You NEED to be Focusing on your Four Pillars
Let’s swing for the fences right away and answer the question you are all silently asking…
“What are the four pillars?”
In no particular order:
Sleep
Nutrition
Physical Activity/Exercise
Decreasing Stressors
There is so much talk about the BEST ways to rehab ‘x’ diagnosis for low back pain or the BEST way to eliminate ‘y’ pain. The conversation going often unspoken is the one regarding the importance of these pillars.
Pain is no joke. It can cause a cascade of events stemming from lack of desire to maintain a lifestyle you enjoy to social and emotional negative contributions. This can happen in acute or chronic episodes of pain. Acute (typically) being defined as anything from immediately post injury to two months. Chronic would be classified by anything longer than that.
Lots of clinicians are great at talking about what hands-on techniques they will use to assist with whatever objective findings they may come upon in an evaluation. The problem that arises next is the tendency of clinicians treating ‘strictly’ to those movement deficits noted. This is where the pain cycle can get stuck in the ditch (so to speak). We can assist in changing how somebody moves, but what is also just as important if not MORE important is educating on what goes unseen in the clinic.
SLEEP
The value of sleep CANNOT go understated when discussing recovery, healing, and pain. If you are sleeping less than 7 hours a night on a consistent basis and can’t figure out why that nagging injury is lingering so long or if you have had chronic pain for years but can’t remember the last time you got a good nights sleep, we need to hit the alarm button RIGHT HERE (no pun intended…). The body needs ample time to recover. This happens best at night. If we don’t give the body this time, we can never expect optimal results in our healing!
NUTRITION
Providing yourself with a well-rounded diet is another pillar that needs to be discussed. I am no nutrition expert and don’t claim to be, but I know the body needs energy and it does better when that energy comes from specific sources. If we are not taking in appropriate levels of macronutrients to assist our body in daily function or in athletic performance, we will see a recovery deficit. Same can be said for pain. Higher ingested levels of sugar leads to greater levels of localized or systemic inflammation. Higher levels of inflammation can lead to prolonged pain mediators. I don’t want to bore you with big words so remember this… More sugar can lead to prolonged pain. Moderation is key as I’m sure we have all heard, but we need to put it into action to start feeling better.
PHYSICAL ACTIVITY
On the home stretch here, so let’s talk about what physical therapists should hang their hat on. Physical activity is something that time and time again consistently shows in the research that people see improvement in quality of life and LOWER LEVELS OF PAIN with a regular physical activity plan. We actually see that the more we ‘rest’ pain or an injury, the slower it progresses back to full capacity. When we move, we are creating a cascade of beneficial changes including joint lubrication, further blood flow stimulation, and release of endorphins helping us generally feel better. Walking hurts your knee? Perform sit to stands from a chair. Low back pain with bending over? Kneeling down to grab those low items. Just because one motion hurts doesn’t mean we eliminate all of it. Modify as needed, whether is be range of motion, load, or volume… and keep moving!
DECREASING STRESSORS
Lastly, but certainly still important, is decreasing your stressors in life. This may be the hardest of them all, which makes it that much more important to talk about. A great research study showed how closely linked stress and pain can be. It does dive into brain science, so be prepared, but the moral of what I want you to understand is the follow:
Stress alone can amplify our pain WITHOUT evidence of tissue injury.
This is a very important concept to grasp! All images in modern science could show no pathological tissue damage, though we can still have pain. Now this isn’t always related to stress and actually this is where physical therapy can be it’s MOST successful, but stress can certainly be a factor. If we can eliminate or decrease the stress in your life, we could see a great reduction in chronic pain. So beginning today, take time for yourself to reduce the stressors (work stress, home stress, environmental stress) in your life and you will be on your way to improving this important pillar!
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If you are a physical therapist reading this, it’s not too late to tweak your treatment plans. Begin to talk about these things with your clients, as it may just be the missing link. Not confident in the topics to bring them up? Please take the time to integrate it into your practice!
If you are reading this for leisure, I hope you can have an honest conversation with yourself on which pillars you are successful with and where you could use some work. If you are actively experiencing pain, start here. Make some of these changes. If you need further assistance as to HOW, reach out to a trusted healthcare provider to get the ball rolling. There is no better time than now to live upon your stable pillars.
All the best,
