2002-12-14 / Columnists

Eye On Physical Therapy

By Tim Rohrs

Eye On Physical Therapy

Timothy Rohrs, P.T. is a New York State licensed physical therapist and the Director of Sands Point Physical Therapy. He is currently working towards a clinical doctorate degree at SUNY Stony Brook.

With the Rockaways being especially hard hit with tragedy during the past 18 months, it is important not to underestimate the effects of spiritual, psychological and mental anguish on physical pain. Depression has been linked with posttraumatic stress disorders. We are mostly aware of how tragedy impacts on sleep patterns, overindulgence in food and drink and possibly even road rage. There are many people who suffer physical pain, mostly back and neck, which have been unresponsive to traditional physical therapies. Patients are reluctant to acknowledge that their neck pain might be caused or exacerbated by stress. In Healing Your Back Pain by John Sarno, M.D., Dr. Sarno explains his diagnosis of Tension Myositis Syndrome. He proposes that the subconscious and or unconscious mind creates pain as a distraction from some emotional stress or issue. There are physical manifestations of this pain including muscle spasm, tenderness, soreness and trigger points. More often than not diagnostic tests including CAT scans, MRI's and X-Rays are negative. When people are experiencing back or neck pain they soon adopt a new set of behaviors to fight that pain. These behaviors include some or all of the following: medications, physical therapy, exercises, body mechanics, and postural awareness. Soon a large portion of their day is devoted to combating this pain, thus distracting them from the stress issue in their life.

We are effectively hard wired to experience tight muscles when confronted with stress. Physical therapy students studying early childhood development are trained to assess age appropriate behaviors and the integration of skills. For instance, a child of 4 months should be able to sit unsupported on the floor. The therapist can assess whether the infant has integrated the task or is still mastering it by observing the shoulders. If the shoulders are elevated and the child is wobbly, then the skill has not been mastered and the child is not comfortable being in that position. Whereas the child that has successfully integrated that behavior will sit confidently with the shoulders at their normal height. If at the age of 4 months a child is exhibiting elevated shoulders with the upper trapezius muscles contracting, can it be that far of a reach to assume that as adults we experience tension, spasm and tenderness in those same muscles because of our daily stress? Muscles in spasm experience decreased blood flow, increased tenderness and soreness and most importantly restrict the head and neck from moving appropriately. Muscle imbalance, spinal asymmetries, stiffness, limited range of motion and postural deviations all result from muscle spasms.

The effects of stress on physical pain cannot be ignored when seeking treatment. Your M.D. can provide you with the proper referral to deal with stress effectively.


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