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Let's Talk About STRESS

Don't wait! Get moving – even if only for 10 minutes! It will help manage your stress, and decrease depression and anxiety.

It seems like we are getting busier by the year, and less equipped to handle the load. Everything is moving faster, we have devices that imply we are available at any time, and this has resulted in a blurring of the distinct lines where work ends and life begins. Ultimately, this means we are feeling more work stress at home, and more home stress at work. Over 70% of American adults say that they experience stress or anxiety daily, and that it impacts their life moderately! Over 70%! Everyone reacts differently to stress. Let's start with what stress is. By definition, stress is a reaction to a stimulus that disrupts our equilibrium – either physically or mentally. Stress happens in three stages. The first is an initial state of alarm (fight or flight response), which produces an increase of adrenaline. This is not always a bad thing, right? If you need to get yourself out of a dangerous situation, this surge of adrenaline and focus can literally save your life! The body can withstand occasional extreme stress and still survive.

The second stage is a shortterm resistance mechanism that the body sets up to cope with the problem. The final stage is a state of exhaustion. The exhaustion stage occurs when the body has used up all its available resources. If the situation is not taken care of, stress can produce long-term damage to the body, including heart problems, high blood pressure, the immune system problems, skin problems, pain, diabetes, and infertility. Let's talk about how this chronic stress affects our bodies. First, think about your  muscles, and how they get tense. This is part of that fight or flight reaction – your body is getting ready to guard itself to prevent injury! I know I hold tension in my shoulders and neck. How about you?

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Those muscles get tight and painful. Are you spending a lot of your day sitting? This can further contribute to the shortening of muscles and cause more tension and pain. Additionally, you may notice headaches, jaw clenching, or teeth grinding.

Often the muscles in our chest tighten up. You may not realize it, but the tight muscles prevent the ribs from expanding fully, so you're not taking in as much oxygen into your lungs. We need this oxygen to circulate around to keep all of our nerves, and organs and muscles healthy. Most important, we need the oxygen to keep our brains alert! Our brains use 20% of all the oxygen coming in to maintain our memories and keep the processing speed fast. Over time you may notice that you're not as sharp, or you start to have feelings of anxiety or depression.

Let's look at even more ways that stress can negatively impact your entire body's normal functions. Stress can cause a consistent and ongoing increased heart rate, and the elevated levels of stress hormones and of blood pressure, can take a toll on the body. This can increase the risk for hypertension, heart attack or stroke. Chronic stress may also contribute to inflammation in the circulatory system, particularly in the coronary arteries, and this is one pathway that is thought to tie to heart attack. Stress can affect cholesterol levels.

The stress hormones traveling around the bloodstream can also cause the liver to produce excess glucose. In a true fight or flight situation, your body needs this glucose for the quick energy. But in this situation of chronic stress, we aren't burning off that excess glucose in a fight. This glucose in our blood is increasing the risk for Type 2 diabetes.

Stress can affect our digestive system in various ways. On one extreme, your nervous stomach may cause nausea and vomiting, limiting your appetite. You may develop stomach pain, or even ulcers. This is because when we need to fight, our bodies divert resources away from the systems that aren't important. When you are fighting, you don't need to feel hungry or digest. This slow digestion may also cause you to be constipated, and bloated.

On the opposite end, you may notice that you eat more to deal. You may eat different foods than you're used to. And with a narrowed esophagus (a result from that readiness to fight!) many people experience heart burn. This could also cause diarrhea.  Worry causes some people to skip or forget to eat meals. For more people, that cortisol hormone that is produced when you're stressed and coursing through your body gives you the craving for foods that are higher in carbohydrates, sugars and fats.

This is the body looking for food that will give quick energy. And I'm sure your work place generously has these options laying around, and difficult to resist, right? But since we aren't burning off these calories in an intense fight, we are storing them as excess fat! There have been numerous studies published that correlates work stress with weight gain.

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HELPFUL HORMONES: Exercise releases endorphins, which help to limit perceptions of stress and give you a clearer view of what needs to be prioritized.

Many of us also use things like caffeine to help get us going, which increases the adrenaline mixing with our cortisol. And we may have some alcohol to help bring us down and help us sleep. You can see how this helps to contribute to the cycle.

Stress is exhausting… with the body and mind under this ready-to-go fight or flight reaction for a prolonged period of time, it understandably gets fatigued! But it also impacts your ability to get a good night of sleep. So, there’s this cycle of fatigue con- tributing to greater perceptions of stress  and that stress, in turn, contributing to fatigue.

When we’re tired, we also have greater perceptions of our pain. We tend to eat more food, and choose food that is less nutritious. We lose our desire to have sex, and maybe even socialize. Prolonged stress leads to a depletion of the body's defenses. Your immune system may not be as strong, and you may find yourself getting colds or flu more frequently. It may take longer to get better when you are sick. And if this continues, those repeated illnesses can lead to a compromised immune system and open you up to more significant diseases.

Now that we know more about how stress affects us, what can we do to better cope or manage the anxiety in our lives? Notice that the goal is not to decrease the stress in our lives! Because that's not likely going to happen, right? We have limited control over what is happening, so we have to focus on how we deal with it.

The great news is that there are some simple things you can do once you are aware that stress is affecting your body and maybe even your health. The great news is that there are some simple things you can do!

Regular exercise is the #1 way to manage stress! It is healthy, it is inexpensive, and there are a multitude of physical benefits! Studies have shown that as little as five minutes has anti-anxiety benefits. The body was made to move, so sitting in an office, at a computer or in a wheelchair for prolonged periods of time is not natural for us. Let's talk about how exercise helps the same systems that were being impacted by stress.

By using the muscles to do a task, the tension held in those static muscles will relax. This will allow for more blood flow and more oxygen. Also, by exercising, you will be counteracting the muscle imbalances that develop from sitting too much, which often lead to pain. Here is a very common example: because we spend so much time sitting, our hip flexors, the muscles on the front of the thighs, get short and tight. They attach to the lower spine, which is the area of least resistance when we move. These tight muscles pull on the lumbar spine and can cause back pain. Exercise will help to stretch out those tight muscles, as well as strengthen the core muscles that support the spine. Exercise help those rib cages expand and get more air into our lungs! It also helps get blood flowing faster through our vessels and, in turn, lowers our cholesterol and our blood pressure. Our hearts pump oxygenrich blood to all of our limbs, our organs, our brains, everywhere! It brings all those nutrients to keep everything healthy!

When we're at rest, our hearts are pumping about one gallon of blood per minute… when we exercise, that goes up to about four gallons per minute! You can see how much more vital oxygen is getting to our nerves and our muscles! And, most important, our brains! All that increased blood flow helps keep our memories sharp, and our processing speed quick. Did you know that the brain uses 20% of all the oxygen coming into our bodies?? Exercise releases endorphins, which are chemicals that naturally improve our mood. These will help to limit perceptions of stress, as well as give you a clearer view of what needs to be prioritized. It will also ward off feelings of anxiety and/or depression.

Another benefit is that exercise helps improve our sleep – both our ability to fall asleep as well as get a deeper sleep, so we feel more rested when we wake up. As mentioned before, when we're rested, we have lower perceptions of our pain, and of our stress!

What is the BEST exercise to help with stress management? Whatever you enjoy! An exercise regimen only works if you do it, and if you don't enjoy it, you won't stick with it. Try different activities and see what you enjoy. Don't wait! Get moving – even if only for 10 minutes! It will help manage your stress, and decrease depression and anxiety. •

THE FITNESS PRIORITY

Kristin McNealus, PT, DPT, ATP received her Masters in Physical Therapy from Boston University then went on to earn her Doctorate in Physical Therapy from MGH Institute of Health Professions. She has been a staff physical therapist on inpatient rehabilitation for people with spinal cord injuries at a number of hospitals in Southern California, as well as Director of a community adaptive gym for people with neurological injuries. She is a member of the International Network Spinal Cord Injury Physiotherapists, and has contributed to the APTA Guidelines for Exercising with a SCI. She has completed 3 marathons, and 25 triathlons, including the Ironman! SCI Total Fitness is designed to promote health and wellness for people with physical disabilities.