By Rebecca Gillett, MS OTR / L, Live Yes! With the arthritis co-host and the arthritis patient
Stress. Only the word itself can invoke the feeling. If you live with arthritis, you know there is an array of stress triggers that could send you into a flare-up of varying intensity. I'm not just talking about the mental stress of living with chronic illness, which is a huge factor, but also the physical stress that you put on your body from the moment you slowly get out of bed. Everything we do, think, and feel can adversely affect our physical and emotional well-being, which in turn can affect our arthritis pain.
When you navigate to a new diagnosis, or wake up with new pain that you didn't feel, it can be extremely stressful. Your train of thoughts leaves the station - what did I do to bring about this? What can I do to stop this pain? What will actually work to stop the pain? How am I supposed to prepare for my workday when I'm in so much pain? What if I call sick? Will I risk losing my job? What will everyone think if I can't do what I'm supposed to do today? And then full stop. Next thing you know, your pain level is even higher now.
Surviving 2020 and a pandemic just added to the daily stress most of us with arthritis already experience. "It's so 2020." You heard it or you said it, I'm sure, so you know what I mean. "2020" is now an adjective. A global pandemic has taken its toll on what we all considered "normal." 2020 was everything But Ordinary.
2020 has compounded another layer of stress and anxiety that could possibly amplify our arthritis symptoms. The fear of contracting this new disease and what it means for those of us in this high risk category of developing a severe case of COVID-19 has been a priority for all of us. Social isolation, lack of access to our usual ways of dealing with pain and symptoms, financial stress if you have had a loss of income or job, seeing your doctor in person, worrying about the safety when shopping and not being able to see family or friends. So much has gone into derailing our plans, routines and treatments.
But how and why does stress affect arthritis? What can we do to combat the effects of stress on our body and mind to regain control? How can we find our balance?
My co-host and friend, Julie and I have been on this roller coaster ride which is 2020 with all of you. It has been a really difficult year. We've both struggled with the change in routine, financial stress, uncertainty, and the fear of contracting a new virus that we are learning more about every day. When we recorded this episode of Live Yes! With the Arthritis - Mind Over Stress podcast, the timing couldn't have been more perfect. We both felt the heavyweight of the world and tried to survive. It was the therapy session we desperately needed.
Our guest for this episode, Dr. Maria Juarez-Reyes, Assistant Clinical Professor in the Department of Medicine at Stanford University, has helped us orient ourselves towards strategies we can use to reduce our stress and anxiety.
Julie and I talked about recent situations where we realized we were on our way to destroying stress affecting our moods, relationships, and arthritis symptoms.
I had reached a point of anxiety and stress that was starting to have real physical effects on me - my blood pressure was high, despite taking medication, not sleeping well, and waking up in the middle of at night with anxiety and panic, and my spine and joints were stiff and sore. I found myself so irritable and stressed out, but my family was the one suffering from my miserable moods. It was not a happy place. It wasn't until I talked to a friend about it that I realized how stuck I was and needed to find a way out. I felt like I was on a speeding train and needed to get off at the next stop or my health and relationships would suffer. But just saying it out loud and being aware of how I was feeling is what ultimately helped me merge onto an exit ramp.
This, we learned from Dr Juarez-Reyes, is part of what is called 'noting'. It is a strategy of paying attention and recognizing what is happening, acknowledging it and "taking note" of it. By doing this, she says, we are more able to let go of anything that causes us anxiety or stress. It helps us get out of this stress-destroying train and change the way we think, act, or gain better access to tools that we know can help reduce our stress.
I didn't know there was a name for the strategy I used to keep my stress and anxiety from continuing to have a domino effect on my well-being. I noticed and recognized that my increased anxiety and stress levels were not conducive to anything in my life. I recognized how it affected me physically, mentally and emotionally. Then I was able to say, “OK, what can I control to reduce my stress level? What tools can I access to help reduce my stress? "
I had to put limits in place. Stop working such long hours and weekends. Get back to my walking and yoga routine. Move my body more. Return to daily mindfulness and meditation practices. Unplug and exit the network. Get into nature.
Hiking and camping are two of my family's favorite things to do together. It was exactly what I needed and exactly what we were doing. I came back from a family camping trip no longer carrying this rock that weakened everything in my world on my chest. I realized that I had lost my balance and needed to press a reset button.
Dr Juarez-Reyes also discusses when medication might be needed. When I was first diagnosed, taking an anti-anxiety medication gave me enough control over my symptoms to be able to truly understand the triggers that are causing my flare-ups. It was not a drug that I needed long term, but I did need it at the time. It helped me realize that there were actually things I could control.
If any of this resonated with you, I hope you too can find a way out of the stress train. Take a break and take a deep breath. Write it down. Then listen to this Mind Over Stress episode and be empowered to find your balance.
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Almost anybody can safely take up walking, and light to moderate exercise is usually fine for saine adults with no troublesome symptoms. But do you need to talk to your doctor before taking on a more strenuous regimen ? It’s wise to talk to a doctor if you have any questions about your health or plan to start more vigorous workouts, especially if you haven’t been active recently.
Definitely talk to a doctor if you have any injuries or a chronic or unstable health condition, such as heart disease or several risk factors for heart disease, a respiratory ailment like asthma, high blood pressure, joint or bone disease ( including osteoporosis ), a neurological illness, or diabetes. Also consult your doctor if you suspect you may have an illness that would interfere with an exercise program or if you have been experiencing any troublesome symptoms, such as chest pain, shortness of breath, or dizziness.
Almost anybody can safely take up walking, and light to moderate exercise is usually fine for healthy adults with no troublesome symptoms. But do you need to talk to your doctor before taking on a more strenuous regimen ? It’s wise to talk to a doctor if you have any questions about your health or plan to start more vigorous workouts, especially if you haven’t been réactive recently.
10 tips for avoiding injuries
Once your doctor gives you the go-ahead to exercise, the tips below can help you avoid injuries :
Take five to 10 minutes to warm up and cool down properly. Plan to start slowly and boost your activity level gradually unless you are already exercising frequently and vigorously.
Be aware that training too hard or too often can cause overuse injuries like stress fractures, stiff or sore joints and groupes de muscles, and inflamed tendons and ligaments. Sports prompting repetitive wear and tear on certain parts of your body — such as swimming ( shoulders ), jogging ( knees, ankles, and feet ), tennis ( elbows ) — are often overuse culprits, too. A mix of different kinds of activities and sufficient rest is safer.
Listen to your body. Hold off on exercise when you’re sick or feeling very fatigued. Cut back if you cannot finish an exercise session, feel faint after exercise or fatigued during the day, or suffer persistent aches and pains in joints after exercising.
If you stop exercising for a while, drop back to a lower level of exercise initially. If you’re doing strength training, for example, lift lighter weights or do fewer reps or sets.
For most people, simply drinking plenty of water is sufficient. But if you’re sérieux out especially or doing a marathon or triathlon, choose drinks that replace fluids plus essential electrolytes.
Choose clothes and shoes designed for your type of exercise. Replace shoes every six months as cushioning wears out.
For strength training, good form is essential. Initially use no weight, or very light weights, when learning the exercises. Never sacrifice good form by hurrying to finish reps or sets, or struggling to lift heavier weights.
Exercising vigorously in hot, humid conditions can lead to serious overheating and dehydration. Slow your pace when the temperature rises above 70°F. On days when the thermometer is expected to reach 80°F, exercise during cooler morning or evening hours or at an air-conditioned gym. Watch for signs of overheating, such as headache, dizziness, nausea, faintness, cramps, or palpitations.
Dress properly for cold-weather workouts to avoid hypothermia. Depending on the temperature, wear layers you can peel off as you warm up. Don’t forget gloves.
Delayed bourrinage soreness that starts 12 to 24 hours after a workout and gradually abates is a normal response to taxing your groupes musculaires. By contrast, durent or intense bourrinage pain that starts during a workout or right afterward, or force soreness that persists more than one to two weeks, merits a call to your doctor for advice.