Does back pain worsen around Christmas-time? If you asked us, we’ve got enough anecdotal evidence to say yes. But why is that? Clinic gets busier, our patients report symptoms are worse and then blame it on the weather… Now why is this? Well, simply put, as we get towards the festive period and the existing stress in our lives is ramped up yet another notch, we often start to see physical manifestations of underlying stress rear their ugly heads in the form of pain and illness.
Now, it’s not news that stress plays a part in pain and disease. What we’re interested in is chronic stress, and how this can make us ill.I wanted to find out more about the role of chronic stress,so I’ve been working my way through a reading list, including “Why Zebra’s Don’t Get Ulcers” by Robert Sapolsky. Now, this blog isn’t really about the inner workings of a zebra’s digestive system, it’s a book which focuses on why we as humans have developed a whole range of accumulative diseases as a result of living our lives chronically stressed. It explains how our body adapts to stress and details what the healthcare profession have had to learn in order to manage our patient’s stress.
Where we used to be killed off by cholera, influenza and leprosy (which did the job fairly quickly, it has to be said), we now suffer long, slow diseases that come about as the result of gradually accumulating a number of healthcare issues. Cancer. Heart disease. Strokes.
In the words of Mr Sapolsky, “Chronic stress can make you sick.”
So why don’t zebras get ulcers? Simply put, zebras don’t get ulcers because they don’t spend hours, days, or weeks stressing about making the mortgage repayment. Or worrying about your big project which needs completing by the end of the month. They worry about if a lion is going to eat them in the next 10 minutes. Their stress is short and to-the-point. It’s only we humans who have geared ourselves up physiologically to have all sorts of physical manifestations to stressful events generated entirely in our heads. If you’ve ever experienced sweaty palms or a racing heartbeat whilst thinking about what might go wrong then you know what I mean. Zebras just don’t do that.
It’s safe to say most of us nowadays live our lives in a state of chronic stress. We don’t take time to look after ourselves and truly de-stress (a soak in a bath doesn’t count!)
What does chronic stress do to our bodies?
In short- chronic stress wreaks havoc. Your body’s response to an acute stressor is perfectly suited for its job. You’re home alone and hear footsteps upstairs- your heart starts racing, blood pressure and breathing rate increase as your body prepares to transport nutrients and oxygen to your muscles STAT. Why?
Because your muscles are going to need that energy as you hot-foot it out the door faster than Usain Bolt! Your body also shuts down digestion (because absorbing dinner suddenly isn’t so important) growth and tissue repair stop, senses are sharpened, sexual drive decreases, and the immune system becomes inhibited (there’s plenty of time to hunt for tumours in a week or so- right now, all your body cares about is getting out of the house and out of danger pronto). Oh, and another neat feature: To stop your body going into shock from extreme pain, your pain perception is decreased. Handy!
So- all good responses from the body and we’re out of danger now thankyouverymuch. But what happens if that stressor doesn’t go away? If your stressor is a busy desk job in a Fortune 500 company, you’ll never be able to switch off the stress response. You might find your heart rate stays at about 180/100 and steers you towards an early heart attack. Your digestion is going haywire, tissue healing and recovery is halted so nothing is ever repaired (hello ulcers!). Not only that, but you’ll never store any surplus energy because your body is mobilised to use it all straight away, and you’ll fatigue quickly.
Sounds bad, doesn’t it? It doesn’t stop there though. Illnesses and viruses will be easier to pick up and harder to recover from if your immune system is permanently compromised. This becomes particularly noticeable at this time of year when germs and viruses are floating around. You’ll be shaping up for a very snotty Christmas indeed if you’re stressed!
Stress disrupts our lives. It can make us very ill. As a chiropractor, my chronically stressed patients have widespread muscular tension and sometimes heightened sensitivity to pain. They suffer from headaches or jaw pain, visual disturbances, lower back pain, tummy upsets… Stress causes changes in our nervous system and can result in muscle tension, spasm, and pain. Now, I can adjust their neck to alleviate the headache, but that won’t help if the headache is a result of chronic stress. We need to manage their stress and anxiety or the headaches will just keep coming back (as any of my patients will tell you- I’m focussed on the long-term resolution.)
So what are we going to do about stress?
There are various management techniques and these all work for different people- you’ll have to find what works for you.
Exercise: A simple place to start is with exercise- being physically fit can lower blood pressure, resting heart rate and increase your lung capacity (yes- directly counteracting the effects of stress). Simply put, exercise releases endorphins and endorphins make you happy PLUS it increases your feeling of self-efficacy and achievement. Instead of sitting at a desk getting tense, you’ll be using your stress response for what it’s meant to do- explosive activity! That’s how exercise can be a powerful way of reducing stress.
There are a few caveats to this though:
Exercise only works to reduce stress if you want to exercise. Your friends forcing you into a spin class isn’t going to help!
It’s effects are short-lived, lasting only for 24-48 hours. So you have to do it regularly to see the benefit.
Too much exercise or overtraining can produce a stress response.
Psychotherapy: For natural stress-heads (or, to use the correct term- type A personality), psychotherapy can change your behaviour, lower cholesterol levels and reduce your risk of a heart attack. Stress often depends on how we view problems, and some studies have found that in the face of terrible news, denial and hope are strong coping mechanisms. Don’t accept a poor prognosis and hope for the best- miracles can’t happen.
Ommm… Zen: Meditation is another interesting one. It can decrease glucocorticoid levels and decrease muscle tone/tension. But again, studies show that it works while meditating, but doesn’t necessarily have a long-term effect.
Social Support: In the immortal words of the Beatles, “I get by with a little help from my friends.” Giving and receiving support from the right friends is going to help, as will the support of a partner or spouse. A problem shared is a problem halved!
What about control?
If you’ve downloaded our resource “Understanding Pain” you’ll already know all about this. If you haven’t downloaded it, we’d suggest you do! Control and belief in your own self-efficacy is a powerful thing. Whilst you can’t have full control over the fact that you have stressful projects to complete, you can gather information about how long the project is going to take for you to complete, what the goals are and who you’ll be working with. This predictive information about impending stressors can help to reduce your stress levels by giving you some control over the situation. This is in much the same way that learning about chronic pain can help you control, cope with and reduce your pain.
The caveat to this is that control isn’t always such a good thing psychologically. If, for example, you have control over a situation that ends up disastrously, that’s going to be completely detrimental to your psychological health. Believing that everything challenge in life can be overcome “provided we work hard for it”, can leave you in a stressed heap in the corner.
How do you cope?
We also need to talk about cognitive flexibility. This is the ultimate ability to “cope”. Try problem-solving the issue and working out if it’s the stressor that needs altering, or your perception of it that does. This can be hugely stress-reducing. Admit that you’re finding something stressful and rely on social support from friends and loved ones- they’ll want to help. You’ll need a selection of coping strategies to effectively deal with stress. You might have a tendency to try to cope with an event, fail, and then go back in and try to cope even harder with the same strategies. If a cup of tea and a chat with friends hasn’t worked, try something different. A meditation class. The gym. Yoga. Speak to a psychotherapist. During times of stress, finding the right coping mechanism for you is critical.
Here’s our ultimate stress-busting check list:
Find ways to view even the most stressful situation as holding the promise of hope and improvement. But don’t deny the possibility that things will not improve. As they say, “hope for the best, but prepare for the worst.”
Take the time to look after yourself, using coping mechanisms that work for you. However, don’t give ulcers to others to avoid getting them yourself. You might find that a midnight drumming session is just the trick to soothe your nerves, but it’s going to make your neighbour’s life awful!
What can you predict about the upcoming stressful events in your life? Is your toddler likely to have an over-stimulation meltdown in the middle of Christmas lunch? If so, plan for a quiet hour beforehand to allow them to settle and calm. Guests coming for Christmas dinner and worried about cooking? Gather as much information as you can about them before you turn on the oven! Are there any food allergies, what can you prepare instead? Gather as much information about the upcoming stressors as you can, and then implement a plan to help you cope.
Accept the things we cannot change
In this blog we’ve learnt about just how stress can impact on our lives and wreak havoc in our bodies. There’s no one way to avoid stress- moving to a remote desert island is going to give you all sorts of acute stresses like our poor zebras. (Just think about all the poisonous critters who might see you as a tasty treat!) Fortunately there are numerous ways in which we can cope with and reduce the stress we experience.
The real world is full of stress yet many of these issues aren’t real, we’re worrying over what might happen. Imagined stressors can take over our lives with worry in anticipation of a horrible event happening. It may happen, it may not- worrying about it isn’t going to make it any easier to cope with!
Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and wisdom to know the difference.
Here it is, the oh-so-predictable New Year’s Resolution post about a “New Year, New You.” We’re going to bypass that this year in favour of something far more important. Whilst New Year’s Resolutions which centre around going to the gym, getting fitter or putting more of an emphasis on our health are fantastic, we want you to spare a thought for your joints before you start a new exercise regime. Search online for “getting fit quotes” and the words that pop up most frequently are “pain”, “hurt”, “sore”, “skinny” or “burn”. Whilst some pain is normal and to be expected, this has given rise to a worrying influx in the number of sport-related injuries we’ve seen from athletes “training through the pain”.
Most sporting injuries occur from what we call the Terrible Toos- doing too much, too soon. After not working out for months or years, people come in and try to run 5 miles or lift 200 lbs at their first session. Their deconditioned, unprepared muscles can’t cope with the action and so injury occurs. We then have to recover from the injury by which point our motivation for our New Year’s resolution is gone. You won’t become Batman (or Catwoman) in one workout session, so please please please train properly and spare a thought for injury prevention this year.
So how does injury occur?
Injury, particularly sports injury, occurs through direct or indirect trauma to muscles, ligaments, and joint capsules. Injury takes two forms- direct and indirect. Direct trauma or injury occurs through blunt trauma or a sudden overload- so dropping a weight on your foot would be a direct trauma (HINT: Don’t do it!)
Indirect trauma or injury occurs from repeated submaximal loading. (When we refer to joint loading, what we mean is the force that is put on a load-bearing or weight-bearing joint during exercise.) This could be therefore be repetitive injury to your elbows when lifting, or your knee when running. Indirect trauma can therefore occur through repetitive lifting of weights, running, or any activity that “loads” a joint.
Regardless of direct or indirect trauma, the end result is still the same- tissue dysfunction that is characterised through pain, inflammation, and internal tissue stress. This can lead to what is known as “functional disability”, where you’re able to go about your day-to-day life largely without issue, but your training or exercise regime is impaired. Not what you want when you’re motivated to get to the gym!
Why does injury occur?
Whilst some sports injury occurs through direct trauma- such as a rugby tackle, overuse injuries are more common in sports than acute injuries. These are subtle and occur over time, hence why early detection and diagnosis is key. Faulty movement patterns, joint restriction or muscle dysfunction can be detected by your chiropractor which can help to identify those who are at risk of an overuse injury and provide advice on injury prevention, modification of exercises, adaptations to technique or treatment if appropriate.
Researchers have reported that impact forces of up to 550% the normal force load are transmitted to our joints when running, with impact forces between 4 to 8 times higher than those during normal walking. Much as you wouldn’t lift a heavy weight without putting some thought into it first (if you even decided to lift it at all!) we need to put some thought into how well equipped our bodies are to cope with these additional stresses and strains before we hit the gym. This is why launching into a fitness regime without putting some thought into how you’re going to do it and how you’re going to protect yourself whilst doing it can be crucial.
Coping with this degree of stress can be challenging enough even for joints that are well-adapted to this degree of stress, but if you are starting a new exercise regime or perhaps picking up a new activity, your joints need some time to adapt to the new activity. They also need to be ready and able to cope with this degree of stress. This is where chiropractic comes in.
How does chiropractic help?
Chiropractors are primary healthcare professionals who are trained to diagnose, treat, manage and prevent disorders of the musculoskeletal system (bones, joints and muscles), as well as the effects these can have on the nervous system and general health.
Chiropractors are often thought to only “crack backs” and only treat back pain. Much like your GP wouldn’t prescribe the same pill for an ear infection as they would for high blood pressure, so a chiropractor doesn’t just perform spinal manipulation for a bad back. It entirely depends on the nature of the injury, the level of pain, and most importantly, your personal preferences (it all comes down to teamwork!) Chiropractors have a vast array of treatment options they can offer and chiropractic care can be crucial in injury prevention because chiropractic emphasises the correct functioning of all joints, muscles, tendons and ligaments in your body to ensure you are performing at your very best. Whether you are an elite athlete, a gym newbie, or perhaps a keen sportsperson returning from injury, chiropractic can be crucial in identifying dysfunction prior to an injury occurring.
A crucial part of treatment at Acorn Health is helping you to develop a firm understanding of how your body works, how pain and problems can occur and how to prevent it. We work with you to develop a new fitness routine and training programme with appropriate exercises that will enable you to strengthen and stabilise your joints whilst reducing your risk of picking up an injury.
So whilst you’re dusting off your trainers and wrangling your way into your sports kit, spare a thought for your joints, and spare a thought for injury prevention.
If you would like to receive our “Injury for Runners” resource, detailing the most common types of running injuries, the mechanism of injury, preventative measures and more useful information, please complete your details below.
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January is the time of year when some of us will set a new years resolution, and it’s not uncommon for these goals of “lose weight” or “get fit” to be at the top of the list. So why is it, that only after a mere 6 months later, only around 8% of us will have managed to stick to those resolutions?
“Lose weight”, in itself, is a vague term. How much weight? How quickly? How am I going to achieve this? The way to success is to set yourself an achievable goal with tangible results. “I want to lose a pound a week, and my end goal is to lose half a stone. To do this, I’m going to cut down on the amount of fatty food I eat, and make sure I take a 20 minute walk around the town three times a week.” Avoiding overindulgence at Christmas will also put you in the right frame of mind to start 2015 off right- don’t set yourself up for failure by jumping on the scales after Christmas and berating yourself for the amount of mince pies you enjoyed, this is only going to make you feel worse! A positive attitude towards health and weight loss is important to ensure success.
Christmas weight is, in itself, no harder to lose than any other weight. In fact, research suggests that sudden weight gain (the average person gains around 2lb between November to January) is easier to lose than weight that has been put on gradually, over several years. So why do we tend to put on weight over Christmas? A lot of us indulge in the occasional treat every now and then, but at Christmas we tend to indulge in fatty foods more frequently than we do throughout the rest of the year. It’s not just the food we need to think about, but the amount of alcohol we consume over the festive season- a 250ml glass of red wine contains around 230 calories. A few pints of beer soon adds up to a significant calorific intake at 170 calories a pint.
So how can you help avoid piling on the pounds this Christmas? Start off by planning your meal and give nutrition a passing thought- why not purchase your fruit and vegetables from the market as close to Christmas day as possible? That way, they’ll stay fresh, and provided you don’t boil your Brussels sprouts into oblivion, will retain the majority of their nutrients. (Note for your diaries- the last farmer’s market in South Street is on 20th December so why not get your veggies then and support your local farmers? Website here) Turkey is a low-fat, high protein meat source so provided you can resist the temptation of the fatty skin on the outside, that won’t add inches to your waistline either. Delicious though it may be, drowning your booze-soaked Christmas pudding in brandy cream might just be an indulgence too far!
The traditional post-Christmas walk is also an excellent idea, and it might surprise you to know that this has a solid research backing. Even just a 15-minute walk after a meal can improve digestion, helping to avoid the dreaded post-Christmas-dinner-bloat, and it will also reduce spikes in your blood sugar levels, which is excellent if you are a diabetes sufferer. Heading out for a walk after Christmas dinner is also a great opportunity to bump into friends and neighbours and wish them a happy Christmas too!
Christmas walk suggestions courtesy of EmsworthWalks.org
Westbourne and Back, 3.1 miles (Approx 1hr 30) Download
Nore Barn Woods, 2.6 miles (Approx 1 hr) Download Two Millponds, Two Marinas, 3.7 miles (Approx 1 hr 45) Download
Remember, always wear correct footwear when walking especially if icy underfoot!