100,000 views. They received daily feedback on how this challenge not only encouraged others to be engaged in physical activity during the most challenging pandemic of our lifetimes, but it also improved their mental health and outlook on the future amid great uncertainty.

The COVID-19 pandemic, the only pandemic of our lifetimes, has dramatically changed how we live. In the quest to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), social distancing has become the “gold standard” (Rubin et al., 2020). While this is an effective strategy to prevent the spread of SARS-CoV-2, social distancing also has several undesirable consequences (Lewis, 2020). Social distancing is often analogous with social isolation. Our typical places of refuge and solace, including gyms and places of worship, are now off limits. So, how do we as health professionals navigate this time of uncertainty? We stay socially connected and fit, while staying physically distant, with the advent of the #SociaDistancingFitnessChallenge.

In March 2020 as the world was acknowledging the gravity of the COVID-19 pandemic, we as physicians recognized that our colleagues and the general population felt disconnected, despondent, and overwhelmed. We felt this way too. Determined to change this narrative, we sought to help mitigate these doldrums for ourselves and others by creating the #SocialDistancingFitnessChallenge. As athletes, we decided to share different exercises daily on two social media platforms, Instagram and Twitter, to encourage others to remain active and preserve a sense of normalcy (Sashin, 2020). We served as the yin and yang of each other in our daily posts. Dr. Salles posted yoga and flexibility exercises, while Dr. Stanford posted high-intensity cardio and strength exercises.

Some of the undesired consequences of stay-at-home orders include physical inactivity, potential for weight gain, social isolation, limited sunlight exposure, and worsened mental health (Lippi et al., 2020; Venkatesh & Edirappuli, 2020). We are more physically disconnected than ever before in our lifetimes. While screen time and technology utilization have traditionally been discouraged, during this pandemic we have found ourselves turning to online social outlets to remain connected despite physical distance. We wondered if an online daily fitness challenge would make a difference. Would anyone really want to see doctors working out daily? With many of our posts yielding tens of thousands of impressions (one of which had >100,000 impressions; Salles, 2020) and engagement from multiple countries around the world, it seems that there is an appetite for physicians to role model physical activity. At the height of the COVID-19 pandemic in March and April 2020, Dr. Stanford’s top #SocialDistancingFitnessChallenge tweet received 14.4K impressions, 24.1K top mentions, top media tweet 10.5K impressions, with 181K tweet impressions (Stanford, 2020). Our efforts were highlighted by the Yoga Journal and Stanford Medicine’s Scope blog.

For 1 month, at the start of each day during the typical work week, Salles and Stanford each posted a short exercise of approximately 1-minute duration or less. We received feedback from physicians, health care workers, patients, and others reaching out with thanks regarding the encouragement that the daily posts provided them. Some social media followers were inspired to post messages in which they mimic the daily post provided by one of us. Even when persons were reticent to post their own physical activity, they responded with likes, views, or messages such as “#goals,” “the inspiration I need to make it to the end of the week,” “Let’s push forward! Let’s dance and lift our spirit,” “Impressive,” “CORE!!! Absolutely Stunning. Will be thinking of you at work!,” and “Count me in!” These messages of encouragement resonate through the ethers of the online community, and with each daily post we provided a sense of hope that this too shall pass. We also reminded everyone that, until it does, we each have the ability to make the most of our days and incorporate physical activity in some way.

Physical activity is helpful for weight maintenance, improved cardiovascular health, and reducing depression and anxiety (Shahidi et al., 2020). In nonpandemic times, it is important; during a pandemic, physical fitness is essential. How will we face the challenges of a virus we do not understand if we are not as fit as we can be? Physicians and other health professionals have shouldered a tremendous burden during this COVID-19 pandemic. Many of us make efforts to include physical activity in our daily routine for our own well-being and to model positive behaviors for their patients. Unfortunately, physicians tend to focus more on our work than our own health behaviors, but studies demonstrate that physicians engage in more physical activity than the general population (Stanford et al., 2012, 2013). The more demanding our work schedule, the less likely we are to meet the U.S. Department of Health and Human Services Guidelines of at least 150 minutes of moderate intensity physical activity weekly. Physicians’ schedules reached unprecedented levels during the COVID-19 pandemic, and this contributed to unhealthy physician and patient behaviors (Ammar et al., 2020).

Our personal level of physical activity as physicians is particularly germane to our ability to provide optimal care to our patients. Drs. Stanford and Salles both received feedback from their patients about how the #SocialDistancingFitnessChallenge kept them motivated during the pandemic. Indeed, a study indicates that physicians who are physically active are more likely to be confident to provide physical activity counseling to their patients (Stanford et al., 2014). Attending physicians have more autonomy with regard to their allocation of time in their professional and personal life than do trainees. With this higher level of autonomy, there is often more time available to engage in physical activity and a greater ability to provide counseling regarding the benefits of physical activity to patients across the spectrum of the stages of change (i.e., precontemplation, contemplation, preparation, action, and maintenance; Stanford et al., 2012, 2014). Yet, during the current COVID-19 pandemic, physicians from all levels of training struggle to maintain any sense of normalcy regarding physical activity for ourselves and the patients we serve (Shah et al., 2020).

While we are unsure of what the future brings us with regard to life after COVID-19, we do know that it is the power of community that will allow us to be resilient and persevere despite all else. We should continue to use small nudges of encouragement with regard to physical activity and other health behaviors to let people know they are not alone. We are here. We are struggling to navigate each day. While none of us knows what to expect regarding the future of this current COVID-19 pandemic, we can support each other through our virtual community. Even though we have stopped posting daily challenges, the hashtag continues to live on, as does our hope that our colleagues and patients will find time in their busy lives to care for themselves.