Brain Benefits of Exercise. Getting Back on My Soapbox.

Tags

brain chemistry and exercise, chronic pain, depression, exercise, fitness, pain, physical therapy

Repost from my blog Brain Benefits of Exercise.  I have been seeing a higher percentage of patients that just need to start moving.  At least half of the people coming in with pain are depressed, sedentary and lack motivation to begin making changes.  So, I am reposting this blog…just to get back on my soapbox.

It is official – we are no longer hunters and gatherers.  We spend most of our day sitting in front of a screen.  Because of this 65% of the United States adults are overweight or obese.  It is well known by now that we are killing our bodies due to inactivity – creating heart disease, type 2 diabetes, and increased cancer risks.  But what many don’t realize is that lack of exercise significantly affects our mood, intelligence, and motivation.  Exercise has recently been proven to be more successful and long lasting than many drugs in treating depression, anxiety and the non-brain related diseases listed above.

Learning and Memory – According to John Ratey, MD in Spark, exercise is “miracle grow for the brain.”  Learning requires Long Term Potentiation (LTP) or a strong affinity between neurons.  When the brain is called to take in new information and a chemical called glutamate is present in the synapses, the link is more likely to bond.  Exercise increases levels of glutamate  and a protein called Brain Derived Neurotrophic Factor (BDNF) – both important for survival of and generation of new synaptic connections to learn new information and tasks.

Depression – In 2000 researches from Duke University made the New York Times with a study showing that exercise is better than Zoloft at treating depression.  In most psychiatric issues, stress causes the brain to get locked into a pattern of pessimism, fear, and retreat.  Stress is normal for people to feel and to recover from,  if the body is allowed to recover.  The problem with psychological stress is that because the brain is so good at creating synapses, the negative pattern is learned and repeated and we never get a chance to recover.  When we exercise, new patterns develop and new hormones are introduced  (serotonin and norepinephrine).  When we are done exercising, the body recovers.

Our brain does not distinguish between good and bad stress on the system, just the increased demand on our system.  How the brain reacts is purely based on how things are processed in the cortex.   Are there enough STRONG and ACTIVE connections and cortisol levels in our brain at the time of the stressor?  If there are too much cortisol levels for prolonged periods (no recovery) it becomes difficult to learn something new, but in short bursts (during exercise for example), our bodies can long term potentiate easier.  This is why it might be a good idea to have a good session of cardio exercise prior to cramming for a test.

The key point made above is that if we stress ourselves in short doses, physically, we can treat our depressive moods.  This is why you feel so euphoric after a High Intensity Interval Training (HIIT) session. What does this all mean?  We need to exercise OFTEN and HARD to help offset the chance of chronic stress that results from overconsumption of social media, high work demands, learned pessimism, or general lack of movement. So what are you waiting for?  Get out there and move.  Your brain and body depend on it.

http://serendip.brynmawr.edu/bb/neuro/neuro05/web2/mmcgovern.html

http://en.wikipedia.org/wiki/Brain-derived_neurotrophic_factor

http://www.biopsychiatry.com/bdnf.htm

 

 

Exercise, Depression, and the Amygdala

Tags

amygdala, chronic pain, conditioning, depression, exercise, fight or flight

Many of you are saying: “The Amygdala?”  What the heck is that?  This tiny part of the brain processes and conditions our responses to fear, addictions, sex drive, search for comfort, anger and many primitive responses that in primitive times kept us safe from harm.   It is the part of the brain that has the power to inhibit the rest of the body systems so that you can accomplish the task at hand.  Super important little part of the brain, huh?  The following is a rough explanation of it’s function, how it becomes problematic, and how to outsmart it.

Good primitive response from the amygdala:

If you are walking down the street talking to your boss on the phone and someone pulls a gun on you.  The amygdala influences the flight or flight response to drop the phone and run.  Forget about the important conversation you are having and save yourself.

The Amygdala

In this example, the amygdala is highly conditioned in that it has formed a neural pathway that links gun to arm and the reaction to run.  Because it is such a powerful contributor to flight or flight or drastic responses and conditioning of them, it does not always use information from higher centers to weed out the abnormal processing.  The amygdala is a key player in chronic pain and depression because of the repetitive nature of the neural pathways formed during both.

Once a nerve pathway is formed, the connection becomes conditioned (stronger) and may become strong enough to control all your daily thoughts and actions.  The conditioned response creates a reaction similar to the reaction during potentially fearful or dangerous situations (even if they are not really dangerous) linking fear and pain to depressive mood.

Bad modern-day response from the amygdala:

If you have a car accident and experience a whiplash injury, the amygdala may overpower the other pathways in the brain convincing you that driving in the car is dangerous.  You knew before the injury that there is risk involved with driving and were comfortable taking that risk prior to the accident, but now you are all together fearful of driving.  If the whiplash injury was initially painful during movement, the amygdala invokes fear and communicates to the motor cortex that movement is dangerous.  Prolonged fear of movement leads to chronic pain. This is an example when the amygdala can become problematic with modern-day coping mechanisms.

If the person above also is unable to work due to whiplash related back pain, the preservation on the loss of their paycheck and FEAR of going broke sends an impulse to the amygdala.  The fear response inhibits the rest the systems and moods (hunger, happiness, immune system).  The back pain intensifies each time they receive the notice to pay rent.  The stress and depressed state intensifies the pain response because the pathway has become conditioned.  Eventually the nerves that process pain become more sensitive to stimuli causing that reaction to require less stimulus to create the pain.  Before you know it everything increases the depressive mood.

Exercise and Redirecting

The typical Physical Therapist solution is to recommend exercise to “cure” the depression and chronic pain.  In the example above, Yes, exercise will help.  Remember how I said that the stimulus telling your brain to experience pain sensitizes when the pathway is overstimulated or fear is involved.  The best way to cure this is to redirect the conditioned nerve pathway.  I am not telling you to ignore the pain, but to second guess your feared response to it.  In other words, DO NOT TRUST YOUR AMYGDALA.  Redirect the pathway and overcome the fear by with physical activity.  Not only will it create a new neural pathway to help you realize that movement is not damaging, it will stimulate endorphin release (which is a mood enhancer) and activate many other positive benefits of physical activity.

The role of the amygdala has morphed in modern times as our society has become more civilized and less environmentally dangerous.  Our motor processing (higher centers in our brain) needs to out smart it so that we can avoid abnormal pain processing and conditioning.  Are you allowing a conditioned response to control your reactions or are you assessing each separate situation to make the most appropriate response?  Begin getting control of your amygdala by becoming more aware of your responses to stressful situations.  And exercise to re-direct your neural pathways and reactions that may be creating pain in your body.

The inspiration to write this blog was in part from reading Linchpin and after attending numerous presentations on pain mechanisms at APTA Combined Section Meeting last month .  Information how the amygdala (or lizard brain) can affect fear with work and life situations is well explained in Linchpin, the new release by Seth Godin.  In addition, there are many websites explaining  the function of the amygdala.

Enjoy.

Pain Management – The Traffic Light System

Tags

central sensitization, chronic pain, exercise, fitness, injury, pain, physical therapy, surgery, treatment

Exercising with an injury or during rehabilitation is confusing.  After a surgery or with a chronic injury a lot of variables contribute to how you manage your habits and react to pain.  Many athletes will endure the pain and ATTEMPT to train through the symptoms.  On the other end of the spectrum people who have had a lot of chronic issues such as spinal pain, headaches, and other repetitive strain injuries tend to avoid pain or fear any activities that cause their symptoms.  It is not a perfect science to determine when to endure the pain, when to rest, when to take medications, or when to ice/heat.  In attempt of generalizing how to manage pain, I use The Traffic Light System. 

Now, before I educate someone on how to use The Traffic Light System, I have asked them many questions such as:  intensity of pain, episodes of pain, activities that increase it, time to recover, sleeping habits, medical history, medication use…  I could probably spend 20 minutes asking specific questions about pain during a Physical Therapy evaluation.  However, most people are afraid of pain.  To focus on it will usually only cause a more heightened response.  Pain, life stress, lack of exercise, and fear of activities can lead to something called central sensitization.  This is when your nerve receptors become sensitive to pain eventually  leading to inaccurate processing.  Non-painful stimuli become painful.  Everyone has a friend, family member, or patient who has been overcome by this type of pain mechanism.  You know… the type that has dedicated their life to treatment modalities such as Massage, Yoga, Chiropractic, Acupuncture, Physical Therapy, MRI’s, and finding the latest research on the surgery to cure their pain.  At one time these people had an acute injury that was not managed properly thus leading to fear of activities and central sensitization.   Many have gone through emotional cognitive events during or prior to the injury predisposing them to this type of pain “mutation.”  These factors eventually lead to chronic pain.  If you follow the Traffic Light System you should avoid this  “mutation.”

We are going to describe how to use The Traffic Light System by using an exercise example:   2 sets of 15 squats to improve your leg strength for decreased pain during running.

Red Light – STOP! During the exercise, if the pain is severe, sharp, radiating down the leg, or your leg completely collapses MORE THAN TWO TIMES do not continue with the exercise or activity you are performing.  If you are walking or using the stairs, modify as needed to reduce the pain.

Yellow Light – Proceed with Caution.  If the pain intensifies with the movement or exercise (mildly), continue for 5-10 reps.  If the exercise intensifies your pain, STOP.  If the exercise seems to loosen things up and you are able to continue without pain, PROCEED with the exercise.  If you have a pain that is unstable in terms of how it reacts to activities, you should not push yourself with intensity (# of sets, reps, speed, vigor).  This is where we get the term “listen to your pain.”

Green Light – Continue with the exercise.  If you do not get your pain, finish out the exercise and progress as muscle soreness allows.

Again, this is a very general way for you to assess your pain during activities.  If you have any doubt, STOP the exercise.  Attempt a similar type of movement to see if it creates pain in the same location (example: lunge).  The Yellow Light and Green Light needs to be progressed as an experiment.  Do a little extra and assess what happens to your body or pain for the next 24 hours.  If you feel the same or better, continue or progress with the exercise.  If you feel worse and know that the pain is not related to any other activity you have done that day, take a step back in intensity of the activity.  If you can’t figure out the equation, seek professional advise.