The human body is a brilliant machine. When the physical body is healthy, it works on our behalf every moment of every day with little to no conscious effort. Our bodies are constantly adapting to our environments – we have the extraordinary ability to acclimate to extreme shifts in climate and changes in food supply. We also have the astonishing ability to adjust to various degrees of mental and emotional stress. Because our bodies adapt so well, we rarely take note of the constant blessing they are to us in our daily lives, until illness, pain, or lack of energy alerts us.
Today, my goal is educate on how our physical bodies adapt to long-term stressors, and equip with effective ways to re-educate the body when current adaptations no longer serve us.
This is Your Body on Stress
Here’s a simple example to create a grid for this topic: Imagine you are camping in the woods. Most people see camping as a fun, leisurely activity. It cultivates feelings of happiness and rest. Now, let’s say you’re camping in the woods and you spot a hungry bear nearby. This once lovely picture of rest and leisure has instantly transformed into a frightening scenario invoking panic and stress.
Camping in the woods with a bear nearby instinctively sends your body into “fight or flight” mode. Your heart rate increases, respirations increase, and blood rushes to the muscles necessary for running away from the hungry bear. Okay, let’s switch up the scenario a bit. Now, let’s say you are a deer. What do you suppose a deer would do in response to the dramatic events that just ensued? Most of you probably answered the question correctly. The deer naturally goes back to grazing in the woods without fear of a returning bear. It’s like an automatic adrenaline on-off switch. The switch turns “on” when there is imminent threat and shuts off when the threat no longer exists.
Unfortunately, as humans, we have this astounding ability to stay in that “fight or flight” mode even when the threat is no longer imminent. If we were brave enough to continue the camping trip, we would constantly be looking over our shoulders for the next bear. The on-off switch isn’t really a switch, but more like a mood light switch, never totally turning “off.” This inability to “turn off the switch” results in things like chronic tight shoulders, tight hips, low back pain, and headaches (this list is not exhaustive. There’s a laundry list of organ-related issues, like cardiovascular disease, that are also affected by this inability to “turn off the switch”).
Re-Learning the Basics
This is where the concept of motor learning, or muscle memory, comes into play. When a particular movement is repeated over a period of time, a memory is essentially created for that specific task with little to no thought. Learning to ride a bike is a common example used to depict this concept. So, what happens when we learn how to do something incorrectly? Or what if what we once learned no longer serves our body? An example everyone can relate to is cell phone use. Crouching over your phone texting, playing games, reading articles, and perusing Facebook significantly impacts your posture. The poor ergonomics repeated over and over have earned people a new and commonly used term for their neck and shoulder pain, called “text neck.” Think about it. How often do you use your phone during the course of a single day? Do you have great posture when you’re tweeting on your couch, in your bed, or at your desk? Before long, your body reshapes itself into these poor positions and it often gets so bad that good posture feels more uncomfortable than poor posture! Can you imagine the level of postural reshaping that takes place when the stimulus is traumatic in nature?
As a chiropractor, I focus on the physical manifestations resulting from these adaptations that do not serve a person. This first part of treatment consists of unwinding tight muscles, breaking down fascial and muscular entrapments, and freeing up stiff and inflamed joints through manual mobilization techniques and chiropractic adjustments. This first phase sort of “cleans the slate” and the immediate reward for a patient is reduced pain in the body. The long-term changes are achieved by implementing new, more efficient, and less stressful ways of moving and using the body. Re-learning how to sit, stand, and sleep are just a few examples of how rehabilitation is used to help reduce pain in the body long-term. In order for muscular rehabilitation to be effective, it’s imperative to start rehabilitating the types of movements a person does every single day – like sitting, standing, sleeping, and kneeling, because the repetition of these basic movements in a person’s daily activities will help engrain the new way of doing that specific movement. As a result, the basic movements that used to aggravate the problem are now a part of the solution.
The Five Primary Components of Effective Neurorehabilitation
In my clinical experience, there are five primary components in effective neurorehabilitation: removal of the negative stimulus, active patient participation, repetition, reward, and longevity. The following provides a detailed example of how this plays out in real time:
Removing the negative stimulus. As previously mentioned, it is vital to remove the things that aggravate the problem. For example, if a patient presents to me for chronic headaches or shoulder tightness and they sleep on their stomach every night with their neck cranked over to one side, the patient would have to stop sleeping on their stomach in order to see lasting improvement. This sleeping position is highly stressful on the cervical spine and often the cause if not major contributing factor of headaches and tight shoulders.
Developing active patient participation. This means the patient needs to play an active roll in the rehabilitative exercise. It should require some brainwork to consciously think about the movement they’re doing. It is also helpful if the movement is novel to them. Expanding on the example above, a simple exercise that requires conscious effort (purely because it requires you to slow down and think about it) is a shoulder shrug. If you experience headaches or tight shoulders, try out this exercise. Start by drawing your shoulders up to your ears for a count of five seconds, hold at the top for a single diaphragmatic breath, and then slowly lower your shoulders down for a count of 5 seconds. In this exercise, a person has to consciously think about raising and lowering their shoulders for a count of five, making them an active participant in this simple movement.
Repeating the rehabilitation exercises over a long period of time. This can be effectively implemented by incorporating a new movement into a person’s daily routine. Furthermore, by incorporating it into a person’s daily routine, it increases the likelihood of the new movements becoming permanent default patterns, creating the new muscle memory we’re looking for. Take the shoulder shrug exercise mentioned above and perform that exercise before every meal or one time per hour for every hour they sit at their desk. Incorporating a repetitive exercise into a patient’s daily schedule helps develop an ingrained habit, and therefore increases the likelihood of producing lasting change.
Constructing exercises that produce an almost immediate improvement in the patient. We are creatures that like reward; it motivates us to continue running the race despite the work required, so having a plan that lends itself to daily improvements and rewards is crucial. In the above example, a natural consequence of slowly lowering the shoulders for a count of five seconds is reduced tension in the upper trapezius muscles (think tops of shoulders), which is a source of high tension in many people’s bodies.
Crafting exercises and movements that can easily translate into other movements or activities. Looking at the example above, the conscious effort of lengthening the tops of the shoulders can easily translate into other daily movements like reaching for a carton of milk out of the fridge or taking the bikes down from the garage rafters.
The example above provides a simple grid to help navigate through the complex connections between our mind and body-the physical manifestations that result from varying degrees of physical, mental or emotional trauma. By creating awareness around this mind-body connection, we can empower people to advocate for themselves and for others in their spheres of influence. As clinical providers, when health and healthcare is addressed from this multi-faceted perspective, our patients actually get better and experience long-term, sustainable wellness.