relax – Essential Physical Therapy

If you know me, you know I love to look at research studies. Sure, they have their limitations, but it’s really cool to see things we intuitively know are good for us proven under the scrutiny of the scientific method!

Take, for example, a recent review of the literature that studies the role of a positive outlook on pain. This study is from the Clinical Psychological Society in the Netherlands.

They found that a positive outlook significantly reduces pain, and reduces sensitivity to painful events.

For people with chronic pain or other painful conditions, they found that positivity can also optimize the effectiveness of other treatments.

Wow! That is pretty amazing. But if you’re anything like me, you’re thinking,

“Well, it’s pretty hard to be happy-go-lucky when you’re in pain! How am I supposed to do that?”

This is especially true if you have chronic pain that you’ve been dealing with for a long time. It’s hard to not let that get you down, and understandably so.

So how can we use this research to make change in our pain and our lives?

My prescription for you is this:

decide, right now, that you are your own first priority.

Yup, that’s right. Before you start thinking of reasons to put yourself second (or third, or fourth…or last), consider this:

When you get on a plane, don’t they tell you to put your own oxygen mask on before helping other people? That’s because you’re not much good to anyone if you’re passed out in the aisle!

Taking care of yourself is like putting your oxygen mask on. You need to be okay before you can be there for other people in a meaningful way. Otherwise, you will end up resentful to those you intended to help, and/or you will burn out. If you REALLY want to be there for the people you love and the causes you care about, you MUST take care of yourself first.

There are so many simple, quick and effective ways to reduce your levels of daily stress, and thereby improve your mood and your outlook.

Some of the things you can do to boost your mood are quick reminders that you can include easily in your day on the fly, and others you have to plan for. Let’s take a look at both.

On the Fly Mood Boosters

I’m gonna give you some daily, stress-busting reminders to try.

Your job is to pick one or two that you can really do over the next week.

Write the one you pick on a post-it and stick it on a mirror, the refrigerator, your desk, or anywhere else you know you’ll see it a lot. You can even post reminders in more than just one place!

After a week, take a moment to notice if anything has shifted in you since you started this practice.

You might keep up with it as it is, change your reminder, or just modify yours a little. It’s your daily ritual, make it how you like it!

List of Reminders For Your Post-It:

“Breathe” (long slow inhales, longer slower exhales)
Be willing to not have all the answers.
When you’re feeling stressed, ask yourself, “what is the most important thing right now?”
Pick a different energy- whimsy, joy, playfulness, or one of your own choosing- and call it into your mind and heart.
Remove extra minor stressors when you find them (e.g. driving just a little too fast…it’s weirdly stressful!).
Be willing to ask for help when you need it.
If you’re pushing yourself to complete a self-imposed task, ask yourself, “will this matter in a year?”
Take several slow, deep breaths before each meal.
Remind yourself to “slow down” more often.
Pretend that you’re at your “vacation job” or your “vacation home,” or in your “vacation car.” How would you act differently if this was exactly what you wanted to be doing, where you wanted to be? If you CHOSE this?

Plan Your Relaxation Time

While it’s good to have little reminders in the day, nothing can match the power of actually scheduling time in your day to do something to take care of you. And, for most of us, if you don’t schedule it in your calendar, it won’t get done.

So grab your favorite pen, your planner, and block out some time for yummy self care!

Here are some ideas you can choose from, or you can come up with your own self soothing experience 🙂

Planned Ways to Reduce Stress

Practice this Active Rest Pose for 5 minutes, a few days a week.
Practice self empathy for a few minutes, especially if you are feeling down.
Take a nap!
Go for a walk outside. If possible, try not to look at your phone (or not bring it if you can!).
Buy yourself some flowers.
Leave early for an appointment and enjoy the journey getting there.
Go for a walk with your dog or child, and let them lead the way. Stop where they stop, notice if you feel impatient, and let them teach you how to slow down and savor the moment.
Use all your paid time off!
Read a book (that’s not related to work or self-improvement!)
Eat your lunch outside, and JUST eat. (try not to look at your phone, read, or listen to something).
Plan a “frump day” where you stay home all day in your comfy, frumpy clothes and do whatever you feel like. Watch movies, do some stretching, bake some cookies, take a bath.
Write a handwritten letter to someone you care for and haven’t seen in a while. Use special stationary that you like.
Lie on the couch for a few minutes. Not to listen to a podcast, sleep, or text. Just be there.
Take a 5 minute stretch break at work- make sure you’re breathing!

Not all of these may appeal to you, but I’m sure some of them do! Incorporating some spontaneous and some planned relaxation into your day can make a huge difference in your outlook, your pain, and your overall experience of life.

After all, what’s the point of all this if you’re not enjoying some of it along the way, right?

Keep taking care of yourself, and the world will reward you.

May you find ease in your body! I’ll be there rooting for you the whole way.

– Dr. Derya

It was my second year of physical therapy school, and I was sitting in the white and beige lecture hall. The room emulated the newness and grandeur of the medical campus, but lacked character or color. The course title, “Musculoskeletal 101,” was stamped in the top right of the slides, and today’s topic was Managing Dysfunction of the Cervical Spine. I was bent awkwardly over my desk, furiously taking notes when I had to take a break because my neck was just killing me.

The irony of this was not lost on me.

Even though in physical therapy school I was learning about all the cool ways to crack joints and push and pull on muscles, the tension in my neck was inescapable. I was seeing a physical therapist myself, who would stick needles in my ropey neck tissue, and I was spending my precious study time rolling all around on tennis balls and stretching in all the right directions to “loosen up” my neck. While these things helped for a short while (and some not at all)

I couldn’t help wondering if there was another reason I was getting so tense.

Did I mention that physical therapy school is one of the most stressful things I have ever done in my life? Long commutes, sleep deprivation, assignments that took longer than the hours I had to finish them, projects and social dynamics, constant testing, hours of note taking, clinical rotations with high expectations… you get the picture. I don’t regret any of it, it was an invaluable experience. But I DO regret not having the tools to help me manage my stress levels, because it was taking a huge toll on my body.

Why Do We Get Tense?

We tense our bodies as a way to protect ourselves. It just so happens that high stress levels cause your body to perceive threat and therefore seek protection. Another reason we get tense in our necks, lower backs and hips is to hold ourselves up when our core is not functioning well. Guess what? Stress triggers us to shunt blood away from our core and to our arms and legs (because if there’s a threat, you better be ready to run!)

This is what I call the stress-tension one-two punch.

It’s the double whammy that stress has on causing tension in our bodies. The first blow is the initial tension you get directly from the stress hormones in your body that are readying you to fight or flee. The second comes from the compensatory way your body carries itself when in a stress state.

Hold on a sec! My stressful scenario wasn’t one where I had to fight or flee, I was just bent over my computer hacking away at a keyboard like a madwoman on a diet of coffee and energy bars. Why would my body have to ready itself for anything?

Tension and Stress

The thing is that your body doesn’t know the difference between the stress of being chased by a mountain lion or the stress of your boss adding an extra pile of work to your already overflowing inbox.

Stress is stress! The same hormones are released, and the same responses occur.

Our systems to manage stress are a primal instinct, present since we were “wild humans,” if you will, and the threat of having to fight or flee for your life was a more common occurrence. The steady drip of minor stressors (emails, traffic, alarm clocks, board meetings) did not even exist yet.

We are designed to manage a stressor that is an immediate threat – it is something that we deal with and then it’s over.

You either get away from the saber toothed tiger chasing you down, or you kill it, or you die. Done. Your system takes a few minutes to an hour to return to relaxed muscles, deeper breathing, and an active core. You can rest, digest, and hold yourself up properly.

When we have that steady drip of stress, however, our body doesn’t know how to get back to that baseline “rest and digest” state anymore.

We’re constantly juiced with stress hormones that make our body tense, despite how many physical therapists or chiropractors poke our muscles or push on our backs. To get rid of that tension, we have to get to the source.

We have to help our nervous system relax.

A Nervous System Reset

Even though we can’t always change the world around us, we can certainly change ourselves. You may not be able to change your work situation, your commute, or your other stressors.

But you CAN take small actions that reprogram your nervous system to quickly get back to that place of calm, and by doing so let go of tension in your body.

There are lots of ways to reset your nervous system. Below are three of my favorites because they are:

Easy to do
Fast
Effective

One way is by balancing the right and left sides of the body with your breath.

Balancing Breath:

sit comfortably. Bring your right hand index and middle fingers down, leaving the right thumb, ring and small fingers up (see video below if this is tricky for you!)
Cover your right nostril with your thumb, and exhale completely through your left nostril.
Pause for a 4 count, then inhale through your left nostril.
Cover your left nostril with your ring finger, pause for a 4 count, then exhale completely through the right nostril.
Pause for a 4 count, then inhale through the right nostril.
Pause for a 4 count, then cover the right nostril with your right thumb and exhale completely through the left nostril.
Continue with this sequence for about 6 breath cycles. Then rest.
Do this 1-2x/day.

https://youtu.be/c6ay8f6bJHk

Alternate Nostril Breath: a simple way to balance the body

Notice how you feel before and after doing this exercise. With some practice you can do this quickly and easily to help your body relax and release tension.

Cupping the Eyes

Did you know that how you see the world affects how tense your body gets? No wonder most people who work at a computer all day develop back or neck pain (or both)!

By letting our eyes relax, our nervous system gets an immediate signal that we are safe, and our bodies relax as a result.

Here’s how to do it:

Lean your elbows on a desk or table. Place your head in your hands so that the perimeter of your palm rests on the orbit (boney part around the eye). You don’t want any pressure directly on your eye.
Close your eyes, and stare into the darkness behind your eyes.
Try to make your field of vision very wide, like you are trying to take in as much of the view behind your eyes as possible.
Notice the gradations of light behind your eyelids. You will notice that it is not all black, but rather that there are different grades of blackness and lightness.
Focus on the darkest areas, see if they get bigger.
Tip: if you don’t notice any different gradation of blackness, just keep focusing on the wide view behind your eyelids.
Stay for 2-5 minutes, then come back by lifting your head and slowly opening your eyes.
Do this 1-2x/day.

How to do it: Cupping the Eyes to Help your Body Relax

Notice how you feel after. Try to connect with and remember in that feeling of relaxation in your body.

Breathe!

When we are stressed, our breathing becomes shallow and rapid. Chances are, if you’ve been stressed for a while, you haven’t taken a full breath in a looooong time. And when I say a full breath, I don’t mean getting a lot of air in, I mean getting air OUT!

That’s right, when we are breathing shallowly, it’s the lack of complete exhales that prevents us from getting new, oxygen rich air to our brain and other tissues. If you can’t get the old stuff out, you can’t make space for something new (that’s a good metaphor for life, too)!

Here’s how to do it:

Sit comfortably.
Place one hand on your lower front ribs.
Inhale quietly through your nose.
Exhale completely through your mouth, making an “ahhhhh” sound.
Pause 1-3 seconds at the bottom of your exhale before inhaling again quietly through your nose.
Repeat 4 breaths. Rest and repeat 4 more cycles of 4 breaths.
Do this 1-2x/day.

Like I said, I wish I had known these ways to de-stress when I was in physical therapy school. I knew stress mattered, but I didn’t realize the incredible impact it was having on my body!

I hope this article prevents you from having to endure chronic tension in your body, and from having to constantly seek ways to release tension. If you can find the wellspring of calm and ease within, the body will follow.

Tag: relax

Reduce Pain by Changing Your Outlook