Stress - what it is, and how to work with it

I’m going to make two assumptions right from the get-go about your clients health. Because your clients are already participating in Pilates, it’s likely that they already know they need to be regularly active, and they need to eat well to maintain their health. But stress is a different beast. And we’ve all seen it before in our clients - they’re under a lot of pressure at work or having a problem at home, and all of a sudden their back pain they’d all but forgotten about comes roaring back in. And we all know that biomechanically there isn’t anything going on there anymore. There may have been injury there once upon a time, and it becomes the go-to spot where their perceived stress accumulates and starts to niggle, eventually becoming overwhelmingly bad that they want to take some form a medication to numb the area. And then they start to develop an attitude of ‘I’ll just pop a couple Panadol and I’m fine’, rather than addressing what the heck is causing it to be sore in the first place.

As Pilates practitioners, we’re limited to an extent as to how we can help with this. We aren’t generally psychologists, most of us aren’t even meant to be working with injuries but in reality, Pilates gets recommend to anyone who is injured and we always step up to help someone. But when it comes to stress, all practitioners are massively under skilled as how to help someone. And it’s got nothing to do with your training - it’s got everything to do with your client. Because you can’t help them, they have to help themselves. You’re job is to hold up the mirror for them to see themselves and identify the issue, without judging or applying pressure. They can only find it at their own pace, and implement changes they can tangible grasp.

Unfortunately that doesn’t make your job easy in the mean time with clients complaining left, right, and centre, about their aches and pains and perceived stress in their lives. So what can we actually do to help them? Well lets consider one definition of stress is a subjective/relative stimulus driven activation of the sympathetic nervous system, causing a mobilisation of resources towards a fight or flight physiological reaction.1

Open ended questions

Part of helping someone work through their stress point is to gently probe them about their current situation, and how that’s different from when they were previously pain free, or as close to that as they can remember? These need to be open questions - you cannot guide them to an answer, they have to come to it themselves. But you can ask questions that would get them to compare their current and past situations, or present it in a way that they have to internally assess their situation. Remember the goal here isn’t to judge them, but to help them assess where they are at and what might be going on beyond the discomfort they are experiencing.

Connect the team

Building a team of caring treatment providers in a fantastic resource. Being on the same page is even better. Sometimes health professionals don’t always agree on the root cause of an issue that comes and goes, and it’s not your job to diagnose it. But having discussions with the other providers, or referring out to those who can probe a bit further is going to ensure you’re looking like a super star for caring so much. Even the providers don’t agree with your views, make sure you listen to theirs and don’t actively disagree with the practitioner in front of the client. Keep patiently probing and eventually if the practitioner isn’t hitting the mark, the client will move on anyway, in which case you can pick back up again encouraging some self reflection.

Lifestyle changes - meditation, nature, grounding, and sleep.

I feel the quote ‘We can’t solve a problem by using the same kind of thinking we used when we created them’ by Albert Einstein has some leverage here. If your client stays in the same cycle of their life, they are never actually going to improve beyond a certain scope. But there are many things they can do to create strategies for better managing stress when it does come on. Meditation in whatever form they can work with in a game changer. Even if we just consider the science, which is that it creates a window of time where the brain is operating a reduced rate, slowing the production of metabolic by-products, giving your glial system a chance to get a head of the cleaning. A cleaner brain is a happier brain, and allows for a bit more robust to move between sympathetic and parasympathetic systems. It also acts a a window to start running some positive mental patterns by saying positive things, or imagining positive outcomes, giving your brain something to aim for. There’s a huge amount of research to back up the ideas that setting positive goals will help reduce pain but also create the opportunity for you client to work towards making tangible changes.

Regular exposure to nature known as forest bathing, has a positive outcome on reducing cortisol, lowering heart rate and blood pressure in your body, with extended exposures having a positive impact that last for months at a time. 2. Tied in to this is also regular skin-contact with nature, generally as close to naturally occurring water sources as possible, as a means of reducing free radicals, or Reactive Oxygen Species in our system, helping to reducing chronic inflammation, aiding in moving out of sympathetic arousal. 3. Being outdoors also creates a greater opportunity to clock up some vital vitamin D from the sun. Sun exposure being key for bone health (easy pitch for most clients), as well as maintaining our sleep cycles - sleep being a key pillar in ensuring our brain has a chance to clean out all the metabolic by products from a full day’s work.4.

Summary

Stress is relative - remember that. It will change on a daily basis, and all you can do is ride the bus with them, without judgement, and help them come to realise they are completely in charge of what stress does to them. But where possible, also implement lifestyle changes promoting meditation, sleep, sun and nature where possible on top of the obvious healthy diet and regular exercise.

References

1 - Taken from AMN Academy director Dave Flemming during a webinar July2020.

2 - https://pubmed.ncbi.nlm.nih.gov/19568835/

3 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265077/

4 - https://www.sciencedirect.com/science/article/abs/pii/S1556407X09000101