Allostatic Overload: Stress and Emotional Context Part 2

What we have learned from Part 1 is that physiological adaptations during training are due to the planning of stress. As humans, we need the stress response to survive. Stress is training variables (i.e reps, sets, intensity, loads, velocities, etc.) and the cascade of the HPA axis is the window into performance. But we also need to be able to turn it off when it is not needed.

A chronic state of stress will limit adaptation and performance. A chronic state can lead to changes in environmental perception, behavior, and anxiety (level of tension). Allostatic overload is a term that reflects the pathophysiology that chronic over activation of the stress response of regulating systems can create. These changes can reflect compensation patterns for movement and be reflected physically, emotionally, and behaviorally. Part 2 will be dedicated to the physical adaptations to allostatic overload.

However, we need to appreciate that it is not just physical. Part 1 discussed emotional and behavioral overload such as heightened threat perception, anxiety, increased level of alertness and tension, and difficulty relaxing (parasympathetic access). “Hyperactivity of amygdala may be part of mechanism through which normal fear process translates into anxiety disorder in some individuals” (15). “Stress- related neuroplastic changes are associated with decreased behavioral flexibility” (4,5).

Everything is connected.

“Do whatever you want, just know that it has a consequence” – Chris Chase

WHAT DOES THIS LOOK LIKE?

Wolff’s Law states that bone in a healthy human will adapt to the loads under which it is placed; if loading on a particular bone increases, the bone will remodel in order to support the increase in load over time. This law also applies to muscle, the muscle will hypertrophy if there is an increased demand on the muscle. For example, if the body is lateralized to the right, the vastus lateralis is eccentrically loaded to support body weight thus creating hypertrophy.

The pictured athlete is lateralized TO THE RIGHT. Not only is it evident in this picture, but it was determined through testing.

Muscles are SUPPOSE to function in a specific way but the position that the muscle is in due to boney landmarks dictates the function. Function is dictated by position. Stress will pull athletes into an extended position due to an increase in muscle tone of spinal erectors, lats, traps, gastrocnemius, and superficial neck muscles. Performance can be effected due to overreliance on non-oxidative energy systems in these muscles.

Superficial neck muscles such as the sternocleidomastoid and traps will be recruited to pull clavicles up to create more space vertically when the diaphragm is not in the most efficient/correct POSITION to function. Both the tendon (attachment point) and belly of the superficial neck muscle will hypertrophy due to increased load. Hello, neck pain.

It doesn’t stop at physical properties of the muscle. Firing patterns can be altered, in which neural pathways for breathing are going to be normalized and directed to using superficial neck muscles instead of the diaphragm, internal obliques, and transverse abdominals to breathe. If the rib cage or pelvis positions are altered and pathophysiology develops, neural firing patterns needed for all three planes of movement (sagittal, frontal, and transverse) may be altered. This may lead to compensation patterns and limit function of major, powerful muscles such as the gluteus maximus.

Impingement may also be a symptom of allostatic overload. An athlete may experience impingement because of lack of anatomical afferent information of where the body is in space. Positional impingement is the instability from misaligned structural position or orientation. Often athletes who experience impingement symptoms (feeling of ‘pinching’ at a joint) lack sensation and resort to a safety pattern. Misaligned body structures can be the result of allostatic overload and impingement becomes the response to threat.

WHAT TO DO?

Sensory processing will reduce emotional intensity and DE threaten the environment and/or task. A low- resourced environment due to a lack of sensory information is likely to result in high levels of stress. Use tempos to SLOW PEOPLE DOWN. Get people to think, find, feel, and process information. Can you feel this? Can you find that? Feel appropriate muscle working and utilize spatial and ground references to provide athlete with sensory information.

Ground and spatial references that provide perceptual feelings will provide brain with sensory information to respond with the appropriate motor signal. Finding and feeling creates stimulation and stabilization which will help assist symptoms of impingement.

We all need sensory processing for proper motor function; this in combination IS performance.

Consider the pelvic floor when you squat. Pelvic floor dysfunction can lead to pelvic floor pain, poor bladder control (adult diapers), vulvodynia, erectile dysfunction in males, and dyspareunia (painful sexual intercourse). “The pelvic floor muscles contribute to postural (control of lumbar spine and pelvis) and respiratory functions” (7). During periods of increased intra-abdominal pressure such as lifting pelvic floor muscle (puborectalis, puboccygeus, and iliococcygeus) activity is increased to prevent or limit rostral displacement (anterior tilt) of the floor, maintain bladder neck, and assist with urethral and anal closure. If the pelvic floor is not in a good position during activity, weakness and dysfunction may result.

If pelvic position is not restored after lifting (external load) and the pattern/position becomes normalized, it further leads to pelvic floor weakness and possible dysfunction. Improper consideration of the position of the pelvis and function (descent) of the pelvic floor during training can lead to allostatic overload. Improper consideration of the position of the pelvis and function of the pelvic floor muscles during external loading (lifting) OR the inability to return to a neutral position after loading may lead to weakness and dysfunction. Consider the health and function of the athlete years after they are done training with you. What are you leaving them with?

Re-think and APPRECIATE how the athlete is anatomically positioned and how this position is allowing and creating movement. How do you do this? TEST. The most beneficial thing I have taken away from Postural Restoration Institute (PRI) course is a greater understanding of anatomy and exercise selection that provides the athlete with the most benefit and least amount of cost on the system. Let’s use the example of a kettlebell swing: The athlete (on right) demonstrated bilateral pelvic anterior tilt with testing. During the KB Swing, the athlete is not maintaining foot contact with the ground, externally rotating the femur into further ranges of external rotation without the ability to flex, adduct, and internally rotate (I know this via testing).

So my question is, why would I prescribe an exercise that forces them to greater ranges of external rotation when I know that they are stuck in external rotation? If I force them to go into a greater range of motion in this position, I am driving them into pathology (overlengthening of ligaments, etc.). Is this beneficial? No. Can I find other ways to work on hip hinging and explosive hip extension? Yes. Be creative and understand the individual.

Address anatomical stress patterns. Promote exhalation and systemic flexion to change entrenched and automatic extension position. Get people to EXHALE. IF your athlete is stuck in extension, is giving more extension the best for that athlete? OR is it leading them down a path of pathology? This doesn’t mean stop training? NO, it means manage the consequences. Are they performing exercises in a safety pattern? Then DE threaten. DE threatening the task and/or environment will reduce stress on the system. For individuals who test as pelvic forward/anterior tilt, trap bar deadlifting may be more beneficial in terms of position to strengthen the posterior chain than squatting under high loads. (Understand the context: I work with collegiate athletes how are not competing for money and will most likely not compete at a higher level, so future health and function is a consideration.)

Create a comfortable, welcoming, and positive environment. Positively influence environment, mitigate athlete’s perceptions of both security and risk (2), create quality relationships/social interactions, and educate/provide awareness. Consider psychological stress, just as much as physical stress; know that they are interrelated.

“We spend so much time and energy designing programs and arguing about ‘best’ exercises or ‘best’ session designs, and yet so little time reflecting on how best to positively manipulate training and competition contexts to optimally reduce the negative impacts of stress.” – John Kiely

As a strength and conditioning coach, the best way to manage cost in consideration of allostatic load is with exercise selection. We shouldn’t just modify exercises if an athlete is injured or has physical restrictions, we should modify exercises to avoid unnecessary wear and tear. Choose exercises that avoid pain, provide appropriate position while maintaining intensity. For example, safety bar squatting instead of back squat to avoid shoulder wear and tear and allow athlete to maintain proper position throughout movement. We all have a tendency to want the biggest and best results as fast as possible, however focus on achieving sustainable long-term returns with the overall health and future of the athlete in mind.

About the Author:  Dr. Michelle Boland

– Strength and Conditioning Coach at Northeastern University (Boston, MA)

– PhD. Exercise Physiology, Springfield College

– M.S. Strength and Conditioning, Springfield College

– B.S. Nutrition, Keene State College

– Follow on Instagram: mboland18

– Visit: www.michelleboland-training.com

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