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Close your eyes and imagine yourself in the middle of downtown traffic. The sound of the loud motorcycle engine next to you. The car horn of a hurried gentlemen two cars behind you. The “tick, tick, tick” of the crosswalk meter counting down from 10. Put yourself in this busy place for 5 minutes. How do you feel at the end of 5 minutes? Anxious, worried, annoyed, or stressed? Don’t fret you are not alone. This is a totally normal response subconsciously ingrained     in our brains. Even a doctor’s office with naked white walls can stir up these same emotions.

Believe it or not, the environment we are surrounded by can have a large impact on our emotional state, physical well being, healing, and even our immune system. I’m sure we have all experienced a time in our life when what we saw or heard considerably changed our mood or emotion. At that moment, our minds and bodies experience much more than just a “mood swing.” Our nervous, endocrine and immune systems were all compromised in that 5 second experience.

When feeling stressed, bogged down, injured, or angry, what types of coping strategies do you incorporate in your life to help subside these effects? Are they positive or negative? Like most humans we tend to lean more toward the negative influences without even realizing the choice we decided upon until our symptoms continue to arise.

Today I want to discuss one positive coping strategy that is available to every individual, free of cost. No I am not here to promote that next “fad pill” to help your aches and pains go away, or a sedative that will help take your mind off the stress of everyday life. I would like to introduce the word “Biophilia” into

your life today. What does the word Biophilia mean? An innate and genetically determined affinity of human beings with the natural world. Wait, what? It basically means you are influenced by the surrounding environment more than you actually think. For example, if an experiment were to be performed on employees that face a plain white wall packed with cubicles from one end to the other, compared to employees that face a window that engulfs a healing garden, it is suggested the individuals that face the window would have a higher productivity rate and positive emotional state. Ding ding ding! Perfect strategy for business employers to raise their employees productivity rate. Even adding a plant in the room if the option for a window is not possible would have this same effect.

There have been studies performed, such as the one mentioned above, involving how nature can actually promote healing. One such experiment involved patients who had recently undergone gallbladder surgery, in which half of them had a view of trees and the other half had a view of a wall. According to the physician who conducted the study, Robert Ulrich, the patients with the view of trees tolerated pain better, appeared to nurses to have fewer negative side effects, and spent less time in the hospital. Even studies taken as far as measuring brain activity through an fMRI have been performed. When participants viewed images of urban scenes, researchers found increased activity in the anterior temporal pole, the part of the brain that is associated with negative emotions and feelings such as anger and depression. But, when these same individuals viewed nature scenes, the parts of the brain such as the basal ganglia, associated with emotional stability, empathy, love, and pleasure, lit up.

Being a practicing Physical Therapist Assistant, I encounter patients on a regular basis that are experiencing the same emotions as you did when you first began reading this article. Their blood pressure and heart rate are elevated, stress and anxiety levels are bursting at the seams, and depression has likely set in due to the extreme pain they are experiencing. It is incredibly important to me to make sure my patients feel comfortable while being treated. Walking into a therapy clinic that has white walls, a cold atmosphere, and uncomfortable chairs is likely to add to the extreme negative emotions these patients are already experiencing. Adding some soothing paint on the white walls and adding pictures that immerse the patients in nature, placing plants in empty corners and bare counter tops can easily change negative emotions to feelings of euphoria.

Imagine the positive effects you feel when the brisk breeze caresses your skin, the sun warming your body, the smell of a wooded area, or the taste of grilled Nebraska beef on your lips. Did your body begin to relax and mind feel at ease? During that very moment your blood pressure, heart rate, anxiety and stress levels have all dropped. Here, at Complete Physical Therapy, we strive to create an inviting atmosphere that will make you feel as you did in the previous dialogue. The warm tan walls are lined with pictures of warm beaches, wooded streams, sunsets, waterfalls, and mountain ranges. Not only do the pictures create a relaxing domain but the bountiful plants and wooded greenery seen through wide open windows promote the proper balance for a speedy recovery.

The next time you are feeling bitterness, resentment, apprehensiveness, or uptight get away from the negativity of the downtown atmosphere described in the beginning and surround yourself with the serenity of nature. I have attached a website that will provide you pictures of nature and animals to reduce the stress you are feeling about the next project that is due by the end of the day or the extra hours needed to put into work this week. Take a break from whatever you are currently doing, put on some soothing music, and check out these fascinating images of tranquility.

http://mangelsen.com/

Sources utilized during this blog to gain relevant information:

https://www.mindbodygreen.com

https://www.takingcharch.csh.umn.edu

Our lives are so bound by time, by order. We are subconsciously measured by time, living minute by minute, working hour by hour. It may seem like we don’t have enough time in the day to be the perfect mom, finish the last load of laundry, start the dishes, or work on the next promotion; ultimately ending the phrase “I’ll sleep when I’m dead.” This causes a vicious cycle allowing an individual only 4-5 hours of sleep a night. Dr. William Dement quoted, “You’re not healthy, unless your sleep is healthy.” If you are an individual living the life that was explained above you will begin to realize being the perfect mom is becoming exhausting, resulting in an extra cup of coffee added to the day or requiring the use of medication to help your brain focus on the new promotion. In reality all that is needed to fix these problems is more sleep.  Being a healthcare professional I rehab patients who have recently undergone surgery or an injury that is limiting them from performing at 100%, exactly what happens to our function when we don’t get the adequate amount of sleep per night.

First let’s discuss the cycles we progress through as we sleep. There are two cycles Rapid Eye Movement and Non-Rapid Eye Movement, I’m sure you have heard these phrases during your lifetime but weren’t quite sure what they meant. NREM has four different stages involved in the process, for the sake of this article I am going to focus on stage 3 and 4 or otherwise considered “deep sleep”. In this stage of the NREM cycle our blood pressure drops and our breathing becomes deeper and slower allowing our brain to experience little activity; ultimately resulting in an increased blood supply to the muscles. This phase is essential for restoring the body, hence why our muscles feel weak or fatigue sets in sooner when the proper amount of sleep is not accomplished.

The REM phase is the stage where we are able to remember our dreams; this is the most important phase of sleeping, as well as the shortest phase. During REM the body is able to restore organs, bones, and tissue as well as replenish our immune cells and circulate the human growth hormone. A lack of the REM cycle is particularly problematic for recovery as well as our physical well-being. If the human growth hormone is unable to be secreted due to difficulty progressing through the REM cycle we are more likely to catch a cold or wake up feeling groggy and ill. For example, secretion of the human growth hormone is critical to my patients’ rehabilitation process when recovering from post surgical work or even a minor strain to their hamstring muscle. It is during NREM “deep sleep” that the brain is resting with very little activity resulting in increased blood supply available to our muscles; which in response will deliver extra amounts of oxygen and nutrients assisting in healing and growth. Muscles and tissues are then rejuvenated and new cells are regenerated during this phase of sleep.

Not only is the proper amount of sleep necessary for muscle and tissue recovery, but also for fundamental brain health. There was a recent study done on high school students that compared standardized test scores of students who began their school day at 8:00 a.m. and those students who began at 9:00 a.m. The results revealed those students who got one extra hour of sleep scored higher on the standardized tests compared to those students who began at 8:00 a.m. How is this? Getting longer hours of sleep allows for an individual to spend more time in the REM phase where memory consolidation takes place. In other words the brain is constantly making memories from our day whether it was a new task learned in school or even the emotional response to the way an individual treated you.

We are always making memories. In order to make the memories stick in the brain there are three stages that need to take place. The first is acquisition. This is where we learn or experience something new. Next, is consolidation. Here, the memory becomes stable in the brain. Lastly is recall. This is the ability to access the memory in the future. Both acquisition and recall occur during our awakened hours, where consolidation occurs during the REM cycle of sleep. This should be clear as to why the students who got an extra hour of sleep received higher test scores. Without adequate sleep the brain has a harder time absorbing and recalling new information or a learned task.

Not only is the suggested eight to ten hours of sleep crucial for muscle, tissue and brain health but also for weight control. Researchers have found that sleep and metabolism are controlled by the same sector in the brain. The hormone Leptin plays a key role in making us feel full; when we don’t get enough sleep our Leptin levels will drop, resulting in a hunger spike or an increased level of the hormone Ghrelin. The Ghrelin hormone has a main purpose to make us feel hungry. This can be a vicious cycle inevitably ending in weight gain. This would explain why crispy fries, a greasy cheeseburger, or a large pizza sounds indulging after a long night of finishing paperwork for the new job or a shortened night of sleep due to a crying baby. I just want to throw this major hint out there, if you are having trouble focusing, constantly experiencing fatigue and have difficulty controlling your weight; set an alarm on your phone to go to bed an hour earlier. Make it a goal to get eight to ten hours of sleep a night. I promise you will be functioning better at work, school, soccer game, and even through parenting.

Of course like anything in life there are a few components that can influence the cycles of sleep I had described above. No I am not talking about the crying baby or the dog that needs to go outside every hour. Every 21 year old has probably experienced this once or twice; alcohol is actually one of the biggest contributors to lack of sleep. Have you ever had a few drinks and felt like it was your cure to insomnia? Alcohol can actually help an individual fall asleep, but once asleep the REM cycle is interrupted or completely skipped when alcohol is in the blood stream. It’s no wonder why we wake up and feel groggy, have difficulty focusing, and feel like greasy food is the answer to feeling human again after a night of drinking. Not only does alcohol affect sleeping, but in obvious manners so do caffeine or stimulants such as nicotine, cocaine, and amphetamines. These  cause hyperactivity in the brain not allowing for a full “deep sleep” in stage 3 and 4 of the NREM cycle. Like caffeine having our eyes stimulated by our smart phones right before bed can also be detrimental to dozing off into a deep sleep.

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Simple Ways to Improve Sleep Hygiene:

• Try to go to sleep at the same time every night and wake up at the same time every morning.
• Choose a bed time when you typically feel tired and a time where you naturally wake up without the use of an alarm. If you still feel groggy when awaking you should consider going to sleep earlier an hour or two earlier.
• Control your exposure to light. Melatonin is a naturally occurring hormone controlled by light exposure in order to regulate the sleep-wake cycle. Our brain will secrete more melatonin when it’s dark (making you more sleepy) and less when it is light (making you more alert).
• Regular exercise will help reduce anxiety and symptoms of insomnia as well as increase the amount our bodies spend in the deep (restorative) phase of sleep.
• Avoid drinking alcohol, caffeine, or inhaling nicotine prior to bed time. All of these substances will interrupt the REM phase of sleep or even completely skip the phase, resulting in symptoms such as difficulty focusing and increased hunger throughout the day.
• Try to perform deep breathing along with visualizing a peaceful and restful place to help reduce late night stress and over thinking.
• Lastly, keep your room cool, dark, and quiet.

Have you ever heard the phrase, “Treat your body like a temple for you are only blessed with one?” What does this phrase actually mean? It wasn’t until I became a healthcare professional that I truly understood the meaning. In my profession I am privileged enough to treat patients of all ages, due to which has given me great insight on many unknown possibilities one may not consider in his or her early 20s. For example, the stress I put on my body in my 20’s will ultimately determine my abilities when I reach my late 80’s. This has changed my mindset when exercising, eating, and overall appreciating my youth. In order to maintain a healthy, well-rounded body in my late 80’s there were a few areas that needed to be improved in my training regimen. This is when I discovered preventative training.

Preventative training is like rowing a boat. In order to get from point A to point B without travelling in a circle, one must evenly distribute the oars from left to right. The same concept can be thought of when exercising. If an unbalanced training regimen is implemented, our body will play the same role as the uneven rowing of the boat. Goals will not be accomplished and the body will remain the same, or worse, injury may occur. Too often at the gym I see individuals working past their limitations. Not only that, but often I don’t even see these individuals perform a simple hamstring stretch. From personal experience, I know this will eventually hinder goals; as well as mentally and physically set them back. Last summer, when attending boot camp after boot camp I began to see change in my body and my exercise regimen was at its peak performance, but I forgot one major piece of the puzzle; stretching. It wasn’t long before sleeping became an issue, standing for long periods of time became painful, and bending over was nearly impossible. Due to such pain, I was no longer able to attend boot camps let alone even make an appearance at my daily “therapy session”, the gym. For months I struggled with this set back, until one day in late November I decided it was time for change.

Most individuals feel that stretching is a waste of time because they don’t get that “exercise high” or they’re not “burning calories” or “gaining strength” from stretching. Unbeknownst to most people, stretching can actually promote fat loss in the body when done on a regular basis. How, you may ask? With proper breathing techniques, stretching encourages relaxation which lowers cortisol levels in the body. Cortisol is a “stress hormone” which spikes with any physical, mental, or emotional stress, which ultimately allows for fat to build up in unwanted areas of the body. After reading this unknown fact, and realizing stretching took away the pain that was limiting my ability to make it to the gym; I decided it was time to stop rowing my boat in a circle and focus on getting from point A to point B. Not only did I notice this similar trend in myself, but as well as the patients I was treating. I’m sure I’m not the first to tell you that everything needs to be done in moderation. This includes exercising. You could work out seven days a week and ultimately end up in the same place as someone who has never stepped foot into a gym. For example, I have treated patients who had the ideal lean, toned, fit body everyone sees in the fitness magazines on the outside, but on the inside there was a different story. All the hard training, no rest days, and neglected stretching led to tonic musculature restricting everyday tasks. Stretching is an activity that can be performed by everyone, from top athletes to senior citizens, meaning any person at any activity level can stretch and notice benefits. A top athlete will be able to perform a deeper squat due to improved range of motion in their lower extremities. Where senior citizens can improve their mobility as well as functional independence when performing regular stretches due to less restrictions in joints.

In order for it to be effective, stretching needs to be done with a purpose. This doesn’t mean flipping through Facebook or posting on social media. Tune out every day stresses and focus, focus, focus. Take slow deep breaths to allow oxygen back into the muscles that were just stressed. Each stretch should be performed twice for at least thirty seconds, with mild to moderate tension on the elongated muscle. During the second set you should be able to stretch the muscle farther than the first. Soon, this will become a standard to your exercise routine. Results will show and you will be able to start making strides toward your fitness and health goals while preserving your “temple” with preventative training. It is now my goal to shift my patients’ perspective on exercising for the rest of their lives, rather than just appreciating their ability in their early 20’s. If you are unsure of how to integrate preventative training into your exercise regimen contact Complete Physical Therapy at 402-483-0006 and a licensed professional can assist in making your life easier in your late 80’s.