STRESS

Most of us would say we know what stress on our body is. We may not be able to describe it well with words all the time but we understand what it feels like.

In the Rehabilitation Sciences world, stress can be broadly described as any physical force applied to or produced by the body.

More generally, Stress can be considered a mental or emotional strain from an adverse or demanding situation (1). It may make one feel irritable or anxious and can also manifest as bodily sensations, such as headaches, nausea, a racing heartbeat, or sweating (1,2).

When you think about the term ‘stress’ it is common to think of something unpleasant but that doesn’t always cover it. Daily stressful experiences in or on our body can be assigned to one of these 3 categories:

• Productive stress, such as when we exercise (ie. building muscle through overload on the tissue) or learn something new (eg. studying for exams)

• Tolerable stress - produces physical, psychological, or emotional strain that is managed using our regular coping strategies (see below) to reduce our level of arousal back towards baseline in a timely manner

• Toxic stress, such as excessive force leading to physical injury or an overwhelming and emotionally abusive relationship

Due to a multitude of individual and situational factors, a similar stressful experience may be considered productive to one person and toxic to the next; this is why different people can experience a similar event differently (2). Your personal history with stress is a big factor in how you will handle future stress (ie. how resilient your are).

TRAUMA

Perhaps fewer people might say they could describe what being traumatized feels like but that doesn’t mean fewer people have been traumatized at some point in their life.

In Physiotherapy, the term ‘trauma’ is most often used to describe a sudden-onset physical injury, such as from a motor vehicle accident, athletic impact injury, or a fall in the garden. These ‘innocent traumas’ are ones we occasionally pick up as we go about living our lives. They can typically be well-managed using our regular coping mechanisms (see below).

However, Trauma is more commonly considered to be the challenging, current emotional response to having lived through, or vicariously experienced, one or multiple distressing events (3). Experiences that have lead to one becoming traumatized occur outside of their logical understanding of the world and often lead to confusion (eg. why did this happen to me?), feelings of overwhelm and hopelessness, and difficulty coping.

Both physical and mental/emotional traumas can cause similar signs and symptoms in our body, such as feelings of helplessness or fear, reduced sense of personal safety, increased bodily tensions, and difficulty regulating emotions or managing relationships (1,3). A traumatic reaction is instinctual and, importantly, is not the result of a ‘weak’ physical, mental, or emotional capacity (4).

Similar to stress, many variables affect whether an experience is perceived as traumatic, which is why similar events can affect different people differently (4). Some examples of variables include age, threat severity, degree of physical harm that could occur, possibility of escape, familiarity with coping with difficulties, and the cumulative effects of previous traumas.

NORMAL STRESS/TRAUMA RECOVERY

As the stressful/traumatic experience ends our body will attempt to deescalate the heightened fight-flight response (ie. sympathetic nervous system activation). Tension reduces in the muscles, hormones and other chemicals return to base levels, and we return to a more even balance between activating and calming nervous system activity. The Coping Strategies we use help with this.

WHAT ARE YOUR PERSONAL COPING STRATEGIES?

These vary depending on what you, as an individual, find helpful to calm your thoughts, emotions, and bodily tensions. What’s interesting is that we often instinctually gravitate towards our coping mechanisms to manage daily stressors and traumas. Some healthy examples include:

• spending time in nature

• taking a hot bath

• reading a book

• grounding, mindfulness, meditation

• seeking appropriate medical care

• spending time with friends/family

• exercising

*Side note: There are also less healthy coping strategies (eg. drinking, smoking, bottling up feelings, etc.) that can be employed but they aren’t typically promoted by health care providers.

POSSIBLE SIGNS AND SYMPTOMS OF UNRESOLVED STRESS OR TRAUMA (2)

• Irritability

• Exaggerated startle response

• Difficulty sleeping

• Lapses in memory

• Disturbing memories

• Flashbacks

• Difficulty concentrating

• Digestive complaints

• Inflexibility

• Physical body tension

• Chronic body aches

• Back, neck, and shoulder pain

• Daily function is impaired

• Detachment

• Avoidance

• Helplessness

Interestingly, many of these signs and symptoms relate to activation of the fight-flight response (ie. sympathetic nervous system dominance; check out my post on the Autonomic Nervous System for more on this).

If left unresolved, the body can remain in a persistent state of fight-flight and the cumulative load of one or more of these signs and symptoms can overwhelm our ability to regulate our mental, physical, and/or emotional excitability or activation (5).

Our regular coping strategies typically suffice to reduce the fight-flight activation/arousal in our nervous system from daily stress or traumas and promote calmness, grounding, and reduce the impacts of stress (2,4,5). However, after traumatic experiences or severe, prolonged, and/or repeated stress our regular coping strategies may not be enough to resolve the tension patterns (or other signs/symptoms) that can develop in our body. This, combined with possible conscious efforts to suppress the mental/emotional impacts of stress and trauma, may then lead to more persistent symptoms (2,4).

WRITER’S OPINION: Stress and trauma care by any Medical professional should include preparation for future times of stress/trauma in order to promote self-empowerment, resilience (ie. our capacity to tolerate future stressors and traumas) and reduce sole-dependency on others to feel better.

Want more ideas on how to manage the effects of stress and tension on the body? Reach out and make an appointment so we can work towards achieving your Physical Rehabilitation goals, together!

References

1. Mental Health Foundation. (last updated: 2021). Stress. Retrieved from: https://www.mentalhealth.org.uk/a-to-z/s/stress

2. Ronhovde, S. (2021). Module 1 and 2 lectures [powerpoint notes]. Retrieved from Global TRE® Certification Training.

3. CAMH. Trauma. Retrieved from: https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/trauma

4. Berceli, D. (2008). The revolutionary trauma release process: Transcend your toughest times. Namaste Publishing.

5. Berceli, D. (2015). Shake it off naturally. CreateSpace Independent Publishing Platform.

- Thanks for reading and keep looking for more posts in the future on other ‘hot topics’ in the world of Physiotherapy and Physical Rehabilitation!