I was recently in the mountains with my family and our cabin was at 10,800' elevation. While I have recently started back on the journey to being more resilient I cannot say that I felt strong. Simply put the overall demands of altitude, sleep deprivation from kiddos, and schlepping around a 16 month or four-year-old at altitude taxed me a bit because my system has become unaccustomed to that amount of stress. Sadly I am not as resilient as I desire to be...yet. This got me thinking about stress and many of the folks who come to my clinic.
If I had one illustration I wish anyone I worked with already knew or solidly understood it would be the this one. Why you might ask. Well, simply because this illustration (though obviously oversimplified) provides an understandable framework for how our bodies cope. The beauty too is that it can be applied (not perfectly in all circumstances) to the whole body, at a system level, and to a more specific tissue level.
For folks who are afraid of graphs, think of the shaded area like your bank account (that might also be stressful but bare with me). In this metaphor your account balance is your ability to deal with stress (physical, emotional, relational, spiritual). This is also know as resilience, the ability to cope with stressors. As your account balance increases or decreases, your freedom to do things such as go on vacations, eat out, buy toys,
spend money on others, increases or decreases as well.
Importantly, as the balance decreases your ability to handle unforeseen hits, like a broken car or a large medical bill, is limited. Unfortunately most of us know how this feels and most of us know that feeling when things go below the dotted line. If you're like me you actually have some visceral discomfort at the thought of this scenario (hold on to that feeling because integrating it into this conversation is important). In my field, people come to me usually at the point of having crossed the dotted line. Their account balance has crossed into the negative and their body is letting them know. How their body lets them know depends on the person, how they process stress, and also on the tissues involved. Sometimes its pain. Sometimes its fatigue. Sometimes its irritability of the mood or bowels. Sometimes its all of them!
The main point is that bodies are complex and rarely are symptoms, even from something as simple as an ankle sprain, ONLY from the damaged tissues (if there are any). Old injuries seem to crop up out of nowhere and often when we are getting poor sleep, no exercise, fighting with family, eating garbage, work is stressful. Why is that? I would argue that usually its because we are trying write a check for which we don't have the money. This could be a person who has been less and less active for the past 20 years or an athlete who pushes beyond their trained limit. When everything is working well, our bodies have been so wonderfully designed and all our systems are so integrated that an unforeseen jolt in any one area will not put our account balance into the red. One system can accommodate for another.
So for the person who has recently been at the bottom of the curve or has been there for a long time the question is how do we increase our balance in the bank? The great news it is that just as there are multiple ways to decrease that balance there is often a veritable smorgasbord of ways to go about putting money in the metaphorical bank. Below are just a few of the proven ways to go about that for folks with pain.
Thank you ISPI!
The beauty of the human body is it is designed to adapt to demands. But when we're in the pit most of us forget this simple point and we need assistance with the what's and how's. For most acute injuries or for chronic pain, being about it and putting more in than you take out every day will gradually increase the balance.
Usually the first step is taking stock of the situation and figuring out what is decreasing the balance. Sometimes professionals are helpful here but often I find that most people know at least 2-3 things that are at least contributing. Then go about figuring out which of those factors are within your control to change or modify so that your trajectory is changed. I cannot think of one person who had no options available to them. Ask if you need help. Be hopeful and start with something small that will increase your resilience.
Resources:
- Aches and Pains by Louis Gifford, 2014
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