Dr. Burrascano's Lyme Rehabilitation

General or non-medical topics with information and discussion related to Lyme disease and other tick-borne diseases.
User avatar
Posts: 2421
Joined: Fri 27 Jul 2007 16:02

Dr. Burrascano's Lyme Rehabilitation

Post by Yvonne » Tue 2 Oct 2007 10:08

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.


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.


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

Listen to all,
plucking a feather from every passing goose,
but follow no one absolutely

Posts: 3182
Joined: Sun 12 Aug 2007 2:27

Re: Dr. Burrascano's Lyme Rehabilitation

Post by cave76 » Sun 21 Oct 2007 18:54

*****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.*****

Well-------- maybe I could do something every 4th or 5th day. :roll:

What I need is a DVD with Burrascano talking me through it. <g>

Or just a DVD engineered for Lymies.

I'll go ask on Lymenet to see if anyone knows of one.

Posts: 299
Joined: Wed 19 Sep 2007 19:10
Location: Zeeland, Netherlands

Re: Dr. Burrascano's Lyme Rehabilitation

Post by Nick » Sun 21 Oct 2007 20:58

I stopped seeing a physiotherapist some months ago, because I had too much pain in my joints after exercising, and after several months that got worse instead of better. And I hate to go there when I'm feeling really ill.

Getting a program like B. recommends would only be possible here if you pay for it yourself (VERY expensive), usually the insurance only pays for 2x 30 minutes a week or less. I'm now thinking about buying some kind of exercising machine so I can work out when I feel well and get the recommended amount of exercise. A rowing machine seemed to work fine for me, but I would need something else to balance things; and I don't know anything about this kind of stuff ...

Posts: 3182
Joined: Sun 12 Aug 2007 2:27

Re: Dr. Burrascano's Lyme Rehabilitation

Post by cave76 » Sun 21 Oct 2007 22:20

I know what you mean about the pain from PT.

Before I was dx'd I was sent to PT (probably just to get me out of the docs hair <g>) and although I requested a very light touch, because of my age and debility, those young healthy Amazon Mary Jane Hardbodies just didn't know how to 'go light'. :D

I'm gonna start walking more, even though the great Dr. B said not too---- but what does HE know? LOL

Massage sounds nice. Wistfully.

Posts: 299
Joined: Wed 19 Sep 2007 19:10
Location: Zeeland, Netherlands

Re: Dr. Burrascano's Lyme Rehabilitation

Post by Nick » Tue 23 Oct 2007 21:24

I think walking should be OK, if that's the best you can do now. It's just very ineffective compared to other ways of working out. I once read that running the stairs up and down a few times is equivalent to one hour of normal walking.

Posts: 3182
Joined: Sun 12 Aug 2007 2:27

Re: Dr. Burrascano's Lyme Rehabilitation

Post by cave76 » Wed 24 Oct 2007 3:45

****It's just very ineffective compared to other ways of working out.*****

Just the words "working out" tires me out. :)

**** I once read that running the stairs up and down a few times is equivalent to one hour of normal walking.****

Surely you jest!!!!!!! :o :D

Posts: 129
Joined: Sun 28 Oct 2007 14:28

Re: Dr. Burrascano's Lyme Rehabilitation

Post by sizzled » Sun 28 Oct 2007 17:20

Definitely can't tolerate the word,"exercise" even!!!

I tried Beginner's yoga and go sicker!! Was told by a reputable chinese doctor that it meant I was weak and too sick....DUH!

Tried a 'bouncy ball' thing and thought it might help move toxins out...until I fell off it one too many times!! AND it deflated!! :roll: I thought it might be a good alternative to the trampoline people were raving about.

Tried massage until I couldn't afford it anymore. It felt good and definitely made me lighter in the pocketbook!

Walking is about the only thing I seem to tolerate and even had a pedometer say I walked an average of TEN miles a day!!

Alas, alack! I have lost none of the 40+ pounds I gained years ago with Bartonella. :|

I even eat only one meal a day....(okay, okay...so it goes from 11am to ...about 4 pm!!!!)

You KNOW you are on a diet when your cat's food starts looking yummy!!! :o

Posts: 140
Joined: Thu 1 Nov 2007 4:47

Re: Dr. Burrascano's Lyme Rehabilitation

Post by Daise » Wed 28 Nov 2007 8:01

Hi everyone,

I'm sorry some of you have problems getting exercise. I don't know what your conditions are. However, just in case it could help some of you, there is such a thing as having a bad reaction to exercise, due to a low cortisol problem. :( That may be a clue to what your body needs.

However, adrenal output means cortisol plus adrenaline and the other hormones from the adrenal. That can also bring a bad reaction to exercise. The book is about various hormones levels and what you can do if there are problems.

The stress of living in the western world and the stress of our disease is very hard on the adrenals. Imbalances of various hormones can happen. For almost three years I told doctors that I had a cortisol problem--and was ignored, at best humored with a test that was inappropriate. It's not on the radar of mainstream docs. :lol: So I gave up, I guess. My new LLMD caught the problem.

Too much or too little cortisol very much affects the immune system. It means our immune system can't work as well in partnership with antibiotics.

Here's a good book: Feeling Fat, Fuzzy or Frazzled, by Richard Shames MD and Karilee Shames PhD RN. Maybe it's at your library. They talk about the reaction to exercise for various hormone imbalances. They offer things you can do on your own to help the adrenal to operate more affectively, if that's a problem, such as eating salt at every meal (as long as you don't have a blood pressure problem) and eating food in small, frequent amounts. They give guidance on herbs and supplements.

They recommend a tiny amount of pharmaceutical hydrocortisone (bioidentical to cortisol) if saliva tests show you need it (be sure it's done by a reputable company.) Saliva testing shows hormone imbalances at the cellular level. This is a temporary medication to give the adrenals a rest, so they can heal. Cortisol is a steroid, yes, but the amounts are tiny, and if your body needs it because it isn't making it anymore, especially to help fight a disease, then it's important.

This is not to say prednisone could help in any way. For one, it doesn't lock-in to cells correctly. And it's damaging for Lyme patients. It's not at all appropriate.

The book features self tests and gives addreses of saliva testing companies. These are home tests. The test for cortisol output needs to be the "4 times in one day test." I have a cortisol problem, however it's being taken care of! The good effects on my Lyme disease and the improvement of energy, stamina and better sleep was noticeable right away.

This is the realm of adrenal insufficiency, also called adgrenal fatigue.

Happy trails,

Daise :)

Posts: 1001
Joined: Sat 3 Nov 2007 10:27

Re: Dr. Burrascano's Lyme Rehabilitation

Post by minitails2 » Wed 28 Nov 2007 10:48

Hi everyone,

Hi Daise, I can't remember if I ever said hi the other, so I hope I did but don't take it personally, I haven't been feeling so hot.

On to exercise. I tend to be pretty good about mild exercise when I'm feeling okay, but below a certain point, I just can't summon the energy. I'm bipolar to start with (yes, not just lyme although it makes it worse at times, like now) and psych drugs are the best drugs for making you fat. So, if you want to gain weight, take lots of mood stabilizers, and just about all types have that potential, but it varies by person. One I was on, which shall remain nameless, helped me put on about 60 pounds in about 2 1/2 months. That's fun!! :cry: It's certainly good for depression.

Anyway, lyme, depending on the person, can also help you right along into the roly poly club in which I am firmly and seemingly, permanently housed. When I am feeling better, though, I enjoy walking which I normally do very quickly (mostly because I'm tall and have long legs) and since I live right on the ocean, I find it very relaxing. Another issue for me right now, though, is I'm on doxy, I'm very fair, and with doxy I burn almost immediately. I also really enjoy lifting but I hate going to gyms. I have also done a lot of PT which I always like, but it's always been for a long messed up neck and back. It's always helped me.

Massage, is the best, though I too, cannot afford it. I really didn't except to spend my most productive years on permanent disability. Lucky for me, my honey is very good at massage and actually likes to do it. Who knew?

The other activity I really like to do is yoga, which isn't that great for cardio but I love it. None of the standing on your head type of junk, just smooth, correctly taught yoga. That's a lot out there that's terrible. Almost every gym has turned it into a cardio routine which kind of defies the purpose. It's obviously very good for mobility, balance, flexibility and also for strength, especially for me packing so many extra pounds these days!! Again, just not going to happen for me right now. Too much energy to get back up off the floor!

On the other side of all that whining is that thanks to a little help from some nasty little pharma junk, (heart attacks, strokes, high blook pressure have stalked my family for generations and have my doctors are starting to worry) I actually have lost some weight and I have to say I was happy when I realized recently, that my jeans are starting to get dangerously close to falling all the way off, not just slip down to places only a plumber could love.

Anyway, I"m hoping when this awfulness passes, and if depression doesn't mess me up, I hope I can at least start doing some yoga with my DVD.

Hope everyone's okay! :roll:

ps. I am so good with the excuses. Maybe I could earn a little extra money, helping others come up with them :|

Posts: 140
Joined: Thu 1 Nov 2007 4:47

Re: Dr. Burrascano's Lyme Rehabilitation

Post by Daise » Thu 29 Nov 2007 0:57

Hi minitails2,

Yes, things are hard for you right now, that comes through well. I'm trying to hear you.

And good grief, you have bipolar, on top of it. That's a full plate. Yet, you have a sense of humor. How do you do that? You wrote: "ps. I am so good with the excuses. Maybe I could earn a little extra money, helping others come up with them."

I was lucky. When I took doxy it was December and January, the low light times of year, when a person bundles up.

You mentioned that it's hard to get up off the floor, when you exercise. I know what you mean! My insurance company has a gym for the disabled with hip-high (for me!) tables you can sit or lie down on, to stretch. But you can only use the gym for a limited amount of time.

Now with my Medicare Advantage plan I get free gym at Defined Fitness (called Silver Sneakers, a nation wide program offered by some Medicare plans.) However, I would have had to crawl across the floor just to find a doorknob I could hoist myself up on. After I felt a whole lot better doing Dr. Burrascano's weightlifting idea, and I'd improved from antibiotics and my body worked better, I added in warm pool. It's the only place I can do serious Lyme stretching. I've really taken that to heart and I get in there and make-up dance stretches. I feel a lot better!

Daise :)

Post Reply