Sleep Deprivation

Sleep is vital to our health and well-being. Short term sleep deprivation can lead to decreased coordination and reaction time, decreased attention, irritability, headaches, stomach problems, sore joints, etc. Long term sleep deprivation can lead to obesity, heart problems, diabetes and a shorter life span. The average adult needs 7-8 hours of sleep a night and getting those hours should be one of our priorities. It’s no drama if we get a few shorter nights as long as we make up the sleep debt in the following days.

Pain: how much is in the mind?

A study by Luis Buenaver and colleagues published in the June edition of Pain has shown some fascinating links between pain, thinking and sleep. It’s already known that about 80% of people with chronic pain experience troubled sleep and that poor sleep increases pain sensitivity. It is also known that pain catastrophizing is a contributor to chronic pain. Catastrophizing is a combination of rumination and negative thinking. What Buenaver and his colleagues discovered was a direct link between pain catastrophizing, poor sleep and worsening pain…a vicious cycle…the more often you think negatively about your pain experience…the more your sleep is disrupted…the worse your pain becomes…which in turn adversely affects your thoughts, etc.

Another piece of research published in this month’s Current Biology by Christian Sprenger et al. demonstrates that mental distraction techniques can decrease pain sensations by inhibiting incoming pain signals in the spinal cord. The effect was found to be partly mediated by endorphins.

In essence, people with chronic pain can improve their sleep and comfort by choosing to focus on pleasant activities or goals rather than brood gloomily over their pain.

To change the way we feel we must change the way we think!

“Don’t let what you cannot do interfere with what you can do.”

John Wooden

When One Door Closes, Another Opens…

Often when clients consult me for advice or physiotherapy treatment, they are frustrated that they have had to stop their usual sport or exercise. They will usually add that they have put on weight and need to get back to it! At this point I routinely ask them if they have tried another form of exercise that doesn’t involve the injured body part? Frequently, a look of surprise ensues “I didn’t think of that!” Sometimes it’s a guilty look “I’ve been lazy…I’ve used it (my injury) as an excuse.” On other occasions it’s just a blank expression “I didn’t know what I could do?” When I tell them that in fact, there are quite a few things they can still do, their eyes light up with excitement at the prospect of resuming some form of physical activity.

I remember treating a triathlete several years ago. He came to see me because of a calf problem that was preventing him from running. Running was his favorite part of the triathlon and so predictably, it had a prominent place in his training regime. Initially I asked him to stop running and focus instead on swimming and upper body strengthening…he actually started enjoying swimming which in the past had been a chore. He would come in excitedly and tell me how his technique was improving. When he returned to competition he was surprised to see that his times had improved dramatically! By allowing him to focus on his weaknesses, his injury turned out to be a blessing in disguise.

Alexander Graham Bell said “When one door closes, another opens; but we often look so long and so regretfully upon the closed door that we do not see the one which has opened for us.” So true, we are constantly surrounded by opportunity but it takes a positive outlook and a flexible attitude to seize it!

“Things without remedy should be without regard;

what is done, is done.”

William Shakespeare, Macbeth

Pain And Perception

I read an interesting article in BBC News Health a couple of weeks ago. It reviewed 2 recent studies on pain. The first was published in The Journal of Pain by Atsuo Yoshino et al. Subjects were shocked with an electric current whilst they were shown pictures of sad, happy or neutral faces. Photos of an emotional face usually provoke the same emotional response in the person viewing the picture. Although the electrical stimulation was the same in all cases, subjects felt more pain when looking at sad faces.

The second study was conducted by Marion Hofle et al. in Pain. The researchers asked the subjects to place one of their hands under a screen. On the screen, they played a video of a hand being pricked by a needle, poked by a cotton bud or just left alone. The subjects perceived the hand on the screen as their own.  A painful or non-painful stimuli was applied simultaneously to the video. Viewing the needle prick increased the unpleasantness ratings of the stimulus.

As these studies have shown, negative emotional states and negative expectation seem to increase pain and so the mind plays an important role in the experience of pain. As a physiotherapist, dealing with pain is a daily occurrence and I can remember qualifying as an acupuncturist over 10 years ago…I was desperately keen to use my new skill on anyone that was willing to try and worked hard at convincing anyone that was hesitant to try! With those that were initially hesistant…possibly due to a slight needle aversion, I quickly noticed their exaggerated responses to acupuncture. I can remember several occasions when I would gently touch them with a finger or with the plastic guide tube that surrounds the needle and they would jump and shout “ouch”…to which I would reply “relax, we haven’t started yet!” I’ve now learnt from those experiences and no longer feel the need to convince everyone to have acupuncture…no matter how great I think it is!

John Milton was right in Paradise Lost…“The mind is its own place, and in itself can make a heaven of hell, a hell of heaven.”

Acupuncture May Prevent Muscle Wasting

A study by Akiko Onda et al. published in Biochemical and Biophysical Research Communications has concluded that “acupuncture can partially prevent skeletal muscle atrophy”. It helps recover skeletal muscle mass and cross-sectional area possibly by increasing protein synthesis and decreasing protein degradation. Although the experiment was performed on mice, it was hypothesised that acupuncture could be used to prevent muscle wasting in the elderly and in patients with “severe conditions”.

Lighter Weights Also Help Muscle Growth

Exciting new research by Burd and colleagues shatters currently held beliefs about the type of resistance training required for muscle growth. Their article entitled “Bigger weights may not beget bigger muscles: evidence from acute muscle protein synthetic responses after resistance exercise” has been published in the journal Applied Physiology, Nutrition, and Metabolism. They found that performing repetitions until fatigue (an average of 24 repetitions) with 30% of one repetition maximum (1RM) was just as effective at eliciting muscle protein synthesis (MPS) as 5 repetitions with 90% 1RM! In fact, exercise performed at 30% 1RM produced longer lasting MPS.

The authors believe that maximal muscle fibre recruitment is fundamental in inducing MPS and that lifting light weights to failure causes the fibre activation required. In addition, low-intensity resistance exercise allows for a higher total number of repetitions and greater total exercise volume, which is important in sustaining the MPS response over time.

Burd et al. note that “skeletal muscle mass is a large contributor to daily energy expenditure and will assist in weight management. Additionally, skeletal muscle, because of its overall size, is the primary site of blood glucose disposal and thus will likely play a role in reducing the risk for the development of type II diabetes”.

“Act when the idea is hot and the emotion is strong“

Jim Rohn