Transcription:
How Physical Therapy Can Help You to Manage Stress

Melanie Cole (Host): Stress is often defined as the body’s response to the demands of life. The American Institute of Stress, calls stress America’s leading health problem. When the stress of life leads to chronic physical ailments or pain, it may be helpful to meet with a physical therapist to receive treatment for the manifested symptoms of stress and working through those issues that cause it. My guest today is Cindy Myers. She’s a physical therapist with Hendricks Regional Health Physical Therapy. Welcome to the show, Cindy. So, tell us, how do we know when the psychological stresses that we’re experiencing in our lives begin to manifest themselves into physical, actual physical ailments?

Cindy Myers (Guest): Well, there are several different ways that one can think about. The first one is, having difficulties sleeping. So, if a person is either having difficulty falling asleep or staying asleep, that’s often an indication that your system is not in a calm state because you have to be in a calm state to be able to fall asleep and stay asleep. The second thing that I would look at is whether or not you feel like you’re able to relax. There are quite a number of folks that we see in the clinic who that’s their main complaint, “I don’t know how to relax. My doctor tells me that I just need to work on relaxation,” and they have no idea what that feels like anymore, so that’s the second thing I would suggest. The third thing is, if you continue to have flare-ups of the same physical problem, and you try different forms of treatment and it doesn’t really calm it down, that can be another indication that your nervous system is ramped up and it’s not able to heal correctly.

Melanie: So, how can physical therapy help with those stressors? People think of stress as a mental health issue, but how can physical therapy and some exercises and things you might teach us help with that physical pain?

Cindy: Well, to start off with, we do a certain set of techniques that are able to calm your system down. So, there are a lot of physical interventions and what we call manual therapy interventions that can be used to assist somebody’s nervous system in calming down. But we have found out that although there’s a wide range of ways to get your nervous system to calm down, some people do better with movement based calming activities so those things would be tai chi, yoga , walking, meditation. So, there’s a lot of overlap between movement and calming for our nervous system.

Melanie: So then, we think of that stress and pain connection. How do you explain to people that it is something that’s going on in their life, and are we talking about major stressors or can it be just the minor stressors - kids and work and bills and that sort of thing?

Cindy: It can be that sort of thing. So, it can be anything from major life stressors down to just everyday things that life brings our way. But what I typically explain to people is we have two halves to our nervous system. We have a calm half, and the extreme of that is sleeping, and that’s also called “parasympathetic”. And, at the other end of the spectrum, we have the excited end of our nervous system, and that’s called “sympathetic”. That’s that fight or flight state that we are all pretty familiar with. If we’ve have had a near car accident, our pupils dilate, our muscles get tighter, our heart starts pounding, so that’s the extreme of the excited state. Ordinarily, we start off somewhere between those two extremes based on our personality but when life brings stuff your way that is stressful, it tends to tug you farther and farther out toward that excited end of the spectrum. It’s an all or nothing system because the excited end is the presence of lots of stress chemicals, and the calm end is the absence of lots of stress chemicals. In essence, there’s a whole set of things that we commonly do that excites our nervous system and then, there are things that we can do to calm it down.

Melanie: So, when we are talking about calming down your nervous system, some people get stress from work, perfectionism, they need to everything perfectly right. How can a physical therapist help them with that when it comes down to their need to fulfill this certain thing that they feel they must to from their life so that causes that stress? So, what do you tell them about yoga, massage; you mentioned tai chi--things that they can do so they realize everything doesn’t have to be perfect all the time?

Cindy: Well, the nervous system works like a teeter totter or a scale. We’re not ever going to get rid of all the things that cause us stress in our lives, but what we can do is periodically sit back and say, “How much of that stuff is loading that side of my scale so that with intention and planning, I can put more calming stuff onto that side of my scale.” You’re right. Life is never perfect, and we can never get everything to work the way that we want it to, but if we consistently look at where our nervous system is sitting, and work to tip it into the calm direction and keep it there, that’s what really helps us achieve better health because we know that when we’re in a calm state that activates certain genes in our bodies that are related to tissue healing and immune function. So, if our nervous system is all ramped up, it actually shuts off a number of those genes that should be healing our bodies, and that’s why we often end up with multiple negative health effects from being in that state.

Melanie: And, where do you feel exercise fits into this spectrum?

Cindy: Well, exercise, far and away beyond any other type of intervention, has shown to be good for us in every way. Good for us physically, good for us emotionally, good for us as far as our weight goes. There’s a whole list of things that exercise is beneficial for. I happen to work with a patient population that largely has chronic pain, and those folks, unfortunately, many of them have ended up in a situation where exercise is a very difficult thing for them to do because they’re painful or they get flare-ups if they overdo, and so with those folks, exercise is still very important but you just have to tinker around and find a method of exercise that you can do that does not aggravate your symptoms, and that’s where seeing a PT can really help with that because we can try a lot of different things, and we have a lot of things in our tool bag to help people find the method that will work for them without aggravating their symptoms.

Melanie: So, give us some tips from your tool bag for some of those things whether it’s water aerobics or yoga, whatever you tell people every single day. Give some tips for reducing that stress through exercise and therapy.

Cindy: Water aerobics is a great method, especially if you have joint pain and irritation because it un-weights you. So, you can perform at a higher level in the pool than you can when you’re working on land against the full force of gravity. So, that is a really good method for people with joint pain and also folks who have widespread pain, and also folks that benefit from a warm environment. So, those would be autoimmune diseases, things like fibromyalgia. Tai chi is a slow motion martial art, and it works on strength and stability in the middle range of motion. So, for people that have pain at their end-range of motion, tai chi is a really good exercise method for them, and it incorporates calming at the same. Yoga also incorporates calming while you’re doing it. It works more on strength and stretching at your end-range of motion. So, if you have any kind of joint problems that would make your joints painful in the end-range of motion, yoga is not what I would recommend for you. And then, just walking is a great type of calming. Any type of whole body repetitive movement activity which would include walking and running, if you don’t have any physical problems that keep you from that, those are also really good methods.

Melanie: And then, in the last few minutes, give your best advice for reducing that psychological stress that might manifest itself in physical, actual physiological pain for people, what you tell them every day. And then, tell us a little bit about your team at Hendricks Regional Health Physical Therapy.

Cindy: What I tell people is, they should avoid, as much as possible having stressed relationships, so do whatever they can to repair relationships in their life. To avoid caffeine after lunch because that’s a stimulant, and often that keeps us from sleeping which ramps our nervous system up. And then, on the flip side, to do any form of rocking. Rocking is hardwired into our nervous system to calm us, so that could include rocking in a rocking chair, rocking on a rocker recliner, rocking on a porch swing. And then, the second thing I would highly recommend people to do is make sure that their sleep hygiene is good because if you’re not sleeping well, then your system is automatically going to be ramped up to a higher level. And then, an additional thing that I try to really urge people to do is to be involved in gratitude journaling. Gratitude journaling has remarkable changes and effects on our brain chemistry which can include our mood, and also it actually can shrink the part of the brain that processes fear and pain. So, it’s a very powerful tool to use, and we know a couple things about it. One is, you don’t have to do it every day but you do need to do it about three times a week. It’s much more powerful if you actually write it down in a journal format. And then, the third thing is that, the more specific you are about what you’re grateful for, the better brain chemistry benefit that you’re going to get from it. As far as our team at Hendricks goes, we have multidisciplinary group of people that are involved in our stress management program, and we actually have begun to call it emotional fitness because in the same way that you have to exercise to stay physically fit, you need to be consistently doing things that keep you emotionally fit as well. So, those folks involve nursing, physical therapy, we have a physician who’s working with us as well, and some other individuals from our wellness team. So, it’s kind of a widespread team that we’re all working toward this together and trying to get these opportunities out to the community as well as to our own associates.

Melanie: Thank you so much, Cindy, for being with us today. It’s really, really great information. You’re listening to Health Talks with HRH, Hendricks Regional Health. For more information, you can go to www.hendricks.org. That’s www.hendricks.org. This is Melanie Cole. Thanks so much for listening.