One night, you're in a bad neighborhood. A grungy thug comes out of nowhere and starts chasing you down the block. Suddenly, you are able to run faster and longer than you thought you ever could. And this is because your sympathetic nervous system has taken charge, which stimulates your adrenal glands to work harder.

But say you have a work assignment that is due the next day, the baby is crying even though you need to get dinner ready for your guests, your other child is screaming at you, and the TV is on full blast in the other room. Your body still interprets this as being under severe stress. The sympathetic nervous system has a hard time shutting off, the adrenal glands are overworking, and problems occur. Unfortunately, modern life often has overstimulation and a lot of pressures and difficulties that keep the sympathetic nervous system in fight-or-flight mode continually.

So where exactly are the adrenal glands? The kidneys are located in the lower back region, right around the second lumbar section of the spine just under your waistline, depending on the person. The adrenal glands are situated right above the kidneys.

The body is a whole universe with an extensive communication network. The body's nervous system breaks down into two parts: the central nervous system and the peripheral nervous system. The autonomic nervous system is part of the peripheral nervous system. The autonomic nervous system is responsible for involuntary movements and actions. It controls heartbeats, breathing, digesting, sweating, crying, etc. It is divided into the sympathetic and the parasympathetic nervous systems.

The sympathetic nervous system controls the fight-or-flight response. This means how your body responds to emergency and stressful situations. When the sympathetic nervous system is switched on your parasympathetic nervous system is switched off so that your body can cope with the emergencies more efficiently. When the sympathetic nervous system is on your heart rate increases, you sweat, your pupils dilate, and your body shuts down your digestion system so that it can focus on dealing with the emergency.

The parasympathetic nervous system kicks in when the sympathetic nervous system switches off. Your heart rate returns to normal, your digestion system starts back up, and body functions return to normal.

Although the nervous system's main communicators as neurons, the endocrine system's main communicators are chemical messengers known as hormones. Hormones are carried in the bloodstream to specific areas of the body, including organs and body tissues. Some of the most important endocrine glands include the pineal gland, the hypothalamus, the pituitary gland, the thyroid, the ovaries, and the testes.

When the sympathetic nervous system has been in flight-or-fight too long, it affects the hormones of the adrenal system. Too little or too much of the hormones can lead to adrenal fatigue and because of the way this fatigue impacts the body, it can lead to illness. This process of adrenal fatigue does not happen all at once. Instead, it is a gradual breakdown in the body.

The Three Phases of Stress

In 1956, endocrinologist Dr. Hans Selye developed a key concept in the study of stress and its effects on the body, which he termed, the general adaptation syndrome. In the general adaptation syndrome, the body passes through three phases in the way it copes with stress:

1. Alarm Phase
2. Resistance Phase
3. Exhaustion Phase

1. Alarm Phase
In the alarm phase, the adrenal glands increase the amount of hormonal secretions in an attempt to maintain homeostasis (normal functioning of the body). The sympathetic nervous system is in excess. When the sympathetic nervous system is on and the parasympathetic nervous system is off, there will be a deficiency with digestion, the sex organs, the urinary tract, and less energy is being sent to these systems in order to deal with the more immediate crisis. That means blood is shunted away from hands, skin, feet, and the digestive tract (stomach and intestines) to the brain and the immediately important organs in the torso like the heart.

This can cause those raised knotted shoulders, tight upper back and neck, chills along the spine, clammy hands, cold feet, increased heart rate, a tight locked pelvis, and tight leg muscles. A good example of this is in someone who has just had a car accident - a hugely stressful event. Just as their body responds to stress by causing the upper back and legs to tighten, the muscles are jerked quickly, causing injury that can take time to heal. On the other hand, the body does this to stay alive, so that the heart can keep pumping blood even under poor circumstances, and so the person won't feel pain as quickly - that's the beauty of the sympathetic nervous system's response. In the alarm phase, stress is relatively short lived and the return back to homeostasis is with ease.

A list of what happens during a fight-or-flight response:

• The sympathetic nervous system response goes into excess as the body mobilizes by bringing large amounts of glucose and oxygen to the organs to ward off danger.
• Non-essential parasympathetic functions like digestive, urinary, and reproductive systems are inhibited.
• Adrenocorticol secretion rises sharply, raising the blood pressure and producing symptoms of sympathetic system hyperactivity.

Symptoms: Shortness of breath, palpitations, emotional instability, headache, back pain, decrease in frequency and quantity of urination, insomnia, lack of appetite, dizziness, nausea, eye pain, cold hands and feet, tight neck and upper back muscles.

Options on how to treat this stage:

• B-Vitamins: B-Vitamins help the body deal with stress better. Deficiencies in B Vitamins can cause muscle cramping and depression, but certain B Vitamins (for example, B-5) are also necessary for adrenal gland function.
• Magnesium: Magnesium can help both the skeletal and smooth muscle cramping that can be experienced as a result of stress. Because magnesium relaxes muscle, it can be helpful for stress-induced Anxiety or asthma attacks, and for lowering blood pressure.
• Electrolytes: After a stressful event or exercise, electrolytes like sodium and potassium can be lowered as well and these electrolytes are necessary for fluid balance in the tissues and regulating transport along cell walls. Also, sodium is closely involved in the regulation of the adrenals. Lack of sodium and potassium can cause swelling, as well as muscle weakness, fatigue, muscle cramps, fatigue, and mental confusion. If you have hypertension, you should check with your doctor about this because there may be a correlation between potassium deficiency and high sodium consumption in the diet of hypertensive patients.
• Vitamin C: Among other reasons to take Vitamin C (there's a list!) ACTH stimulation causes marked loss of ascorbic acid from the adrenal cortex. ACTH is what stimulates cortisol production when there is stress.
• Cutting down on coffee consumption: Coffee stimulates the adrenal glands, so if you are having problems with stress, this would be an important thing to cut down on. Try going without the afternoon cup and just having one cup in the morning.
• Drinking Water: Drinking water is important for treating stress as your body needs it for virtually every function so it's easier for your body to bounce back if it's hydrated. If you haven't been drinking water, you can begin drinking more along with taking in essential fatty acids and lecithin.
• Lecithin: Lecithin helps cell walls repair tissue and helps organ hydration and function.
• Essential fatty acid (EFA): EFAs attract water to dehydrated cells and connective tissue and maintain cell hydration.
• Meditation: Meditating for at least 5 minutes a day will help the body to relax, mitigating the effects of stress and keeping you from moving to stage 2.
• L-Theanine: If you have sudden high spikes of stress leading to extreme stress symptoms this is a great supplement. A good example is if you have test Anxiety, panic attacks, extreme sweating, and blanking out in stressful situations. L-Theanine is an amino acid taken from tea leaves, such as green tea, that creates a sense of relaxation 40 minutes after ingestion. This works in two different ways. It stimulates the production of alpha brain waves, creating a state of deep relaxation and mental alertness similar to what is achieved through meditation. It is also involved in the formation of gamma amino butyric acid (GABA), which influences two other neurotransmitters, dopamine and serotonin, producing the key relaxation effect.
• Rhodiola Rosea root: Rhodiola rosea root supports the functioning of the adrenal glands and encourages a healthy response to physical, emotional, and mental stress by normalizing cortisol levels and other stress-related hormones. If used regularly, it enhances the body's natural resistance and adaptation to stressful influences. In some people it can make you hyper, so take with caution.

2. Resistance Phase
According to Hans Selye, M.D., traumatic situations cause an elevated function of the adrenal glands. If this elevated activity is prolonged, the adrenal gland will be overworked and become exhausted, and thus be unable to release adequate amounts of adrenal hormones, such as cortisol and epinephrine.

In the resistance phase, constantly reacting to stress leaves the body depleted, leading to a general decrease in overall resistance to illness, inflammation, and pain. Stress is wearing the body out even though the body is still resisting it. There is constant energy being sent by the adrenals and sympathetic nervous system to only the most important organs for a flight-or-fight circumstance. For example, since digestion is a parasympathetic function, undigested food begins to enter the colon, causing gas and bloating, and as the body can't pull the nutrients out of food as efficiently, there are less number of important nutrients to keep the body healthy and pain free. Secretion of the adrenal hormones is initially still high, but slows down as they begin to wear out. The sympathetic nervous system weakness leads to sympathetic deficiency. The parasympathetic nervous system begins to become more dominant as it attempts to compensate.

The parasympathetic nervous system will switch on and take over, but not because the sympathetic nervous system has switched off, but because it's so exhausted that the parasympathetic nervous system has to pick up the slack so the body can function. What occurs is a constriction of blood vessels such as capillaries and arteries in the brain, excitement of the digestive system, and adrenal gland deficiency along with a whole host of problems listed below.

What happens during the Resistance Phase?
-Parasympathetic dominance
-Sympathetic exhaustion
-Adrenal gland exhaustion

What kind of patient has moved from the Alarm Phase to the Resistance Phase?

• The adrenal gland exhaustion sign is most active on those who have suffered or are suffering from shock, trauma, or extreme stress.
• This could be a person under chronic stress, who has a sudden trauma or a big life change.
• This could be a person under chronic stress who has had past trauma that still challenges them in some way (car accidents, sexual abuse, child abuse, psychological abuse, fear of death).
• People may have also had many children or many abortions, have had surgery(s), a history of chronic disease and pain. Also, drug abuse or a history of strong medication can lead to this stage.

Symptoms:

• Feeling tired, low back pain, shoulder pain and muscular tightness in whole body. Other symptoms include lack of sweat (except on palms of hands), cold lower back, cold abdomen, cold extremities.
• Upper respiratory tract symptoms: Constriction of airways and wheezing, shortness of breath and coughing. Allergic asthma may have presented itself in the alarm phase but is more typical in the resistance phase.
• Urinary Tract symptoms: Parasympathetic system dominance can stimulate contraction of the bladder, causing frequent urination.
• Gastrointestinal symptoms: abdominal pain, cramps, diarrhea, excessive salivation and gas.

Options on how to treat this stage:

All the recommendations from Stage 1 will help, but here are a few more for the more severe stage 2. All of these should be checked out with a doctor first as you may be having more severe symptoms stemming from stress (for example, high blood pressure):

• Holy Basil: Holy Basil is an Ayurvedic herb that supports a healthy response to stress, nourish the mind, and elevate the spirit. It contains a variety of constituents, including eugenol, camphor, caryophyllene, ursolic acid, luteolin and apigenin that function collectively to normalize stress hormones and enhance adrenal function.
• Ashwaganda: Ashwaganda is an Ayurvedic herb and an adaptogen that supports mental and physical Vitality and stamina. It contains steroidal compounds and additional chemical constituents that advance the body's natural resistance and adaptation to stressful influences. It supports mental endurance, promotes total metabolic efficiency and encourages an overall sense of well-being.
• Schizandra berries: Schizandra (Wu Wei Zi in Chinese medicine) is an adaptogen that promote overall health and Vitality, enhances the body's natural resistance to stressful influences, supports mental endurance and promote overall metabolic efficiency. This is also an astringent herb, so it may help if diarrhea and having to urinate too often are symptoms.
• Try different relaxation techniques: Meditation, deep breathing, long hot baths, relaxing yoga classes, journaling. You need to find something that relaxes you that you can do every day. This seems simple but is a great help for your body.
• Avoid sodium: Avoid sodium if high blood pressure is a symptom. In restoration of the adrenal gland function, typically one should include potassium rich foods and avoid foods that are too high in sodium.
• Cut out coffee completely: Coffee stimulates the adrenal glands and in this phase, they are over-stimulated. At this point, you need to do everything you can to calm them, so this is the time where you actually should consider not just cutting down on coffee, but quitting entirely.
• Cut out smoking: Smoking inhibits the ability of your lungs to breathe so it can be really important to quit at this phase.
• Cut out or significantly lower sugar: The injury to the sympathetic nervous system and adrenal gland weakness can affect the way your body metabolizes glucose. This may be especially important if you are diabetic (chromium increases the ability of your body to metabolize glucose, so this may be something to look into if that's a problem). Sugar will also increase inflammation.
• Watch out for inflammation symptoms: Increases in body pain, sudden muscular tension, allergy attacks, and new food allergies - all of these are signs of inflammation which are common in this stage. Turmeric /curcumin can help with this, as can essential fatty acids, but the inflammation may be happening because stress is affecting the body.
• Ginger: Ginger is very warming, and if you are constantly feeling cold due to stress, this would be a great tea to make you can buy ginger at any grocery store and slice a few pieces to make tea out of. It works in soups too.
• Bitters: Bitters might be good to take at this time if digestion and elimination is a large problem.
• Overstimulation: If you are experiencing an inability to relax even when exhausted, you might try making a tea out of linden flowers, skullcap, passionflower, and chamomile, but make sure you aren't driving and have a night of relaxation and sleep ahead of you.

Stage 3: Exhaustion Stage
- This stage occurs only when stress is extremely severe or when it continues over a long period of time.
- If stress continues to this level, cortisol secretion increases above normal rate and may even surpass levels produced by alarm reaction. However, the body's adaptive mechanisms are not adapting, they are decreasing.
- The body is not able to successfully cope with the stressor.

Possible Consequences of Exhaustion Phase:

• Arthritis, arteriosclerosis, nephrosclerosis, gastrointestinal ulcers, hypertension, etc.
• Prolonged exposure to high levels of cortisol and other hormones involved in the resistance reaction causes wasting muscle, suppression of immune system, and pancreatic beta cells.
• Even if changes are made in lifestyle now, resistance reactions persist even after stressor is gone.
• Serious diseases like Cushing's syndrome and adrenal diabetes may occur.
• Due to the fact that the body's systems are very much out of homeostasis, a multitude of problems may now occur and so we won't discuss natural remedies and supplements as this is the more emergency stage where you must work with a doctor.

Sources

- Bodymind Energetics Towards a Dynamic Model of Health. By Mark Seem, Ph.D.
- Kiiko Matsumoto's Clinical Strategies Volume 1. By Kiiko Matsumoto and David Euler
- Principles of Anatomy and Physiology. By Tortora and Derrikson
- The Ciba Collection of Medical Illustrations, Volume 4, Endocrine System and Selected Metabolic   Diseases. By Frank H. Netter, M.D.
- Color Atlas of Human Anatomy. By R.M.H. McMinn and R.T. Hutchings
- The Stress of Life. By Hans Selye, M.D.
- Natural Health Complete Guide to Medicinal Herbs. By Penelope Ody, MNIMH
- Medical Nutrition From Marz, 2nd Edition. By Russell B. Marz, N.D., M.Ac.O.M

Sports massage is a form of massage therapy that is tailored to treat the needs of athletes. The use and application of specific techniques is the foundation of sports massage, yet what distinguishes it from other modalities is the intention behind the therapy. Many of us might think of massage as relaxing and holistic. Sports massage, in contrast, is designed to achieve specific goals, such as increasing performance or treating or preventing injury. The purpose of a sports massage session can vary, depending upon numerous factors that are unique to each athlete. For instance, sports massage can be used effectively to treat conditions such as tendonitis, strains, sprains, and adhesions. It can also be used in conjunction with training schedules and conditioning programs to enhance performance, aid in recovery and reduce the potential for injuries.

The major applications of sports massage are recovery, remedial (to improve a debilitating condition), maintenance, and event (pre, inter, and post). An athlete can enhance his or her performance by knowing when to incorporate sports massage into a training routine. Healthy, injury-free muscles perform better, longer, and with less chance of injury.

Sports massage can help to optimize the positive factors that affect performance, such as healthy muscle and connective tissues, normal range of motion, high energy and fluid and pain-free movement, as well as inducing mental calm and improving alertness, and concentration. It also can help minimize negative factors such as dysfunctional muscle and connective tissue, restricted range of motion, low energy, staleness, pain, and high anxiety^(1a).

Sports massage decreases injury potential by helping to prevent acute injuries (muscle tears) as well as chronic injuries stemming from wear and tear (tendonitis). Regular massage allows the muscles and soft tissue to stay supple and healthy, lengthened and flexible and free from adhesions, thereby reducing the potential for injury. By increasing circulation and assisting the body’s healing processes and breaking down scar tissue and adhesions, sports massage can help chronic injuries get better.

Important Primary and Secondary Effects of Sports Massage^(1b)

Primary effects refer to the physiological and psychological condition of the athlete and include:

• Improved fluid circulation (blood, lymph),
• Muscular relaxation,
• General relaxation,
• Functional separation of muscle and connective tissue (i.e., breaking up adhesions),
• Connective tissue normalization (releasing areas of tension, etc.),
• Increased mental alertness and clarity, and
• Deactivation of trigger points. (A trigger point is a nodule of tight muscle tissue that can refer pain locally or to other areas of the body.)

Secondary effects refer to performance-related outcomes and include:

• Greater energy,
• Greater flexibility and range of motion,
• More fluid movement (i.e., referring to the quality of the range of motion),
• Faster recovery, and
• Pain reduction.

If you decide that sports massage is the right treatment for you, it is important to find a well-trained therapist. Check out if a practitioner has had training in sports massage from an accredited school. Currently, there is no national credentialing that signifies a person who has passed a test demonstrating a solid understanding of the foundations and techniques of sports massage, so you will have to ask a few questions. How many hours of training (in general) did they have? Was their school accredited by the American Massage Therapy Association? How many hours of training in sports massage did they receive? What kind of athletes have they worked with? Were the athletes training or competing at the time? Is your therapist an athlete (on any level)?

Many sports massage practitioners participate in races or competitive events, which increases their understanding not only of the uses and benefits of sports massage, but of other factors that go into being an athlete. For example, the length of time between the massage session and the athletic event directly relates to the depth of pressure a therapist should use. A knowledgeable therapist will know that a pre-event massage, which is meant to encourage general looseness, calls for less deep work than a regular “maintenance” massage. It is important that your therapist always errs on the side of caution when using deep pressure, and that they have an understanding of the psychology of an athlete and the physical demands of training.

One of the benefits of working regularly with the same sports massage therapist is that he or she can learn to feel what is “normal” for your tissue and body type and can keep a watchful eye on any changes that may signal the need to head off potential trouble spots. If an injury does occur, the therapist can join the team of health care practitioners helping you to recover. Here, the focus is on healing the injury quickly and effectively, minimizing the side effects of the injury and decreasing the chance of re-occurrence.

The use of sports massage in training routines varies depending on the athlete, the sport being trained for and the level of competition. It is important to mention that every athlete and every situation is going to be different, and that each person should research and find a plan that is most suitable for them. With that in mind, let’s take a look at how two different athletes used sports massage in conjunction with their training.

When Uta was competing in 5K to 10K races, or preparing for a marathon, she received sports massage twice a week. Usually, she scheduled her massages the day after one of her harder training sessions for the week. If that wasn’t possible, she would allow herself a treatment session on the same day as her hard workout, but she would wait at least 3 to 4 hours to let her body recover some from the training before addressing soft tissue needs. Getting regular massage during her intense training periods also helped Uta psychologically, by allowing her to give back to her body and take some time for herself.

Training for my first triathlon, I used sports massage regularly. I noticed that I could identify potential problems and head them off before they became an impediment in my training. I also felt, during the most intense training periods, that taking the time to give back to my body really helped me to feel like I was rounding out my training program. Having time to recover, making the effort to work my muscles and being in tune with my body, all played integral roles in my ability to train as hard as I did, without hurting myself.

Getting regular massages during training is a great way to generate feedback for yourself about how you are doing. The more feedback you can gather about performance and training, and how your body is responding to it all, the better informed you will be about how you can compete and recover from competition. Sports massage, therefore, can be a great tool for athletes in their training. It provides myriad benefits, including increasing performance potential, speeding recovery time, and reducing the prevalence of injuries. And let’s not forget the wonderful relaxation, stress relief, and whole body integration that everyone—not just the athlete—can obtain from massage!