Stress Management

by Sarah Woodward, PT, DPT Pivot Physical Therapy Point Breeze

Let’s face it, 2020 was a stressful year; it’s to be expected when we are faced with so much that feels outside of our control. However, there’s good news. While we can’t always control our stressors, we can control how we respond to them.

Stress typically comes from any physical or psychological threat to our safety or well-being. When our bodies go into a stress response, we see an increase in the hormones adrenaline and cortisol which elevate our heart rate, blood pressure, blood sugar, respiratory rate, and decrease digestive activity.

Short term stress is not necessarily a bad thing, as it can be very powerful in helping us meet goals, or retreat to safety when danger is near. However, it is well-documented that long term stress has negative effects on our body, as our bodies were not designed to handle chronic stress. With a long-term stress response, we see an increase in cortisol secretion, which can lead to cortisol dysfunction. Cortisol dysfunction has been shown to increase inflammatory response which in turn may initiate, exacerbate, or prolong pain. Given that pain is the leading cause of disability, and the number one symptom that drives patients to seek physical therapy treatment, stress management has become an important tool in my practice to help patients heal and rehabilitate.

In addition to knowing what stress is and how it affects the body, it’s important to understand where stress comes from in our daily lives. Stress often results from exaggerated or recurrent negative thoughts, rumination and worry, magnification of events or a persistent feeling of helplessness and lack of control. Chronic stress often results in headaches, joint pain, stomach pain, back pain, neck and jaw pain, and fatigue. Chronic stress has also been shown to increase risk of illnesses such as stroke, heart attack, immune deficits, and depression.

Stress is unavoidable (especially in 2020), and my intention is not to scare you, but to give you some tools to combat this stress a little bit at a time. Fortunately, the tips I have to relieve chronic stress are basic lifestyle modifications which you can easily implement from home on a daily basis.

The first tip is to implement mindfulness techniques. Studies show that mindfulness-based interventions can lower levels of perceived stress in groups who are guided through meditation and mindfulness practices. Since we find ourselves in the midst of quarantines and lockdowns, a practical solution is trying some free cell phone apps such as Calm or Headspace. These apps have tools for helping you relax, such as instructions for guided meditation and sleep stories. I encourage you to try these for yourself to see if it helps you manage your stress.

Another strategy is deep abdominal breathing. This can be practiced by placing one hand on your chest and one hand on your belly. Slowly breathe in, allowing your diaphragm and not your chest to expand, exhale slowly, and repeat. Try this for 2-3 minutes. You may find some relief, as this encourages a decrease in your sympathetic tone which helps turn off that stress response.

The next strategy is proper sleep hygiene. Poor sleep affects your ability to handle stress and pain throughout the day and causes decreased resilience to stressors. Research has shown that simple changes can translate into increased sleep leading to more energy, feeling refreshed, and possessing greater ability to handle stress. Some examples of simple changes to improve sleep include: setting a routine bedtime and wake up time; no television or computer screens in the bedroom or an hour before bed; limiting consumption of water, caffeine, and alcohol before bed; keeping the bedroom cool and dark; staying in bed with eyes closed if having trouble falling asleep; limiting daytime naps to 20 minutes or less; and, of course, exercise.

Exercise is not only effective in promoting good sleep hygiene but also a powerful tool to combat chronic stress. It may seem contraindicated, but putting your body through physical stress to relieve mental stress truly works! Regular exercise reduces the level of the body’s stress hormones adrenaline and cortisol as well as triggers the release of endorphins which are natural pain relievers and mood elevators.

I recommend aiming for 150 minutes of exercise a week, which breaks down into 30 minutes, 5 times a week. Ideally, the exercise intensity should be moderate (breathing heavily but can hold short conversations and still somewhat comfortable) or vigorous (borderline uncomfortable, short of breath, can speak a sentence). This will help you maximize physical and mental benefits. I also want to emphasize that exercises are easier to perform at home than you probably realize! There’s a tried-and-true formula for exercising at home called EMOM, which stands for Every Minute on the Minute. Set a timer, perform an exercise for one minute, reset the time, perform another for a minute, and repeat until you’ve met your exercise goal for the day. Use this effective strategy to get your heart rate up and get your body moving. I encourage you to look up EMOM workouts online for nearly endless examples of exercises that can be done from home.

I hope these strategies help you alleviate any stress you may be carrying from this difficult year and prepare you to feel your best heading into 2021! Finally, if you feel you may benefit from physical therapy services in the future please feel free to reach out for your complimentary consult at 412-371-0241.