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As you wander through your bedroom in the early morning, reaching for shelves that seem to shift as you approach, you realize how helpless you are without your eyesight. Instead of walking, you carefully scootch your feet step by step, hands forward like a zombie, into the inky outline of a bathroom door. Now it may come as a ‘duh’ kind of question, but why would we do this? Why would we modify our behavior to accomplish a goal that could easily have been accomplished much faster and efficiently if we just marched right through the dark towards what we thought was the bathroom? I’ll allow these gifs to speak for me:   We modified our behavior based on those memories of SLAMMING our toe into that damn table one too many times, just as we modify our behavior when anything incredibly painful happens to us. Remember that time you sprained your ankle when trail running? I’m sure you learned to be more careful with your steps! Remember that time you played volleyball for four hours and woke up like a train rolled over you, backed up, then body slammed you? Sure you do. You remember. Your body remembers. And, due to these memories, we do our best to make good decisions to avoid these painful problems in the future. The reason I’m telling you these stories is to paint a picture that our body and mind remember injuries, and that these injuries that may have occurred decades ago are still affecting our bodies today. Don’t believe me about your body remembering injuries? Research shows a good ability to predict osteoarthritis in patients decades before it occurs… the main predictor is if they’ve had a knee surgery or injury.1,2 That osteoarthritis is your body’s ‘bad memory’ of your bad night you messed up that knee. And your mind remembers injuries just fine as well… just think of one of your many injuries and I’m sure it’s as vivid as a firework on the 4th. Growing from these painful metaphorical and literal memories is a major challenge, and that challenge is met daily with the help of proper physical therapy treatment; to reset your body’s movement and your mind’s pathologically-based control of your body in order to imprint a new patterning system that accommodates your injury. In short: Unlearn old patterns. Build new ones. Grow. Let’s go through a typical case of how I teach my patients to build these new patterns: Bob Smithy Jones Fake Name Jr III comes into the clinic with back pain due to paratrooping since he was 5. He’s now 31 and his lumbar spine is comprised mostly of Legos and popcorn. He likes to deadlift small horses and fight yoga instructors to pass the time, but his lower back isn’t letting him do the things he loves. Bob is desperate. He knows he has to live with this spine for the rest of his life and is concerned with what the future holds. After going through a thorough physical movement and manual assessment, I see half a dozen regions that are contributing to Bob’s pain and dysfunction. His mechanical memories are leaping out at me from each of my assessments, and his compensations are showing me exactly how he has been subconsciously “avoiding stubbing his toe” for decades. His mental memories are evident every time he guards, takes a sharp breath, or shows hesitation when trying a new exercise. The good news is, the more time I spend with him, the more I can help him! Breaking these movement dysfunctions down, one by one, session by session, into compartmentalized pearls of digestible information for him to relearn movement is the treatment program. Some of these memories need to be processed with manual therapy, stretching, and motor control training. Some of these memories need to be processed with a good dose of strength training. Through time, grit, and trust, these memories no longer have their teeth around the throat of Bob’s aspirations. The “memories” such as osteoarthritis will always be there, but with the dozens and dozens of pearls in his toolbox, he is able to manage and grow into a new version of his old self. He is also better able to step back and contextualize the different types of pain he feels and is less fearful of his future. This is growth. Our mind is a powerful thing. Our bodies are equally powerful. Each of them twist together into a complex story that many times involves loss, pain, fear, and sadness. As a working clinician, I see this day in and day out, which is why I am so motivated to help my patients’ minds and bodies learn new movement memories they need to better live the lives they deserve. With work, these old movement memories are reprogrammed into a new movement system that can give a fresh capacity to the function of the previously painful and weak movement patterns. Thanks for reading, Marcus Rein, PT, DPT, CF-L1
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This month, we focused our blogs on the pillars of health that we cover with all patients—sleep, nutrition and stress. All of these play a major role in how you feel, how your body functions and the pain you may feel. Our society is riddled with stress due to packed schedules, short attention spans and growing involvement of technology. It may seem simple, do less and stress less. But for many, there doesn’t seem to be TIME to do LESS. When it comes to stress, it manifests in 2 major ways: MIND and BODY Mind(n)- the element, part, substance,or process that reasons, thinks, feels, wills, perceives, judges, etc. The mind is a powerful thing- particularly when it comes to how your body feels, reacts, copes, and heals. It is how we process the world around us. The environment in which our mind is processing will set us up for stress and anxiety or relaxation and control. When we are constantly in a stressed mindset, our nervous system ramps up the epinephrine. This is a hormone that elevates heart rate and blood pressure to enhance our awareness and prepare for an attack. You've probably heard of fight-or-flight. This is necessary for survival, but the problem is that every day we have this chronic increase in epinephrine due to stressful lives. Our bodies are staying in "fight or flight" mode for hours each day, even though we are simply sitting at desks or working a relatively low risk job. This leads to chronic fatigue, decrease immunity and various health issues. What can you do to mitigate the effects?
For some, just deciding to put the time aside- in the morning, after work, etc- is enough for them to incorporate this in their day. Others might need a reminder or piece of accountability. Something that I suggest, at least to help you get started, is an app like Headspace. It gives you 10 minutes each day of guided meditation/relaxation. I learned that meditation & quiet time is not about just having a blank mind or taking a quick snooze, rather directing your mind to a different place, away from stress. Try it for yourself. It might not sound like something you would enjoy or buy into, but you may be pleasantly surprised. I was!
Body (n)- the organized, physical substance of a human. The body is what we, as physical therapists, are trained to treat and manage. However, the tissue- muscles, bones, ligaments, tendons- are all directed and supplied by the nerves. What makes this difficult, is that healing of the tissue can be slowed by a heightened neurological system. That is, chronic stress leading to poor immunity, heightened fight-or-flight hormones (epinephrine and cortisol), poor diet choices due to the stress, lack of sleep again due to stress... Do you see how this turns into a vicious cycle or sickness, weight gain and general un-wellness? The easiest way to stop this in its tracks is to address stress immediately. We can mobilize, offer corrective exercises, dry needle, cup, manipulation, etc endlessly, but if we don't address the state of their neurological system, then we are doing this person a disservice. My two favorite drills for this will address tissues but also has an effect on relaxing the neurological system. The diaphragm has a close relationship to the nervous system; breathing deeply can stimulate your vagus nerve. The vagus nerve functions to trigger the “rest and digest” hormones of the body- a.k.a the opposite of “fight or flight.” This will help keep the heart rate constant and controlled. Don’t I breathe all day? What’s different? We often take shallow breaths throughout the day, which also falls in line with “fight or flight.” It’s not often that folks stop and take a few deep breaths! Try these out and see how it feels: All you need for this is a wall that you can put your feet on! For this, we like to use a soft inflatable ball. The one Danny uses in the video is from The Roll Model, or go to Target and buy a $2 kids ball with Elsa or Spiderman on it!  Stress directly affects the results that you will see in the gym, sport, health, wellness, happiness, and so on. If you don’t have time every day for an hour workout, at least take about 10 minutes to breathe deeply and clear your mind. You will see a world of difference! Thanks for reading, Athletes' Potential Adrenal fatigue is the inability of the adrenal glands to carry out their normal function. The kidneys produce hormones to regulate blood sugar, blood pressure, burn fat and protein and react to stress. A disruption can cause changes in metabolism, fluid and electrolyte balance, the cardiovascular system and sex drive. The adrenal glands are the main stress control of the body and thus are affected with a stressful, overworked and under nourished lifestyle. Some common triggers or causes of adrenal fatigue are: over-exercising, high stress levels, sleep deprivation, high sugar intake, chronic illness, depression, surgery. This is not an exhaustive list by any means but you can likely identify with a few of these. The signs and symptoms of adrenal fatigue can be slightly different with each person. Keep in mind, one or two symptoms does not suggest adrenal fatigue. Rather, a cluster of the symptoms and lifestyle factors in an otherwise healthy adult could point towards adrenal fatigue. Unfortunately, adrenal fatigue is not on the forefront of “old school docs” minds or they were never taught this in med school. Holistic medical practices, dietitians or nutritionists are more likely to recognize the symptoms and prescribe a non-medicinal approach to working back to health. Weight gain and inability to lose it- often abdominal area High frequency of sicknesses that tend to last longer than normal Reduced sex drive Lightheadedness Lack of energy, even with adequate sleep Reliance on caffeine- coffee, soda, energy drinks Food cravings Chronic pain of unknown origin Chronic fatigue Obviously, we at Athletes’ Potential are not dietitians or nutritionists but we have a strong belief that input = output. We tend to treat the output side, but you could see they are directly related! So if you train 6 days per week, crave and/or eat sugary foods, sleep 4-5 hours a night and have trouble sleeping once you lay down--- your body is TIRED. As a society wrapped up in the ‘go until you drop’ mindset, it is not often that we take time to slow down and let the mind and body recover. Take a minute to answer these questions for yourself: How many minutes each day are quiet and calm? Meaning, no phone, no TV, no conversation, no working, no cooking. After a workout or long day at work, what do you do to ensure that your body is ready to do it all again tomorrow? How do you respond when your body sends stress signals? Any “I don’t know” or “I don’t have time” responses? Keep reading! Where to start? Nutrition- Not my area of expertise, but definitely an area of interest! A friend of ours is a Nutritional Counselor at a Holistic and Integrative Medicine clinic here in Atlanta. She shared a short blog about supplements that she suggests if you are experiencing these symptoms, found HERE. There is also a delicious recipe--- you’re welcome! A dietician or nutritionist can work with you one-on-one to talk through symptoms and which food changes could impact your health. Meditation- Meditation doesn’t have to be some mystic, religious experience unless you want it to be. By meditation, I mean taking a small chunk of time to relax the mind, breathe and calm the body. This is a new practice for me as well! The first time I tried it, I only lasted about 30 seconds before I was thinking about something else. Now, I almost always make about 10 minutes of relaxation! Check out the app Headspace. It’s free and is directed mindfulness for 10 min each day. Journaling- Very similar to meditation, but some people prefer journaling. For those with busy minds, taking a few minutes to write down what you are thinking about can be freeing and lighten the load swirling in your mind.
Listen to your body- Although last, it is the most important and closing thought. Listening to your body while training is paramount to all practices. If you feel fatigued, foggy headed, have various aches and pains over the body, perhaps today isn’t the day to run your 10-mile loop or try to PR a lift. Take the time to slow down and be attentive to the signals your body sends! Thanks for reading, Dr. Jackie, PT, DPT |
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