We are nearing the two-year mark of a global pandemic and while there is a light at the end of the tunnel, it is faint. Countries are still contemplating lockdowns, vaccine rates remain below desired levels, and masks are still the norm.
All of this leads to increased levels of stress.
We have plenty of sources of stress without a pandemic adding fuel to the fire. Our jobs, family life, politics, and sports (I can attest as a Dolphins fan) all impact our stress levels to varying degrees, and that stress impacts the health of our bodies.
This impact can be seen in the long-term, with epidemiologic studies showing….
It can also be seen in the short-term, with impaired healing, recovery from exercise, and increased susceptibility to pain. Before continuing, I’d like to assure you the goal of this article is not to add to your stress. I’m not here to explain, with research, that everyone living in this pandemic-world is doomed to high levels of stress and poor health. Instead, I will show the specific effects of stress — with various examples of how it can manifest — followed by strategies to reduce your stress.
These strategies are research-backed and implemented in many professional settings. As a physical therapist, I have used them in the clinic and thought them to my students. As a parent of two toddlers, I have used them personally with success.
Lastly, knowing what drives stress and the potential consequences can alert you when you may need to make lifestyle adjustments, such as implementing a deload week in your workout plan.
So, let’s dive in.
There is a reason stress is referred to as the silent killer. Stress does more than deteriorate health over a long period of time, however. It has an immediate effect on our ability to heal. But hope is not lost.
There are many research-backed strategies that can be employed to address these effects. They aren’t just theoretical. I have seen them work well in my clinics.
The relationship between stress and our health
As a physical therapist, I assess stress levels with each patient. Without it, my timelines for recovery would be marginal guesses at best. The road to recovery for any type of injury becomes a steeper climb as stress piles on.
Studies assessing wound healing models and outcomes show there is an average correlation of 0.42 between psychological stress and wound healing. That value is a moderate correlation, indicating a relationship is present.
So what does this mean for you?
Recovery for exercise and strenuous activity, such as a heavy manual labor job, is impaired by stress. If you are plateauing in the gym, struggling to recover between workouts, or dragging at work, stress may be the culprit.
If you suffer any type of injury — an ankle sprain while hiking, a hamstring strain while playing softball intramurals, or whiplash from an auto accident — stress will delay your recovery time. The standard recovery times you find online — 3 days to 6 weeks for sprains and strains depending on the severity and grade rating — are averages. They also relate to ideal healing environments.
Individual characteristics such as age, gender, comorbidities, cardiovascular fitness, nutritional status, injury history, sleep hygiene, recovery expectations, and psychological stress all affect healing time.
Psychological stress comes in many forms, all of which can delay wound healing. People with depressive symptoms are 3.6 times more likely to experience delayed wound healing relative to controls. During examination week, dental students took 40% longer to heal from an experimental wound than when they were on vacation. Even stressful careers, such as being a caregiver, can delay wound healing by 24%.
Delayed healing is not the only concern when dealing with stress.
Stress has a strong relationship with how we experience pain, too.
We know pain is a biopsychosocial phenomenon — every time. All pain is influenced by emotions and the context of your situation. It’s inescapable.
When stress levels rise, your sensitivity to pain rises with it. Take COVID, one of the primary drivers of stress the past two years, as an example.
This study in 295 college students found the compounding stress of college life with new COVID restrictions increased their stress levels and prevalence of neck pain. It’s not the frequency of sitting or posture — research is clear there is no ideal posture and posture is a poor predictor of pain or injury — as they were already sitting frequently as college students, rather, it was the added stress of lockdowns.
Lockdowns inhibit socialization. Now, I am not here to debate the merits of lockdowns and other strategies to combat the pandemic (just follow the science and scientists who know a hell of a lot more than any reporter or blogger — no cherry-picking either), I am here to discuss why stress can’t be ignored when it comes to the health of our bodies.
As you can see, stress impairs our ability to heal and it increases our sensitivity to pain, a brutal combination. As a population, we already struggle with meeting activity guidelines. With an increased susceptibility to experiencing pain and blunted recovery response, the barrier list to exercise only lengthens when stress is added to the equation.
How to use this information
You can approach the information on two fronts. The first is acknowledging the delay the current situation will cause. If you are injured, plan accordingly with your doctor and physical therapist. Develop realistic expectations.
Second, address the risk factors you can modify. There are many activities and strategies you can use to modify stress. Pursue the strategies that work best for you.
For example, positive behaviors related to social support have been shown to improve wound repair. One study demonstrated self-disclosure, acceptance of a partner, relationship-enhancing statements, and humor within a marriage lead to faster wound healing compared to people in marriages that lack those positive behaviors.
Research shows a lack of exercise can slow would healing rates. Conversely, regular physical exercise can both reduce psychological stress and reverse its negative impacts, improving cardiovascular function, reducing depression and anxiety, and providing a means of social support.
Exercise is challenging, however, and many barriers exist for some people, including time restraints and lack of equipment. Fortunately, you don’t need much exercise to see health benefits. You can build strength through “exercise snacks” throughout the day.
You don’t have to perform formal “exercise” to see health benefits either. If you enjoy yard work, gardening, dancing, or other forms of physical activity, those can be outstanding methods to reduce stress. Walking has been shown repeatedly to provide tremendous health benefits — physically, socially, and psychologically.
In addition to physical activity, meditation is a powerful tool for reducing stress and improving our mood. I’ll admit, I have been hit or miss with meditation, but when I use it regularly, I find benefit.
Stretching is a hybrid of meditation and physical activity and may be a good option for you. Stretching won’t reduce injury risk, but it can be relaxing and reduce pain in the short term. Increase the challenge by implementing yoga, and you will gain additional musculoskeletal and neurologic health benefits.
Another version of stress reduction and self-care that has been critical for me is reading. Reading allows me to unwind and step away from the stress and business of the world. While I love reading non-fiction, as it is a great way to expand my perspective and learn a variety of topics (I read about business, psychology, history, etc. — gradually fewer self-help each year), reading fiction is one of the best things you can do for self-care.
Research shows that reading fiction is one of the best ways to expand your creativity. Reading fiction improves your ability to empathize with and understand the thoughts and feelings of the people you interact with — important qualities for content creators. The same benefits are not found in people who primarily read non-fiction.
“Imagination is more important than knowledge. Knowledge is limited. Imagination encircles the world.” — Albert Einstein
Reading fiction expands your perspective and creativity by stimulating new experiences. Research shows reading fiction helps people “experience realities outside of the ‘here-and-now’, including hypothetical events, distant worlds, and other people’s subjective experience.” This helps us step away from the stresses we deal with and teaches us new ways to manage stress.
I love High Fantasy and Space Operas, with Steven Erikson’s Malazan Book of the Fallen series and the Expeditionary Force Series at the top of my lists.
Finding the right source of stress relief and a plan for consistent physical activity for you is vital, as other common cop behaviors are often sought, and, unfortunately, these exacerbate the problem by creating a compound effect.
It is common for people experiencing high levels of stress to turn to alcohol, tobacco, and comfort foods while reducing positive health behaviors such as exercise. Heavy alcohol use and smoking delay cell migration and collagen deposition — two vital processes to begin healing and repair of injuries. Poor sleep impeded growth hormone production, which is needed to stimulate the growth of new tissue.
There is no one-size-fits-all approach to handling stress, but there are many options. The key is to take a long-term approach, not seek short-term “fixes” repeatedly.
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