Can mindset effect tissue healing time?

As a physical therapist I see a lot of different types of people and personalities. While I’ve only been practicing for just under a year, I have been in/around the rehab setting since 2011. I feel I can confidently say that the trends I see in the rehab setting can be applied to multiple aspects of our daily life. This post will primarily be about rehabilitation and recovery; however, I will be writing follow up posts about how this same concept seeps into our relationships and careers.

Opinions are important, but they are more impactful when the research points to the same conclusion. For that reason what I want to talk about today is how emotion and mind set impact rehab potential, healing potential (supported by cited research), health, and fitness goals in general.

I read an interesting study that discussed the impact of anxiety and fear on wound healing time post operatively. The study stated that “converging evidence from different research paradigms suggest that psychological stress and other behavioral factors can affect wound healing…This suggests that the relationship between stress and wound repair is not only statistically significant, but also clinically relevant”. ¹ The results of the study showed that people who experienced less stress and had less anxiety/fear before a surgery had better outcomes in regards to wound healing, shorter hospital stays, and a decreased chance of re-hospitalization. Interesting, right?

How is it that the mind has such control over the body physically/physiologically? In a nutshell, our bodies were created to protect ourselves when harm and danger are eminent. When a threat is sensed, the body releases chemicals and hormones, which in turn raise the level of sensitivity of the nervous system to prepare us for “fight or flight”. However, there are times when this response becomes more damaging than helpful. The Institute for Chronic Pain blog notes that stress, fear, anxiety and depression etc. all have an effect on our nervous system and in turn can make us physically tense or uncomfortable. There are familiar areas where most people tend to carry this increase in tension: neck, shoulders, head, jaw, and low back. Not only do our muscles become tight, but we can also feel it in our gut. Stress and anxiety can lead to upset stomachs, reflux, diarrhea, and even ulcers. Over time, chronically tense muscles can ache and spasm, leading to pain. In my experience, when it comes to rehab, someone experiencing chronic pain typically reports an elevated level of stress and frustration.

This means that as time goes on, something that used to only mildly increase pain every now and then may increase pain with greater intensity and frequency. This is a very shortened introduction to a very complicated topic known as the pain cycle. It is important to understand this concept, even briefly.

Since we know and have scientific evidence suggesting that perseverating and continually thinking and dwelling on pain actually makes pain worse…This is where the victim mentality comes into play. Have you ever been around someone who only seems to talk about the negative things that are happening or have happened to them? Someone who is set on the idea that absolutely everything in his or her life is happening TO them? I think we all know someone like this, or have at one time or another been this person ourselves, and have seen the toxic negativity of that mindset.

I want to challenge everyone dealing with chronic pain or dealing with a physical injury to really step back and do some assessing. What can you do to directly impact your situation? What are you physically capable of? What is an activity that you would like to return to that may motivate you in your rehab process? Instead of focusing on what you cannot do and how much your pain is impacting you, think about the positive. Focus on the progress you HAVE made. I am not trying to imply that this will eliminate or even significantly reduce pain; however, if studies show that fear, anxiety, depression and stress can alter something as visible and tangible as wound healing time, we must take into account a broader possible impact of mindset/emotions. Could we not also conclude that continued focus on pain or limitations with a negative mindset may also set back rehab potential and recovery time for the less physically obvious and measurable components involved (i.e. internal tissue healing time or unexplained chronic pain)?  Hormones and other chemical balances play a large roll in body weight as well, so while it is an influential component to rehabbing for maximum recovery and functional ability it is also important to remember in fitness goals as well.  Below I have listed several known contributors to delayed healing as well as offering counter suggestions to help improve healing.

Known contributors to delayed healing:

• Heavy alcohol use has been associated with delayed healing process
• Dehydration
• Smoking has been related to slowed healing of naturally occurring and surgery wounds
• Sleep disruption delays skin barrier recovery…and diminishes growth hormone production
• Lack of regular physical activity can slow wound healing rate
• Maintaining high stress and anxiety levels

What can you do to help improve your rehab potential?

• Attempt to have a healthy, balanced diet with minimal alcohol intake
• Aim at drinking ½ your body weight in oz of water for adequate hydration
• Stop smoking
• Get a full 7-8 hours of sleep
• Begin a walking program with gradual increases in distance. Walking results in the body releasing endorphins and serotonin…. natural analgesics!
• Find healthy outlets to help reduce anxiety and stress in your life; seek professional help if necessary
• Focus on what you CAN do and make reasonable and measurable goals for what you would like to return to doing in order to keep yourself motivated

References:

1. Gouin J-P, Kiecolt-Glaser JK. The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms. Immunology and allergy clinics of North America. 2011;31(1):81-93. doi:10.1016/j.iac.2010.09.010.
2. “Stress and Chronic Pain.” Institute for Chronic Pain Blog. N.p., 15 Nov. 2015. Web. 18 Mar. 2017.