RESILIENCY TRAINING: "Daily discomfort vitamin"

Today's guest post comes from colleague Catherine Cowey. Catherine is a personal trainer and post-rehabilitation expert based in Oakland, CA. More information about Catherine can be found at https://www.fitwizesf.com. 

In our present day lifestyle we live in a state of perpetual comfort and ease. Not too long ago, if you wanted to survive you had no choice but to work hard and brave the elements. In our modern world, technology has automated and controlled for all of those hardships. Recently people have been starting to ask, what is all of this comfy living doing to us on a physiological level? Are our bodies in fact hindered by this omission of hardship and discomfort? Was the exposure to a daily challenge part of an integral stimulus to our biology succeeding and staying healthy? Do our bodies require something like a "daily discomfort vitamin"?

There is growing evidence that exposure to small bits of challenge to the system could actually be crucial to its vitality. It appears that exposing the body to "threat" in one area, say, cold exposure bleeds into the workings of the immune system, bolstering it. This cold exposure has preliminarily been shown in studies to improve the immune system.(1) Scott Carney further explores this concept in his book "What Doesn't Kill Us". He takes an in-depth look and personally experiences the teachings of Wim Hof, who is world renowned for his death defying stunts of cold water plunges and honed breathing techniques. Hof and many of his followers (big wave surfers, extreme sport enthusiasts) have found his methods effective in achieving epic potential out of their bodies. 
     
In "An Epidemic of Absence," Moises Valasquez Manoff investigates how exposing the body to an allergen, (which is a threat to the patient), can ultimately decrease an overactive autoimmune response. The "hygiene hypothesis" theorizes that our immune systems need constant exposure to germs (threat) and dirt to develop a healthy immune system. Proper immune function is contingent on a daily lesson in dirt in order to inoculate itself from future onslaught. 

Exposure to load in the form of strength training has been shown to have an effect in areas of pain management and psychology. Educator and physiotherapist Greg Lehman uses slow graded exposure to load on the body to strengthen it, as well as calm the body's hypersensitive nervous system; this creates a decrease in the sensation of pain. Several investigators have also found that individuals benefit psychologically with the implementation of strength training programs.(2) 

Even in brain health, Lisa Barrett noted leisurely doing Sudoku puzzles doesn't cut it to increase the brain's capacity.(3) There has to be an intelligible challenge for cerebral tissue as well for increased brain functioning. A little steam has to be coming out of your ears as you toil over a solution to a complex math problem, or conjugate that verb in a foreign language. The common thread tying them all together is that exposure to a bit of discomfort, irritant, load, or challenge incrementally increased over time on a daily basis, is a fundamental ingredient to a healthy system. 

Where I find this idea to be lost is on those individuals who are either recovering from injury or trauma. In the initial stages of healing and/or trauma recovery there is indeed an amount of time that individuals need to steer clear of stressors in order to facilitate healing. Unfortunately, with our present medical model these people are discharged acutely. They are not coached on how to make it back to the world without feeling a bit like a greenhouse flower. Instead of being an orchid only able to withstand 2 degrees of temperature variation, they should strive to become that determined, resilient weed that is thriving despite growing in concrete, receiving two drops of rain, and freezing temperatures. They need to be exposed to that daily discomfort pill to become more comfortable with discomfort.

Now if you have worked with folks who have chronic pain or trauma you will know that it comes with a good amount of fear and anxiety. Exposure to any sort of discomfort can be terrifying for them. They end up avoiding all irritating factors. They become religious about sleep, food, and stress in order to quell the nervous system, which as I said before is fine to do in the acute stages, but this is not the route to a resilient system. 

First, you want to educate them on the basics of pain science.*  Try to get them to embrace the sense that their body inherently has the ability to heal, and can recapture a healthy status. There will be bits of discomfort along the way which can be scary, but ultimately lead to a stronger body. Patience by the caretaker and client is critical. The path is definitely not a straight line and there will be setbacks, but remind them often of their overall progress and milestones. Implement a program in a VERY slow fashion as you expose them to challenge. The challenge, for instance, may be walking to the end of the block. Over time, with consistency and gradual progression this might lead to something bigger, like a 5k run a year later. Ultimately, the goal over time is a human being that will be able to withstand and bounce back from any proverbial curve ball thrown its way.  

Lastly, there is no denying that any system works best when looked after properly with optimal food, sleep, exercise, and socialization. These elements can be looked at as the "comfort vitamins". When the body has this optimal care its ability to withstand a challenge is at its peak. In the stress strain curve below there is a point at which the tissue breaks (failure point).(4) The body's breakdown threshold (failure point) can be looked at in a similar fashion; it's at its highest when it's healthiest. The daily exposure to discomfort can simply push that threshold(failure point) on the graph higher. It will take more stress to break you! 


For example, if you had 2 runners who didn't have much to eat, had a family crisis, and a red eye flight the night before, the runner that has trained in a bit more discomfort has better prepared his body for the difficult circumstances. The athlete has inoculated his body for the not so ideal conditions thereby trained to withstand more without overreacting(immune system), breaking down(tissue breakdown), or flaring up with pain(nervous system). As Dan John puts it, athletes need to know "Can you go?". The bouts of discomfort into the training regime will turn that question into, "Can you go", when life's a s@&$ show?
     

The daily discomfort vitamin needs to be an integral part of all human beings, but it's usefulness especially needs to be considered in those who view themselves as broken. The daily discomfort pill can be a crucial ingredient along a path to putting the pieces back together. 

*Resources: http://www.pain-ed.com/public/resources/, http://www.greglehman.ca/ 

**Catherine and I are co-teaching the nature and movement retreat in Napa Valley June 2-4. More information can be found at http://www.bewellpt.com/events/2016/9/11/mind-body-nature-a-two-day-movement-retreat

References:

  1. Kox, M. van Eijk L.T., Zwaag J. et al. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proc. of the Nat'l Academy of Sciences of the USA. 2014 vol. 111(20)pg. 7379-84.
  2. Stone, Michael, Stone M., Sands W., 2007. "Principles and Practice of Resistance Training." Human Kinetics, pp. 229-240.
  3. Barrett, Lisa Feldman, "How to Become a Superager" New York Times. Dec. 2016.
  4. Graph:  Rami K. Korhonen and Simo Saarakkala (2011). Biomechanics and Modeling of Skeletal Soft Tissues, Theoretical Biomechanics, Dr Vaclav Klika (Ed.)