Features Practice Technique
Understanding Stress – Part 1

When we know better, we do better. – Maya Angelou

If you are a manual therapist of any denomination, your hands have touched it – stress. Tissues so tightly wound and densely compressed that you pause for a moment and contemplate . . . is this bone or is this flesh? There is an old saying that goes: “There are only two things in life that are certain, death and paying taxes.” By the looks of it, we need to add a third – experiencing stress. Although some stressors may be obvious and some avoidable, it would be virtually impossible to eliminate all potential stress triggers from our lives. Whether you are human, cat, dog or mouse – experiencing stress is simply a part of life. Although not all stress is harmful, it’s estimated that somewhere between 75 and 90 per cent of doctors’ visits are for conditions that are stress-related. It is probably not much of a stretch to apply this statistic to massage therapy visits!

Because stress is such a highly subjective and complex cornucopia, in terms of the variety of its triggers, perceptions, responses and impacts on the body’s systems, it can be pervasive and difficult to manage effectively.

However, as previously noted, response does have its time and place – like when we need to run fast or leap far to avoid some calamity. However, when the imminent danger is – or seems – unavoidable, or is continuous or non-productive, then one can be adversely impacted rather than assisted by the stress response.

Cultivating a better understanding of what stress is, its potential stress triggers and how our bodies respond to stress will improve our ability to support our body and being in ways that fortify our resilience, health and well-being; alter stress-inducing situations and behaviours; implement strategies that help us manage “unavoidable” stress more effectively; and reduce the adverse impact of prolonged stress response on our health and well-being.

And thus . . . when we know better, we improve our potential to do better!

WHAT IS STRESS/A STRESSOR?
In 1936, Hans Selye coined the word “stress” and defined it as; “…the non-specific response of the body to any demand for change”.¹

A stressor is defined as an event or perception that triggers the stress response.

WHAT ARE SOME COMMON STRESS TRIGGERS?
Common stressors, or stress triggers are:

• environmental elements (e.g., elevated sound levels, over-illumination, overcrowding, and/or an unsafe home, school or work environment);
• daily events (e.g., family, school or work responsibilities, personal conflict with family members, peers or co-workers, dealing with traffic);
• significant life changes (e.g., bereavement, relationship dynamics, health-related issues, job loss).

Prolonged or repeated stress responses can be triggered by physical threats, emotional distress and/or psychological triggers that are either current, perceived or remembered.

Like musculoskeletal injury, a stress trigger can occur as an acute episode or chronic syndrome. Therefore, stress response can occur as a short-lived episode, or as an insidious undercurrent that is known to have a detrimental impact on one’s health and well-being.

HOW DO WE RESPOND TO STRESS?

Tend and befriend
There exists a vast array of potential stress responses. In any given circumstance one may run like crazy, fight when cornered, stand perfectly still so as not to be seen or gather with others – i.e., the “safety in numbers” paradigm.

“Tend and befriend” refers to coping with stress through social or group support (i.e., befriending) and providing or receiving protection, nurturing or emotional support (i.e., tending to others or being tended to).

Social isolation significantly enhances risk of mortality, whereas securing social support results in beneficial health outcomes, including reduced risk of illness and death.²

Fight or flight (flee)
Fight or flight is mediated by the sympathetic nervous system (SNS) and is recognized as the initial stage of stress response adaptation.

Fight may manifest not only as a physical exchange but also as vocally aggressive or argumentative behaviour.
Flight can occur as escaping in either a sensory way (e.g., social withdrawal, substance abuse or television viewing³) or a physical way (e.g., running away from something perceived as threatening or towards something that is needed or feels safe).

GENERAL ADAPTATION SYNDROME
Selye went on to describe the universal response to a stressor as the General Adaptation Syndrome (GAS). GAS comprises three stages:

The first stage is alarm – Governed by the SNS, alarm results in the production of adrenalin, which is the fuel for the fight-or-flight response. There is also some activation of the hypothalamic-pituitary-adrenal (HPA) axis, producing cortisol.
The second stage is resistance; if the stressor persists, then eventually some means of coping with the stress becomes necessary. Prolonged and continuous adaptation (coping) will eventually deplete the body’s resources.
The third stage is exhaustion. Once the body’s resources have been depleted, normal functioning breaks down. If stage three is extended (i.e., prolonged SNS predominance) long-term damage may result.^4,5

Once activated, the SNS sparks a cascade of physiological events. SNS predominance will suppress or alter any function that is governed by the parasympathetic nervous system (PNS).

A fundamental function of the PNS is to govern homeostasis. Any system or physiological function that is generally the domain of the PNS will be impacted when the SNS takes the helm.

PROLONGED STRESS RESPONSE
Prolonged stress response (triggering continuous SNS predominance) has been shown to suppress the immune system, disturb diurnal rhythm, stimulate or sustain obesity, adversely impact the body’s pH balance and increase the incidence of chronic myofascial tension – to list but a few potential health risks!

Research shows that the human body more readily succumbs to illness and disease when pH is unbalanced and mineral reserves are depleted. Constructive enzymes can become destructive. Oxygen delivery to cells can be diminished.

Stress and cancer
According to Nobel laureate Dr. Otto Warbur: “When pH is off, and our bodies are running more acidic, our cells are getting less oxygen. Cancer thrives in an acid tissue pH/oxygen deficient environment.”

Stress and the cardiovascular system
In an acidic environment, fatty acids (circulating in our bloodstream) switch from a negative electro-magnetic charge to positive and automatically are attracted to, and stick to, negatively charged, arterial walls (i.e., athlersclerosis).⁶ Prolonged acidic pH has also been shown to play a role in degeneration of the internal arterial walls.

Stress and the myofascial system
Psychological distress or anxiety has clearly been identified as a source of “unnecessary” muscular tension. “Unnecessary” muscle tension is defined as the confusing intermediate between a non-voluntary muscle contraction (spasm) and viscoelastic tension (a fascial property) showing no EMG activity.⁷

According to Dr. Leon Chaitow, “… the shortened fibers of the soft tissues may be the result of a combination of structural anomalies, trauma, and/or physical or emotional stress, and are always influenced by underlying nutritional and behavioral elements. Some of these shortened fibers and tender spots (i.e. trigger points) may be the source of reflex symptoms and pain. All such soft tissue dysfunctions respond to manual pressure in the form of modalities like – massage therapy.”⁸

Clearly, massage therapy fulfils a number of the strategies for stress support (e.g., tend and befriend, providing a safe and calming environment) and is a means by which to reduce the adverse impact of prolonged stress response on the soft tissues. As you are probably thinking – all that stress talk just to “plug” the virtues of massage therapy? Well . . . yes!

In Part 2 of this article – an interview with Dr. Leon Chaitow – we will look at stress, breath and pH. Dr. Chaitow will expand on the impact of pH imbalance on the soft tissues.

REFERENCES

1. www.stress.org/topic-definition-stress.htm.Stress, Definition of Stress, Stressor, What is Stress?, Eustress? Retrieved from www.stress.org on December 10, 2006.
2. Cohen, S., Willis, T.A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310-357.
3. Friedman, H.S., and Silver, R.C. (Eds.) (2007). Foundations of Health Psychology. New York: Oxford University Press.
4. Selye, Hans: “A syndrome produced by diverse nocuous agents” (1936). Nature 138. “Selye Biologic Reaction to Stress chart”.
5. Poesnecker, G. Chronic Fatigue Unmasked (1999); ISBN 0916285618.
6. Philpott, W. Heart disease is really a function of heart muscle acidosis. “Biomagnetic Handbook.”
7. Simon, D. G. and Mense, S. Understanding and Measurement of muscle tonus as related to clinical muscle pain.” Fascia Research, Basic Science and Implications for Conventional and Complementary Health Care. Elsevier (2007).
8. Chaitow, L. ND, DO. Soft tissue manipulation: diagnostic and therapeutic potential. Retreived from, www.leonchaitow.com on March 10, 2007.

ADDITIONAL REFERENCES

• www.leonchaitow.com
• Fascia Research, Basic Science and Implications for Conventional and Complementary Health Care. Elsevier (2007)
• www.biomedex.com
• www.wikipedia.org
• www.webmed.com
• www.mayoclinic.com

Cathy Ryan has maintained a diverse, treatment-oriented massage therapy practice, and an extensive postgraduate training roster, since 1990. She is a long-standing member of the OMTA and has served as a subject matter expert, examiner and examiner trainer at the CMTO’s provincial licensing examinations. Ryan is the managing and commissioning editor for TouchU.ca, which provides education for touch professionals, students and the public. She is available to teach workshops and can be reached at: cryanrmt@gmail.com or www.touchu.ca .