Adaptation and Stress

Mike Reinold, a physical therapist on the East Coast, had a piece on his website titled Career Advice for Students and Young Professionals from Experts in the Field.  Leon Chaitow, who is a famed manual therapist, had a nice response.  I have posted it here.

I recommend a thorough understanding of Hans Selye’s general and local adaptation syndrome concepts.  This suggests that whatever the actual health problem – and in fact the more complex the problem the more important this formula becomes – it is essential to appreciate that almost all health issues can be seen to represent failed/or failing, adaptation. Once this is understood it becomes important to consider which adaptive stressors can be identified – whether lifestyle, biomechanical, biochemical or psychosocial – and how these can be modified or eliminated. These adaptive stressors represent one facet of the therapeutic equation, which might involve postural, respiratory, nutritional, behavioral or functional factors. The other part of the equation that needs to be considered relates to way(s) in which functionality might be enhanced, so that the stress burden can be better managed. Aspects of this would entail improved strength, stability, flexibility and mobility – along with sleep, rest, exercise etc.

So the bottom line of this therapeutic formula boils down to – reduce the adaptive load, while improving function. The only other choice is to treat symptoms. Into this mix it is also critical that we tailor the therapeutic interventions to the ability of the individual to respond positively – so that treatment doesn’t become yet another stress burden.

I believe this statement has a lot of meaning to coaches in the field of sports performance.  There are two concepts that I take away from it.  The first is to the body’s ability to deal with adaptation, and stress.  The second is the actual treatment of the adaptation, or failed adaptation, and stress.

First, everything has a stress on the body.  Buddy Morris, strength coach for the Arizona Cardinals, has stated that the stress of training is much more harmful to the body than the stress of a broken bone.  A broken bone is localized vs. the entire organism being affected by stresses of intense training.

The body is always in a constant battle of adaptation.  Injuries, sickness, diseases, etc. all go through this battle in the human body.  Take an overuse injury such as patellar tendonitis.  It is the tendon failing to adapt to the implied stresses over time.  We walk a fine line between too much, and too little.  Too much / too often a stimulus and the body reacts in a negative way.  Too little and the body won’t rise to a higher level of performance.  I have always been a firm believer that I would rather undertrain an athlete than to overtrain them.  Training is the same process just on a larger scale.  If we fail to adapt to the stresses of training, our performance begins to decline.  Sickness, or injury will be right around the corner.

For stress, there is no better resource than a book called Why Zebra’s Don’t Get Ulcers by Robert Sapolsky.  The book is about the human body’s reaction to stressors and how it can disrupt / cause a cascade of events in our body.  It is an interesting read to say the least.  It’s not only a great book on stress but an awesome physiology book written in a way ties all the events that happen in your body together.  And the author Sapolsky, does it all with a dose of comedy.

My second take home point in the statement above deals with improving function while correcting the failed adaptation.  The last paragraph is what commonly happens in the world of rehabilitation.  We treat symptoms and not the actual root of the issue.  Surgeons are some of the best examples of treating symptoms.  “Lets operate,” is all too often the answer.   When correcting movement patterns, or fixing soft tissue restrictions,  may actually be the cure.

One of the best analogies I have heard for correcting movement is this:

When a car loses its alignment the area that usually receives the most notable damage is the tires.  So the average person sees the tires worn and goes out an buys new tires.  However, we haven’t fixed the actual problem which is the alignment.  So while new tires will look nice, they too soon will wear out quickly in the wrong place.  The underlying issue is the alignment.  Fix the alignment and you fix the problems with the tires wearing.

The body is the exact same way.  Fix the underlying issues and you actually fix the problem even though they probably aren’t the same thing.

Compensations generally occur above or below an injury, or problem site.  Restrictions in motion, lack of motor control, hyper-active tissue, etc. can all play in to compensation patterns, and eventual breakdown.

  1. Rotational athletes who have restrictions in the hip and lack the ability to rotate pay for it in their lower backs.  By not looking at the underlying issues, people start working the lower back claiming it to be weak, or stiff, or what have you. The treat the symptom by trying to stretch the back, or strengthen the muscles around it.   However, if we fix the hips we fix the back.
  2. The ankles are another easy source of compensation.  Basketball players often have knee dysfunction.  Ankles are often locked up from not only the nature of the sport, but braces that are worn all the time.  The ankle loses full function so the knee must take on added stresses up the chain.
  3. Everybody should know how important the ankles are in squatting.  Reduced range of motion results in stresses up the chain that most commonly manifest themselves at the lower back.  The inability to flex the ankle while squatting alter the every joints function up and causes athletes to compensate by reaching forward with the torso in an effort to balance.  Again, what looks like a back issue is really not the underlying problem.  Unless the ankles are corrected the problem will never be cured.

Always look for compensations occurring in movement.  When those are found and corrected, injuries and failed adaptation begin to disappear.