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Reflexology and Pain Management – Part 1

Pain is a fact of life, it is a necessary part of being human.  Pain is a universal experience that serves the vital function of triggering avoidance. Pain is not a simple sensory experience, it can occur even in the absence of tissue damage. It involves emotional, social and cognitive beliefs. The four pillars of pain include

  1. Peripheral nervous system or the movement system
  2. Autonomic system, composing the sympathetic, parasympathetic, hormonal and visceral systems
  3. Central nervous system
  4. Psycho-emotional aspects, such as stress, anxiety, fear, social life and memory of pain.
Physiological pain acts as a warning of actual or potential tissue damage and is usually transient.  It may be accompanied by an increase in heart rate, blood pressure and temperature.  Physiological pain of pathological origin results from tissue damage.  Tissue damage causes the release of neurotransmitters into the bloodstream creating inflammation, which can produce redness, swelling, and heat and further enhance the pain experience.  The area may also be sensitised, stimulating further neurochemical output and resulting in an ongoing cycle of pain - referred to as chronic pain. A growing evidence base for reflexology in pain management.  It is not yet fully understood how reflexology helps manage pain, although current opinion suggests it works on the neurological system through the release of endogenous opioids*. So if you are in pain, why not book a reflexology treatment.   * Sources Stephenson NLN and JA Dalton (2003).  Using Reflexology for pain management; a review, Journal of Holistic Nursing 21(2) pg 179 - 191 Mackereth P (2005) An explanation of therapeutic outcomes of reflexology and relaxation interventions for people with multiple sclerosis, University of Mancherster  

Rethinking stress…

We all know that a little bit of stress helps motivate us but too much stress is bad for you, or is it?  Most people, including me, that write about chronic stress talk about the devastating impact on our mental or physical health. But a recent study has made me rethink how I look at stress. A study, Does the Perception that Stress Affects Health Matter? The Association with Health and Mortality (Keller et al, 2012) tracked 30000 adults in the USA for 8 years.  The researchers asked, “How much stress have you experienced in the past year?” They also asked, “Do you believe that stress is harmful for your health?” Then they waited to see who died by consulting public death records. No surprise, those who had experienced a lot of stress in the past year had a 43 percent increased risk of dying.  The big surprise to me, this finding was only true for the people who also believed that stress is harmful for your health. Not only that, people who experienced a lot of stress but did not think it was harmful had the lowest risk of dying, even lower than those who had very little stress.  So the belief that stress is harmful to your health seems to be more harmful than the stress itself! According to Dr Kelly McGonigal (a Stanford University Health Psychologist), this translates to more than 20,000 Americans a year dying not from stress, but from the belief that stress is bad for you, so she urges us to see stress as positive and introduces us to an unsung mechanism for stress reduction: reaching out to others. We all know the physical response to being under stress, heart pounding, breathing faster, breaking into a sweat. Normally we interpret these physical changes as anxiety or signs that we are not coping very well under pressure. “But what if you viewed them instead as your body was energized, preparing for you to meet this challenge?”  A Harvard study, Mind over Matter: Reappraising Arousal Improves Cardiovascular and Cognitive Responses to Stress,  (Jamieson et al, 2012) she cited validates this view. In the study, participants were taught to rethink their stress response as helpful (breathing faster, for instance, gets more oxygen to the brain) before they were exposed to a standard stress test (such as doing a math test in public). The participants sailed through the test. Get ready for the significant finding:  Ordinarily, when stressed, your heart rate goes up and your blood vessels constrict. Those in the study experienced pounding hearts, but their blood vessels stayed relaxed. According to Dr McGonigal, the response “actually looks a lot like what happens in moments of joy and courage". Dr McGonigal states that when oxytocin (you may know this as the cuddle hormone) is released as part of the stress response, our biology is nudging us to seek support instead of bottling everything up. The hormone also benefits the heart (which has oxytocin receptors). Accordingly, when you reach out to others (either to seek help or give support) your stress response becomes healthier and you recover faster. Thus, our stress response has its own secret weapon for resilience, which is human connection. One more study: Giving to Others and the Association Between Stress and Mortality (Poulin et al, 20013) tracked a thousand people over five years. Predictably, the ones who experienced recent major stressful events (such as financial difficulties) incurred a 30 percent increased risk of dying. But - surprise, surprise - those who spent time caring for others showed absolutely no increase in dying. Thus, says Dr McGonigal: The harmful effects of stress on your health are not inevitable. How you think and how you act can transform your experience of stress. When you choose to view your stress response as helpful, you create the biology of courage. And when you choose to connect with others under stress, you can create resilience. This made me think its time to rethink my beliefs around stress, may be its time for you to do the same? In addition, why not help yourself face life's challenges by trusting yourself and building a supportive network of friends, family and colleagues around you. See Kelly McGonigal: How to make stress your friend

Good news for the desk bound…

We have all heard about the target of walking about 10,000 steps per day which roughly equates to walking 5 miles per day.  Well many years ago when I worked long hours in IT some days, and lets be frank even some months, the possibility of me walking 10,000 steps per day was a pipe dream.  I would say this was especially true in the winter when the dark skies, cold, wind and rain didn't exactly entice me to go outside even though I love walking. Researchers in Trondenheim University in Norway have discovered that in heart patients after just 12 weeks of walking 3000 steps every day, the hearts pumping function improved which in turn improved their ability to exercise. They concluded that moderate continuous exercise, such as walking 3,000 steps or 1.5 miles in 30 minutes had as much benefit on the heart as more vigorous, intensive exercising.  Moderate walking decreased the strain on the heart, improved heart muscle function, improved blood vessel dilatation, helped form new blood vessels and lowered blood pressure. On average a sedentary person completes between 1,000 to 3,000 steps per day.  Which is good news for the desk bound as you can now aim for 3,000 continuous steps which is much easier to achieve than 10,000! Reference http://circ.ahajournals.org/content/early/2017/01/19/CIRCULATIONAHA.116.022924  

A potential alternative to antibiotics

I am sure you are aware of the current level concern about the rise of antibiotics resistance and the need to find new antibiotics or alternatives.  So I read with interest that a traditional indian herb is being studied by scientists as an alternative to antibiotics. The herb, andrographis, which is known at the "king of the bitters" grows in India and Sri Lanka.  It is thought to be responsible for combatting the Spanish flu epidemic that reached the Indian subcontinent in 1919. Researchers from the University of Southampton in the UK have recruited 20 primary care facilities to participate in a trail, which will be using andrograhpis supplements.  It will be tested as a natural remedy against colds and flu - and treating these commong problems like these with antibiotics is bringing the era of drug-resistant superbugs closer to reality. Its a placebo-controlled study - which means patients could be given the real herb or a fake version -  that will look at the herb's ability to treat acute coughs, sore throats and sinusitis. The study could lead the way for a larger study involving more patients with acute respiratory infections.  

More on building your resiliance

Following on from last week’s entry on building resilience, it is important to state that resilience don’t just help you manage stress but it fosters inner strength to help you meet goals, life challenges and achieve success. Most of my clients hold more or less physical tension which I would like you to think of as a bad habit that relaxation will help you break.  Relaxation is like changing the idling speed on a car.  When a car turns over too quickly, wasting expensive fuel and putting a strain on the engine, the mechanic can reset the idling speed to a much lower level.  Similarly when busyness, concerns, time pressure have speeded us up too much, making us tense and irritable, we can learn how to let go and attain a much calmer state of being.  So taking the time to learn what relaxes you! It is worth re-emphasising the point that it is possible to make an enormous difference to your state of mind through yoga, tai chi, relaxation and meditation and all other sorts of physical exercise. While most of celebrate our wins, it is also important to celebrate when we do good for others, as often other’s don’t notice.  We all know life has its ups and downs, when your life is in turmoil, you may not do things "perfectly".  Rather than worrying or simply surviving turmoil, why not ask what you can learn from the situation.  But don’t beat yourself up, remember you always do your best, when you know better, you do better! One habit that I try to cultivate to help put a smile on my face especially when I am feeling down is to cultivate a gratitude attitude.  However bad my day goes, before I got to sleep I try to think of three things that I am grateful for.   These don’t need to be big things; it can be as simple as “I am grateful that the transport system ran on time” as I had a busy day.  A gratitude attitude helps foster joy, fulfilment & peace of mind.

Pro’s and Con’s of our Shoulder Joint Design

While sometimes it may not feel like it, your shoulders are the most flexible joint in your body.  The joint is formed by the union of the humerus, scapula (or shoulder blade) and the clavicle (or collarbone).  While we normally think of it as a single joint, it is actually three joints

  1. glenohumeral joint
  2. sternoclavicular joint
  3. acromioclavicular joint.
These three joints work together to allow the arm both to circumduct in a large circle and to rotate around its axis at the shoulder.  As with most joints it is stabilised by ligaments.  However the shoulder joint is unique in that it is strengthened posteriorly and superiorly by the rotator cuff muscles, which act as "active and relaxable ligaments".  Unlike most joints which have a high degree of passive stability the shoulder joint depends largely on the active stability of the rotator cuff muscles. As soon as you move your arm joint stability is provided by the rotator cuff muscles alone.  The muscular action of the joint is more complex to move the joint in numerous directions. This design of the shoulder joint makes it the most flexible joint giving us a high degree of mobility & power.  This great range of movement comes at the cost of reduced stability.  A key benefit of the design is it does reduce the risk of arthritis in the shoulder when compared to other joints. Given the additional importance of muscles in shoulder's design when in the gym, it is important to:
  • Work all joint articulations - if it moves that way, strengthen it.
  • If you do a pushing exercise, counter it with a pulling exercise.
  • Always use proper exercise form - control the resistance.
And don't neglect the smaller stabilizing shoulder muscles that make up the rotator cuff. Spend time fortifying them via internal and external rotation exercises with the upper arm at various positions.

Is reflexology or massage better at reducing stress or pain?

While amongst my clients there is a clear preference for massage, I decided to investigate if there was any scientific evidence if massage was better than reflexology (or vice versa) at reducing pain and stress. In 2012 there was a small study comparing massage to reflexology on cancer survivors over the age of 75 living in a care home.  The study compared the effectiveness of 20 minutes of reflexology treatments against 20 minute Swedish massage by examining the impact on the patients stress levels, pain levels and mood.  Pre and post treatment levels of salivary cortisol, observed affect and pain were compared. Both reflexology and Swedish massage resulted in significant declines in salivary cortisol indicating a reduction in stress levels, reduced pain levels and improvements in mood.        So to go back to my original question, there is scientific evidence for both and I suggest you book the treatment you prefer. Hodgson N, Lafferty D (2012) Reflexology versus Swedish Massage to Reduce Physiologic Stress and Pain and Improve Mood in Nursing Home Residents with Cancer: A Pilot Trial. Evidence Based Complement Alternat Med. 2:456897               

Do you know how to protect yourself from a leading cause of disability?

The injury to a brian caused by stroke can lead to problems with talking, seeing, thinking, remembering, moving, eating, swallowing and more.  It's no wonder stroke is a leading cause of disability in adults worldwide. Here are some lifestyle tips to cut the risk of suffering a stroke:

  1. Eat at least 3 to 5 services of fruit and vegatables a day - the more the better.
  2. Exercise most days of the week.  Brisk walking for an hour a day five days a week can cut the risk of a stroke in half.
  3. Maintain a health weight, and especially watch out for abdominal fat.
  4. Limit alchol to no more than two drinks per day if you drink.
  5. Eat more grains such as oats, quinoa and brown rice.
  6. Eat more sources of good fats such as fatty fish, walnuts, flaxseed and chia seeds.
  7. Destress - psychological stress is a known risk factor for stroke.
References https://www.ncbi.nlm.nih.gov/pubmed/27375141 https://www.ncbi.nlm.nih.gov/pubmed/16443039 https://www.ncbi.nlm.nih.gov/pubmed/9756580 https://www.ncbi.nlm.nih.gov/pubmed/17620537 https://www.ncbi.nlm.nih.gov/pubmed/9892451 https://jamanetwork.com/journals/jama/fullarticle/193111 https://jamanetwork.com/journals/jama/fullarticle/195646 https://www.ncbi.nlm.nih.gov/pubmed/26563170

Arm and Hand Stretches

These stretches can either be done as a complete series or individually and most of them can be done at your desk.  Some will ease tension in specific parts of the body whilst others are generally relaxing.  Please remember stretching should always be relaxing and never painful! To get maximum benefit from these stretches you should do them daily and hold each stretch for 15 seconds and repeat twice unless otherwise stated. Arm and Hand Stretches

  • Stand with your feet together, keeping you feet together and your knees soft.  Raise your arms alternatively swinging them over your head as if you were performing backstroke.
  • Raise your left arm above your head and push up as high as you can.  Feel the stretch down the left side of the body.  Hold for 30 seconds.  Repeat on the right.
  • Raise your right arm to the side, keeping at shoulder height.  Point your fingers towards the ceiling and push your palm away from your body.  Hold for 30 seconds and repeat on left side.
  • With your right hand by your side, point your fingers behind you with your palm facing up.  Push your right shoulder and wrist towards the floor, then make a fist.  Hold.  Repeat on the other side.
  • Keep your arms by your side and clench your fists as tight as you can, then spread your thumb and fingers as far apart as possible.
  • Let your arms hang loosely by your side and shake them for about 15 seconds.
 
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