NEWS

This is a page of various articles that I have gathered and feel are appropriate to the content of this website. The subject matters are from projects and assignments that I have covered whilst studying Sports Therapy. They are not in any order and some are rather long but interesting. All Internet links have been retained they should be live and working once on-line.

INDEX: Just click on to your subject of choice for more information.

1. HOMEOSTASIS: 
2. ANATOMY: 
3. THE LYMPHATIC SYSTEM: 
4. SPORTING INJURIES: 
5. POSTURE ASSIGNMENT: 
6. THE ENDOCRINE SYSTEM: 
7. HIRSUTISM: 
8. MUSCLES IN GENERAL: 
9. SKIN DISEASES: 
10. SPORTS EVENT MASSAGE: 
11. STRETCHING: 
12. NUTRITION SPECIAL DIETARY NEEDS: 
13. DIABETES: 
14. COMPULSIVE EXERCISER: 
15. FOOD LABELS: 
16. FAT BURNING - FAT REDUCTION: 
17. LOSING WEIGHT OR LOSING FAT: 
18. ANOTHER WAY TO EAT: 
19. HEART RATE TRAINING: 
20. BENEFITS OF EXERCISE: 
21. SPECIAL POPULATIONS: 
22. SYSTEMS OF TRAINING: 
23. MUSCLE CONTRACTIONS: 
24. BLOOD: 
25. THE BREAST: 
26. DIGESTION: 
27. THE HEART: 
28. THE KIDNEYS: 
29. RESPIRATION: 
30. NERVOUS SYSTEM: 
31. CARDIOVASCULAR DISORDERS: 
32. PERSONAL TRAINING:

HOMEOSTASIS: Dynamic self-regulation. The condition of a system when it is able to maintain its essential variables within limits acceptable to its own structure in the face of unexpected disturbances.

Homeostasis is one of the fundamental characteristics of living things. It refers to the maintenance of the internal environment within tolerable limits. All sorts of factors affect the suitability of our body fluids to sustain life; these include properties like temperature, salinity, acidity, and the concentrations of nutrients and wastes. Because these properties affect the chemical reactions that keep us alive, we have built-in physiological mechanisms to maintain them at desirable levels.

When a change occurs in the body, there are two general ways that the body can respond. In negative feedback, the body responds in such a way as to reverse the direction of change. Because this tends to keep things constant, it allows us to maintain homeostasis. On the other hand, positive feedback is also possible. This means that if a change occurs in some variable, the response is to change that variable even more in the same direction. This has a de-stabilizing effect, so it does not result in homeostasis. Positive feedback is used in certain situations where rapid change is desirable.

A process of interaction or mechanism which balances various influences and effects such that a stable state or a stable behavior is maintained. Often that stable state or that stable behavior is essential to assume structural stability e.g., the size of the pupil of the human eye is negatively correlated with the intensity of light entering the retina thus keeping the amount of light within the limits of optimal processing of visual information.

Too much light will destroy the light sensitive cones of the retina. The blood sugar content and many other chemical quantities are similarly balanced within the human body.

Stable homeostatic states or behaviors need not have this purposive interpretation, however. The "balance of power" idea in international politics denotes a homeostatic mechanism whose outcome presumably neither country desires by itself.

An another example of homeostasis in cells is the phenomenon called contact inhibition, in which division in a population of cells stops when they become so numerous that they touch each other. It is believed that, a chemical "messenger" that inhibits further cell division is passed from cell to cell. In contrast, cultured, or artificially produced, cancer cells continue dividing even after cells touch. Thus, cancer cells appear to have lost the homeostatic mechanism of contact inhibition. Homeostasis in organisms is exemplified by the operations of the endocrine system. The hormone-synthesizing activities of the endocrine glands are regulated by events occurring in the systems that the hormones regulate. For example, a rise of blood-glucose levels stimulates the pancreas to secrete insulin, which acts to accelerate the removal of glucose from the blood by conversion into the storage products glycogen and fat. The sensations of hunger and thirst are also homeostatic mechanisms; they help the organism maintain optimum levels of energy, nutrients, and water.

ANATOMY: Bones provide attachment points and support for muscles. Bones are connected together by fibrous tissue called Ligaments. Tendons are also fibrous tissue and attach muscle to bone. Both have some elasticity and do not heal on their own if torn. An overstretched tendon is called tendonitis and is an inflamed tendon. Cartilage is also fibrous tissue but is not elastic. Cartilage is used to cushion the junction of two bones.

The body is divided into three anatomical planes the Frontal, Sagittal and Horizontal. The Frontal plane divides the body from front to back. The Sagittal plane divides the body down the center. The Horizontal plane divides upper and lower. The table below lists the anatomical term and the corresponding description.

The three types of muscle contraction are Isometric, Isotonic, and Isokinetic. Isometric is defined as that type of contraction where muscle tension and muscle length remain constant. This type of exercise provides muscle strength gains but only at the joint angle held during the exercise. Isotonic contraction is defined as that where the muscle tension remains constant and muscle length varies. Isokinetic contraction is defined as varying tension and length.

In each exercise there are four main functions of the associated muscles, Agonists (prime movers), Antagonists, Stabilizers and Assistors. The Agonists is generally the muscle we are exercising. The Antagonist is the opposing muscle and acts in contrast to the agonist. The Stabilizer muscles are those that hold a joint in place so that the exercise may be performed. The Assistors help the Agonist muscle doing the work. The stabilizer muscles are not necessarily moving during exercise, but provide stationary support.

For example, when doing biceps curls, the biceps are the agonists, the triceps are the antagonists and various muscles including the deltoids are the stabilizer muscles. However, when doing a triceps push down, now the triceps are the agonists and the biceps are the antagonists. Again the deltoid muscles are the stabilizer muscles. The agonist/antagonist relationship changes depending on which muscle is expected to do the work. However, every muscle group has an opposing muscle group. The following table lists muscles and their opposing counterparts:

In reference to Agonist and Antagonist, this above list could easily be reversed when exercising the muscles in the right hand column. Muscle balance is that relationship between the Agonist and Antagonist. It is important to have muscle balance to prevent injury. If the Agonist is much stronger than the Antagonist, the Agonist can overpower and injure the Antagonist.

Tendons are made up of fibrous tissue and connect muscle to bone. Tendonitis is an inflammation of the tendon due to overuse. A stretching or tearing of the tendon is referred to as a strain. A Strain is a muscle or tendon injury.

Ligaments are also fibrous tissue and connect bone to bone. There are less flexible than tendons. The function of ligaments is to restrict the joint movement within normal parameters. When a ligament is over stretched or torn it is called a sprain. Since ligaments don't have a vascular system, they may take a very long time to repair or may never return to their original length. This can cause abnormal joint movement and even cartilage and bone wear due to this unrestricted movement.

Joint Action: Joints provides a fulcrum point for muscles to do work. There are six types of joint action:

The human skeleton consists of 206 bones. We are actually born with more bones (about 300), but many fuse together as a child grows up. These bones support your body and allow you to move. Bones contain a lot of calcium (an element found in milk, broccoli, and other foods). Bones manufacture blood cells and store important minerals.

The longest bone in our bodies is the femur (thigh bone). The smallest bone is the stirrup bone inside the ear. Each hand has 26 bones in it. Your nose and ears are not made of bone; they are made of cartilage, a flexible substance that is not as hard as bone.

Joints: Bones are connected to other bones at joints. There are many different types of joints, including: fixed joints (such as in the skull, which consists of many bones), hinged joints (such as in the fingers and toes), and ball-and-socket joints (such as the shoulders and hips).

Differences in males and females: Males and females have slightly different skeletons, including a different elbow angle. Males have slightly thicker and longer legs and arms; females have a wider pelvis and a larger space within the pelvis, through which babies travel when they are born.

The bones provide the structural frame-work of the body. They keep the organs in –place and maintain the shape of the body. Bones are very light. The 200 odd bones in your body weigh less than 20 pounds. They are however, extremely strong. As mentioned they have the qualities of both compression – allowing us to hop, skip and jump – and tension, allowing us to carry heavy objects. How is this accomplished? Criss-crossed through the concrete-like calcium in bones run fibers of collagen, which provide support and reinforcement. So, effective is this design structure that bone is eight times stronger than reinforced concrete.

What else is unique about the bone structure? For one, thing from birth they are constantly growing for about twenty years. Yet, there is no halt to their function. The bones are also self healing. If a shaft in an engine breaks, we take it out and find a new one. But if a bone breaks, we expect it to mend itself and, after a while, to be as good as new.

The joints between our bones are self-lubricating. This aids in transmitting the force and power from one bone to the next. In fact, the joints between bones normally show no wear at all, yet they are able to withstand a weight that is three to ten times the body weight. Because of the lubrication, very little energy is lost to friction. The end of long bones is also made of bones that are spongy and more resilient. This aids in resisting impact injuries. Inside the bones, a marvel of creation is taking place. Here new blood cells are made, and these are constantly re-nourishing our indispensable blood supply.

Your bones are truly masterpieces of design. Just, imagine, if your bones were replaced with the next strongest material known to man, steel, they would weigh about 800 pounds – without the compression benefits of the real thing. So, we can be grateful that we are kept together by something that man can only marvel at – human bone.

THE LYMPHATIC SYSTEM: The fluid passing through the lymphatic system is called lymph. It is composed of white blood cells, waste products, and water. It is a component of the circulatory system and comprised of vessels; nodes (lymph glands); and other lymphoid tissues, such as the spleen.

Vessels of the lymphatic system are found throughout most of the body. Lymphatic capillaries permeate the body’s tissues and merge together into larger ducts, which follow the veins and arteries towards the center of the body. These converge and eventually empty into the venous system in the chest.

Lymph nodes are situated along the lymphatic vessels, and are concentrated in various regions of the body, such as the armpits, groin, and neck. They act as filters and produce cells that are part of the immune response.

A significant percentage of the proteins and water that pass from the capillaries to body tissue is not directly taken back up by the venous system, and must instead be removed by the lymphatics. The lymphatics also take up products of tissue breakdown. As lymph returns to the venous system, it must pass through the lymph nodes, where bacteria, viruses, and other particles are removed.

The right lymphatic duct and the thoracic duct drain lymph fluids into two veins that come together to form the inferior vena cava, which passes into the heart. The cisterna chyli is a widened portion of the thoracic duct, where fluids from several lymph-collecting vessels are received. The spleen removes and destroys worn-out red blood cells and helps fight infection

The lymphatic system lacks a central, heart-like propulsion mechanism. Instead, lymph movement arises from peripheral mechanisms, including contraction of the muscles of the body, contraction of muscles that surround the larger lymphatic vessels, and valves that prevent backflow.

The lymphatic system begins as a series of sacs at the points of junction of certain of the embryonic veins. These lymph-sacs are developed by numerous venous capillaries, which at first lose their connections with the venous system, but subsequently, on the formation of the sacs, regain them. The lymphatic system is therefore developmentally an offshoot of the venous system, and the lining walls of its vessels are always endothelial. 

The fluid passing through the lymphatic system is called lymph, found only in the closed lymphatic vessels, is a transparent, colorless, or slightly yellow, watery fluid of specific gravity about 1.015; it closely resembles the blood plasma, but is more dilute.

When it is examined under the microscope, leucocytes of the lymphocyte class are found floating in the transparent fluid; they are always increased in number after the passage of the lymph through lymphoid tissue, as in lymph glands.

Lymph capillaries are microscopic tubes located between cells. Lymph capillaries resemble blood capillaries somewhat, but differ in important ways. Whereas a blood capillary has an arterial and a venous end, a lymph capillary has no arterial end. Instead, each lymph capillary originates as a closed tube. Lymph capillaries also have a larger and more irregular lumen (inner space) than blood capillaries and are more permeable.

The wall of a lymph capillary is constructed of endothelial cells that overlap one another. When fluid outside the capillary pushes against the overlapping cells, they swing slightly inward, like a swinging door that moves in only one direction. Fluid inside the capillary cannot flow out through these openings.

Lymphatic Vessels: Consist of a single layer of endothelium lacking a BASEMENT MEMBRANE; Larger lymph vessels are the same as veins except for: 

• larger lumen, thinner walls,

• thin adventitia  

• greater variation in thickness of media

• presence of leukocytes and no erythrocytes.

Lymph vessels have a similar structure to veins. Lymph ducts interconnect and eventually drain into one of two principle vessels: the right lymphatic duct, and the thoracic duct. The right lymphatic duct drains into the right subclavian vein. The thoracic duct in the abdomen, enlarges to form the cysterna chyli, and in the thorax, it leads into the left lymphatic duct which drains into the left subclavian vein

COMPONENTS OF THE LYMPHATIC SYSTEM:

Lymphatic plexuses.
Lymph capillaries.
Lymph nodes.
Lymphoid tissues.
Cisterna chyli.
Thoracic duct.
Collecting vessels.
Tonsils.
Thymus.
Spleen.

FUNCTIONS OF THE LYMPHATIC SYSTEM:

Drainage of tissue fluid.
Absorption and transport of fat.
Defense.

The primary role of the lymphatic system is to remove excess fluid, molecules, and particles from the body’s interstitial spaces. 

The thoracic duct conveys the greater part of the lymph and chyle into the blood. It is the common trunk of all the lymphatic vessels of the body, excepting those on the right side of the head, neck, and thorax, and right upper extremity, the right lung, right side of the heart, and the convex surface of the liver. In the adult it varies in length from 38 to 45 cm. and extends from the second lumbar vertebra to the root of the neck. 

It begins in the abdomen by a triangular dilatation, the cisterna chyli, which is situated on the front of the body of the second lumbar vertebra, to the right side of and behind the aorta, by the side of the right crus of the diaphragm. It enters the thorax through the aortic hiatus of the diaphragm, and ascends through the posterior mediastinal cavity between the aorta and azygos vein. Behind it in this region are the vertebral column, the right intercostal arteries, and the hemiazygos veins as they cross to open into the azygos vein; in front of it are the diaphragm, esophagus, and pericardium, the last being separated from it by a recess of the right pleural cavity. 

Opposite the fifth thoracic vertebra, it inclines toward the left side, enters the superior mediastinal cavity, and ascends behind the aortic arch and the thoracic part of the left subclavian artery and between the left side of the esophagus and the left pleura, to the upper orifice of the thorax. Passing into the neck it forms an arch which rises about 3 or 4 cm. above the clavicle and crosses anterior to the subclavian artery, the vertebral artery and vein, and the thyrocervical trunk or its branches. It also passes in front of the phrenic nerve and the medial border of the Scalenus anterior, but is separated from these two structures by the prevertebral fascia. 

In front of it are the left common carotid artery, vagus nerve, and internal jugular vein; it ends by opening into the angle of junction of the left subclavian vein with the left internal jugular vein. The thoracic duct, at its commencement, is about equal in diameter to a goose-quill, but it diminishes considerably in caliber in the middle of the thorax, and is again dilated just before its termination. 

It is generally flexuous, and constricted at intervals so as to present a varicose appearance. Not infrequently it divides in the middle of its course into two vessels of unequal size which soon reunite, or into several branches which form a plexiform interlacement. It occasionally divides at its upper part into two branches, right and left; the left ending in the usual manner, while the right opens into the right subclavian vein, in connection with the right lymphatic duct. 

The thoracic duct has several valves; at its termination it is provided with a pair, the free borders of which are turned toward the vein, so as to prevent the passage of venous blood into the duct.

The right lymphatic duct is about 1.25 cm. in length, courses along the medial border of the Scalenus anterior at the root of the neck and ends in the right subclavian vein, at its angle of junction with the right internal jugular vein. Its orifice is guarded by two semilunar valves, which prevent the passage of venous blood into the duct. 

The right lymphatic duct receives the lymph from the right side of the head and neck through the right jugular trunk; from the right upper extremity through the right subclavian trunk; from the right side of the thorax, right lung, right side of the heart, and part of the convex surface of the liver, through the right bronchomediastinal trunk. These three collecting trunks frequently open separately in the angle of union of the two veins.

Therefore, it can be seen that the right lymphatic duct has a much smaller field of drainage than the thoracic duct. The right lymphatic duct drains mostly the upper right quadrant of the body while the rest of the body is drained by the thoracic duct.

Lymph nodes are small bean shaped structures lying along the course of lymphatics. They are aggregated in particular sites such as the neck, axillae, groins and para-aortic region. Knowledge of the sites of lymph nodes is important in physical examination of clients.

Lymph nodes have two main functions:

• phagocytic cells act as filters for particulate matter and micro-organisms

• antigen is presented to the immune system.

Lymph nodes have a fibrous capsule from which trabeculae extend towards the centre thus forming a framework:

The node is made up of three components:

• lymphatic sinuses

• blood vessels

• parenchyma (cortex, paracortex, medulla)

B cells: These enter the lymph node via HEVs and pass to the follicles. If activated by antigenic stimulation they proliferate and remain in the node. Unstimulated B cells, however, pass out rapidly from the node to return to the general circulation. Activated B cells within the lymphoid follicles are known as follicle centre cells. The pale staining central area of a secondary follicle is known as a germinal centre and this is surrounded by a mantle zone consisting of small, naive B cells and a few T cells.
The follicle centre cells within the germinal centres consist of cells with cleaved nuclei (centrocytes) and cells with larger more open nuclei and several nucleoli (centroblasts).
Stimulated mature B cells responding to antigen change into centrocytes and then centroblasts. The centroblasts leave the follicle and pass to the paracortex and medullary sinuses, where they become immunoblasts. The immunoblasts divide to give rise to plasma cells or memory B cells which are ready for their next encounter with specific antigen.

Accessory cells: Lymphocytes alone are not to make an effective immune response. They are assisted by so-called accessory cells. These may be grouped as follows:

• sinus macrophages (highly phagocytic)

• tingible body macrophages (ingest cellular debris in germinal centres)

• marginal zone macrophages (found beneath the subcapsular sinus)

• follicular dendritic cells.

Paracortex: The paracortex contains lymphocytes and accessory cells along with supporting cells and it is the predominant site for T lymphocytes within the lymph node.
T cells: The various types of T cell enter the node from the blood via the HEVs. When activated they form lymphoblasts which divide to produce a clone of T cells responding to a specific antigen. Activated T cells then pass into the circulation to reach peripheral sites.
Accessory cells: Interdigitating cells are numerous in the paracortex and they act as antigen presenting cells.

Medulla: The medulla comprises:

• large blood vessels

• medullary cords

• medullary sinuses

The medullary cords are rich in plasma cells which produce antibodies that pass out of the node via the efferent lymphatic. Macrophages are also numerous within the medulla.

Passage of lymph: Lymph passes into the node through the afferent lymphatic into the marginal sinus, though the cortical sinuses to reach the medullary sinuses before leaving via the efferent lymphatic. Particulate matter in the lymph is removed by macrophages. Antigens are taken up by antigen presenting cells and these facilitate the specific immune response. Less than 10% of lymphocytes enter the node in the lymph, the large majority entering from the blood via the HEVs.

The spleen is located in the upper left quadrant of the abdomen. It has two main functions acting as part of the immune system and as a filter.

The spleen has a thin connective tissue capsule from which short septa extend inwards. These septa are, in turn, connected to a complex reticulin framework. There are two distinct components of the spleen, the red pulp and the white pulp. The red pulp consists of large numbers of sinuses and sinusoids filled with blood and is responsible for the filtration function of the spleen. The white pulp consists of aggregates of lymphoid tissue and is responsible for the immunological function of the spleen:

Red pulp: There is a complex system of blood vessels within the red pulp arranged to facilitate removal of old or damaged red blood cells from the circulation. A small proportion of the splenic blood flow passes through more rapidly without undergoing this process of filtration.

White pulp: The white pulp contains T cells, B cells and accessory cells. There are many similarities with lymph node structure. The purpose of the white pulp is to mount an immunological response to antigens within the blood. The white pulp is present in the form of a periarteriolar lymphoid sheath. This sheath contains B cell follicles and T cells. At the edge of the T zone is a region known as the marginal zone where larger lymphocytes and antigen presenting dendritic cells are located.

Massaging the lymph system. The lymph system's impact is so far reaching that many don't even realize that minor aches and pains, low energy or susceptibility to colds and flu may be due to a sluggish lymph system and a compromised immune system.

Lymph vessels make an intimate meshwork that covers every inch of your skin, and surrounds each organ in great detail. The lymph vessels start very small in what are called the initial lymphatic. Over 70% of the initial lymphatics are in and just under the skin. 

The initial lymphatic is a very delicate structure, one cell thick. Those cells are supported within the connective tissue by collagen and elastin fibers that help to anchor them in place. When the pressure within the interstitial space increases due to a buildup of fluid, or when the skin is slightly stretched, the filaments deform the wall of the initial lymphatic, opening it up. 

Then the interstitial fluid flows in and starts to move along the channel. At this point we start calling it lymph. Although only 2-3 liters of lymph is filtered through the lymph system per day, it is vital because it helps to remove proteins that that are too large to get back through the capillary wall. 

The spaces that open in the initial lymphatic are 4 to 6 times bigger than the spaces in the capillaries. Removal of protein is essential because draw water to themselves, so excess protein in the interstitial spaces causes swelling or edema. The lymph vessels also collect dead cells, waste products, bacteria, viruses, inorganic substances, water and fats.

By performing lymphatic drainage massage correctly, you can stimulate the opening of the initial lymphatic and increase the volume of lymph flow by as much as 20 times. But if we push too hard, we collapse the initial lymphatic, diminishing the lymph flow. Excessive pressure can even break the filaments that hold the initial lymphatic in place. This is one reason that Deep styles of massage are contraindicated in areas of edema. Luckily if deep pressure has broken any filaments, they usually reform within 24 hours.

After the lymph has entered the initial lymphatic, the lymph moves into a larger vessel called the pre-collector, and then into even larger vessels called the collectors. The collectors are 100-600 microns in diameter. These vessels have one way valves every 6- 20 mm that only allow the lymph to move in one direction. When you’re performing lymphatic drainage massage, you never have to worry that you are damaging your clients by pushing the lymph in the wrong direction- because it literally can’t flow backwards. Pushing in the wrong direction won’t be very effective, but it won’t hurt you client unless you are using deep pressure- and in that case, you are not doing lymphatic drainage massage.

From one one-way-valve to the next is called a lymphangion. The lymphangions have a layer of smooth muscle that spirals around them. Angion means heart- so this is really the pump that pushes the lymph. Each lymphangion has an internal stretch sensor. The walls of the lymphangion stretch when they fill up with lymph, and then the stretch sensor tells the muscle to contract. This spiraling muscle contracts squeezing the lymph into the next chamber. This swells the next lymphangion, which then contracts, pushing the fluid down the line. At the same time the lymphangion is pushing the lymph forward, it also is creating a vacuum behind it. It is partly because of this vacuum effect that the lymph gets pulled into the initial lymphatic in the first place. 

Once the lymphangions begin contracting, they cause a chain reaction, or a wave of contractions that start to push and pull the lymph through the body. In this way stimulating lymph flow in one area can increase lymph flow in another. Other factors that can assist the movement of the lymph are skeletal muscle contractions, breathing, the pulsing of arteries, as well the ability of the angions to contract independently of the stretch receptors. Lymphatic Drainage Massage’s effectiveness lies in its ability to activate the stretch response, which significantly increases the pulsation rate of the lymphangions, increasing lymph flow through the vessels.

Eventually, all lymph vessels lead to lymph nodes. Lymph nodes can be as small as the head of a pin, or as big as an olive. There are 400-700 lymph nodes in the body, half of which are located in the abdomen, and many are in the neck.

The primary function of lymph nodes is to filter and purify the lymph. The lymph nodes produce various types of lymphocytes. Lymphocytes destroy harmful substances within the body, and are a big part of the immune system. The lymph nodes reabsorb about 40% of the liquid content of the lymph. This makes the lymph much thicker. Because of this thickening and the filtering process, the lymph nodes offer the greatest resistance to the flow of lymph. In fact the lymph nodes offer about 15 times more resistance than the vessels themselves. Lymphatic drainage can help overcome this resistance and get the lymph flowing.

Each cell is nourished by the nutrients, oxygen and proteins that flow across the walls of capillaries into the interstitial fluid. There is a dynamic balance between the forces that help those nutrients to first exit the capillaries, and then get reabsorbed back into the blood stream. 

Proteins play a big part in this transfer because they have a tendency to draw water to themselves. This means that the proper amounts of protein on both sides of the capillary wall are vital to keep the tissues balanced. If there are too many proteins within the interstitial spaces, fluid will start to accumulate, causing edema. The lymph system’s role of removing proteins is vital to keeping edema down. If the lymph system becomes sluggish, or is damaged by surgical removal of lymph nodes, edema can develop. This type of edema is called lymphostatic edema- or a high protein edema. Lymphatic drainage can be helpful in reducing this type of edema because the cause is a reduced functioning of the lymph system.

Other causes of edema can be a chemical imbalance in the body caused by liver disease, diabetes, or a variety of other ailments. This type of edema is called lymphodynamic edema, and requires other forms of therapy due to the fact that it is a chemical imbalance. 

Lymphatic drainage massage is a profound technique to help increase lymph flow. With an increase of lymph flow immune function is increased. Harmful substances are removed from the tissues and neutralized in the nodes. 

Clients that have extreme amounts of edema should work with a group of healthcare practitioner trained in lymph drainage, bandaging and other modalities. However, with a proper understanding of contraindications and some basic training, massage therapists can enhance the health of their clients and reduce minor cases of edema.

Lymphatic drainage in this arena can be applied to clients who are suffering from a lack of energy, or a sluggish immune system.

Lymphatic drainage massage is also useful when working with clients who have sports injuries. After the initial inflammatory stage has passed, lymphatic work can be applied after Sports or Neuromuscular massage has been completed. This will help to clear the tissue of debris, and help to reduce the minor edema that sometimes occurs after deep massage. Continued applications of lymphatic drainage while the client is healing can help to enhance the tissue regeneration process by keep the tissue as health as possible.

Not only is lymphatic drainage useful for sports injuries, but it can also help scars. Lymph work has been shown to help the scarring process by enhancing circulation and immunity. As the lymph flow around the scar is increased, lymph vessels that have been damaged are stimulated to heal, and the increased lymph flow also draws away toxins, improving the health of the tissues

When attempting to assist healthy scar formation, it is important not to push the lymph into the scar, which can cause the formation of keloids (a buildup of collagen fibers). All scar work should be done without deforming a newly forming scar- so as to not rip the tissue. One way is to work above the scar (closer to the node that drains the area). For example, a lymph therapist could work in the axilla and upper arm to help increase the lymph flow around a scar in the forearm.

Beyond its application for injuries, Estheticians have been using lymph drainage massage for years to enhance the quality of the skin, especially on the face. When the lymph is flowing, the cells are being bathed in fresh fluid, causing the skin to look fresh and alive. We have all experienced having minor edema in our faces- that puffy feeling and baggy eyes when we first wake in the morning after a long night. Usually after a few minutes of being vertical the lymph system starts to drain the face. A great way to see the power of lymph drainage is to apply a few strokes on one of those mornings, and watch in just a few minutes the tissues drain right before your eyes- leaving you looking vibrant and healthy.

Another common use for lymph drainage massage is with women who have had breast cancer and had some axillary lymph nodes removed. Sometimes these people develop edema in their arm. If there is a great deal of swelling, then this is out of the scope of practice for a most massage therapists due to the need for bandaging. If the swelling is minor however, then a massage therapist with a good knowledge of contraindication and a few techniques can do a great amount of good.

Contraindications: For the most part lymphatic drainage massage is safe. With such a light touch, the danger of causing damage to the tissue is slim. However, there are a few conditions that are contraindicated, and these happen when an increase of lymph flow would be detrimental. It is a good idea to get clearance from their doctor if you ever feel uncertain about working on someone. Acute inflammation, Malignant tumors, Thrombosis and major heart problems are all contraindications to lymphatic drainage massage. Lets look at these one at a time.

Acute inflammation caused by bacteria, viruses, poisons or allergens is contraindicated. You can tell if this is the case because the tissues will be , , and painful, with congestion accompanied by fever. Lymphatic drainage massage will push these substances into the lymph channels before the body has a chance to eliminate them through phagocytosis in the interstitial spaces. If you perform lymphatic drainage you can spread the toxic substances throughout the body. Wait a few days until the condition is not acute, and the body has had a chance to clean up the area.

Malignant tumors are a contraindication for lymphatic drainage massage because of the fear of spreading the cancer. Wait until after the malignancy is treated to perform lymphatic drainage massage.

Thrombosis and phlebitis are two conditions that can lead to free floating blood clots. Usually people with these conditions will be in a hospital on blood thinners. If you are working in a hospital setting, do not work on these clients. In your practice, one indication of a possible femoral thrombosis is when the client has pain in one leg and a sudden swelling and bluish discoloration of the skin. People who are bedridden have a greater likelihood of developing thrombosis in the legs.

Major heart problems. If the heart is not fully functioning the edema can be lymphodynamic, due to lack of venous return. Putting more fluid into the heart would only stress it more, worsening the condition.

SPORTING INJURIES: Immediate treatment for almost all acute athletic injuries is Rest, Ice, Compression, and Elevation (RICE). Rest is instituted immediately to minimize hemorrhage, injury and swelling. Ice causes dermal vasoconstriction and helps limit inflammation and reduce pain. Compression and elevation help limit edema.

The injured part should be elevated. A bag that is chemically cooled or filled with chipped or crushed ice (which will conform bette than ice cubes to body contours) should be placed on a towel over the injured part. An elastic bandage should be wrapped over the ice bag and around the injured part, loosely enough to permit blood flow. After 10 min, the wrapping and the ice bag should be removed, but the injured part should be kept elevated. After a further 10 min, the ice bag and the wrapping should be replaced. Ten minutes with and without ice should be alternated for 60 to 90 mi. This procedure can be repeated several times during the first 24h.

Pathology of ice application: Cold limits swelling by vasoconstriction and reduction in capillary permeability. It helps to limit pain by reducing impulse transmission from pain receptors. It limits muscle spasm by reducing impulse transmission from tendon receptors to muscles. It limits tissue destruction by decreasing cellular metabolism.

Prolonged application of ice, however, can cause vasodilatation, increased swelling, pain, and tissue destruction.

Supports and splints: In most injuries, pain is greatly reduced if the injured part is immobolized correctly. Supportive bandaging or splinting reduces stress, prevents painful movements, and helps control the swelling which is produced when tissues of any kind are damaged. Inflatable splints are a very convenient method of providing a comfortable, removable, adjustable support to a led or an arm.

A simple splinting method is to tie one injured part to a neighbouring uninjured part, with crepe bandages, cotton bandages, or scarves and towels.

Splints and bandages should never be tight, as they can constrict the blood flow and cause further damage. To check the circulation, you should press on the thumb-nail or toe-nail on the bandaged limb, to see whether the blood returns to the nail immediately after the pressure has turned it white. If the blood return is sluggish, the bandage must be loosened or removed immediately. It is best not to use non-stretch strapping as a first-aid binding.

Applying heat: Whereas cold therapy can be applied immediately to an injury, and continued through the rehabilitation phases for as long as there is swelling, bruising and pain, heat should only be applied, if at all, in the recovery phases of rehabilitation. Applying heat draws blood to the skin under the heat source. This tends to increase internal bleeding or fluid exudate (swelling) in an immediate injury. Therefore heat is not appropriate in first-aid.

Heat is used later on to relieve muscle tension, promoting relaxation.

Creams: Massage, like heat, aggravates the situation when an injury has just happened. Any cream applied must be laid gently on the skin and allowed to soak in. If you rub it in, not only do you risk increasing internal bleeding, but you could stimulate blood clotting and bone formation in torn muscle fibres.

Fractures, dislocations, sprains, and strains: Physicians call broken bones fractures. Fractures result whenever a bone is hit by enough force to make it break, creating either a small crack or, in a serious fracture, a complete break.
Dislocations occur when the bone has slipped out of its normal position in a joint where two bones meet. Sprains occur when the ligaments in a joint are damaged. For example, a sudden twisting of the knee or elbow causes this type of injury, which ranges from over-stretching and small tears to a complete parting of a ligament.
Strains - also called muscle pulls - are the most common and usually the mildest of the three injuries. Overworking or overextending muscles, doing heavy exercise during cold weather, and even failing to drink enough fluids can lead to small tears that make using muscles painful.
Torn, severed, or irritated tendons the tissues that connect muscles to bones, are very common

Fractures: There are two basic types of fractures, open and closed. The open fracture - also called a compound fracture - is generally more serious because in this type bone has broken through the skin. The break causes considerable damage to surrounding tissue and can cause serious bleeding if a large artery is broken. It also exposes the broken bone to the possibility of infection, which can interfere with healing.
A closed fracture may be either a crack in the bone or a complete break, but in either case the skin is not broken. Often the surrounding tissue is undamaged, especially when the bone is only cracked. But even though bone does not break the skin, it can cause serious internal damage. A skull fracture that causes pressure on the brain or a broken rib that pierces a lung can be life-threatening without prompt medical treatment. Bones that tend to get broken include those of the collar, foot, leg, hand, wrist, and arm. The elderly break bones more easily than younger people because their bones become weaker and more brittle with age - in severe cases this tendency becomes the disorder osteoporosis. A broken hip resulting from a fall is fairly common among older people, especially those with osteoporosis.
Though some minor fractures can be hard to detect without an X ray, the symptom most usually noticed is severe pain. The injured area will probably swell, and in complete breaks, an arm or leg may look deformed. See your doctor immediately whenever you suspect a fracture, even if you think it is minor.
After taking X rays, the physician will realign any broken bones that are out of normal position. The most severe fractures may require surgery to reset the bones into their proper place; or the doctor may decide it is best to brace a broken bone internally with metal screws, rods, or plates. Ordinarily, a doctor will simply align the bones and immobilize a broken arm or leg with rigid devices (splints) held in place with a bandage, with a plaster restraining tube called a cast, or with an inflated restraint, also called a cast.

Dislocations: A finger, thumb, or shoulder bone may be pulled out of the joint, usually by a fall or physical blow. Such a dislocation may damage ligaments and other tissues in the joint, which will become misshapen, swollen, and the source of intense pain. Get medical help as soon as possible. A doctor may be able to quickly realign the bones if internal damage is not serious and swelling has not progressed too far. Only someone with proper training should realign dislocated bones, however. Otherwise further damage may result.
The joint will be immobilized with a cast or other device for about two weeks to allow ligaments and other tissues time to heal. Surgery may be necessary to repair severely damaged tissues.

Sprains: Any ligaments holding bones or cartilage together at a joint can be twisted, torn, or otherwise damaged by a fall or other injury. Ankle, knee, and finger joints are regularly subjected to force in daily use, so the ligaments at these joints tend to get sprained most often.
A sprain's severity depends on how much damage has been done to the ligament. Stretching and small tears produce a mild sprain. They make the joint painful to move but still able to function. When ligaments are ruptured completely torn - the sprain is severe. There will usually be swelling and pain, and depending on the extent to which the ligaments are torn, the joint may look deformed.
See a doctor for a severe sprain or if the pain of a mild one continues for more than two to three days. If X rays show severe tearing of the ligament, your doctor may recommend surgery to repair the damage. Otherwise the treatment may be nothing more than a splint or cast to immobilize the joint while ligaments heal.
For mild sprains, wrap the joint with an elastic bandage and use an ice pack periodically during the first day or two to help keep swelling down. Start exercising the joint very gently after a day or two of rest and ice packs. Try building the ligament back up slowly without forcing it to take too much weight too soon. Keeping the joint elevated when possible helps reduce swelling.

Strains: As most athletes soon find out, muscle fibers will tear with too much exertion or stretching. You will probably feel some immediate pain if you tear a muscle, say, by lifting too much weight or by suddenly reaching out to catch a baseball. The muscle gradually becomes swollen, tender, and stiff.
Muscle strains are nearly always minor and heal completely by themselves within a few days. But if the muscle will not function at all, it may be completely torn and you need to see a doctor. Be careful of less severe muscle strains as well. If you do not treat a serious muscle strain properly, or if you strain the muscle repeatedly, you may lose strength in the muscle permanently.
For minor muscle strains an ice pack can help ease the pain and keep swelling down. An elastic bandage wrapped around the affected area also reduces swelling, but the bandage must not be so tight that it hampers blood circulation. If the pain or swelling is severe, get medical treatment.
A doctor may recommend surgery for muscles that are torn completely. If the damage is less severe, a physician may prescribe medication for pain and tell you to rest the muscle for a specified period. If the muscle pull is bad enough, you might have to undergo physical therapy to rebuild muscle strength.
You can usually prevent strains by doing warm-up exercises to get blood flowing to muscles and to increase muscle flexibility. Jogging in place for several minutes is one way to warm up. Another consists of going slowly through the motions of the activity you are about to perform. Once you have broken a light sweat, stop and stretch the muscles you will be using.

Overuse injuries: Some injuries to bones, joints, and muscles occur because of wear and tear over a long period. Called stress injuries, they frequently happen to tennis players, joggers, bicyclists, and other athletes who work out regularly, performing the same motions over and over again. Athletes are not the only ones to develop repetitive stress injuries. Carpal tunnel syndrome is most common among people who use a computer keyboard or mouse, although it also occurs in others who repeat the same hand motions.
Basketball players, runners, and aerobic dancers are among the various athletes who may suffer stress fractures of foot and leg bones. Usually these cracks are so small they do not even show on an X ray, but they can be quite painful. Caused by repetitive pounding against hard surfaces, stress fractures heal with sufficient rest from the activity.
Runners may develop shin splints, a pain in the front of the lower leg. Sometimes it is just a minor muscle tear, a stress fracture of the bone, or an inflammation of the tissue covering the shinbone. Swollen muscles pressing against blood vessels (a condition called anterior compartment syndrome) also cause shin splints. In any case, resting for a week or two usually clears up the disorder.

POSTURE ASSIGNMENT: Scoliosis is the lateral deviation of the normal vertical line of the spine which, when measured by X-ray, is greater than ten degrees. Scoliosis consists of a lateral curvature of the spine with rotation of the vertebrae within the curve.

Everyone's spine has natural curves. These curves round our shoulders and make our lower back curve slightly inward. But some people have spines that also curve from side to side. Unlike poor posture, these curves can't be corrected simply by learning to stand up straight.

This condition of side-to-side spinal curves is called scoliosis. On an X-ray, the spine of an individual with scoliosis looks more like an "S" or a "C" than a straight line. Some of the bones in a scoliotic spine also may have rotated slightly, making the person's waist or shoulders appear uneven.

Scoliosis affects a small percentage of the population, approximately 2 percent. However, scoliosis runs in families. If someone in a family has scoliosis, the likelihood of an incidence is much higher - approximately 20 percent. If anyone in your family has curvature of the spine, you should be examined for scoliosis.

• Children - The vast majority of scoliosis is "idiopathic," meaning its cause is unknown. It usually develops in middle or late childhood, before puberty, and is seen more often in girls than boys. Though scoliosis can occur in children with cerebral palsy, muscular dystrophy, spinal bifida and other miscellaneous conditions, most scoliosis is found in otherwise healthy youngsters.

• Adults - Scoliosis usually develops during childhood, but it also can occur in adults. Adult scoliosis may represent the progression of a condition that actually began in childhood, and was not diagnosed or treated while the person was still growing. What might have started out as a slight or moderate curve has progressed in the absence of treatment.

In other instances, adult scoliosis can be caused by the degenerative changes of the spine. Other spinal deformities such as kyphosis or round back are associated with the common problem of osteoporosis (bone softening) involving the elderly. As more and more people reach old age in the U.S., the incidence of scoliosis and kyphosis is expected to increase.

If allowed to progress, in severe cases adult scoliosis can lead to chronic severe back pain, deformity, and difficulty in breathing.

In planning treatment for each child, an orthopaedist will carefully consider a variety of factors, including the history of scoliosis in the family, the age at which the curve began, the curve's location and severity of the curve.

Most spine curves in children with scoliosis will remain small and need only to be watched by an orthopaedist for any sign of progression. If a curve does progress, an orthopaedic brace can be used to prevent it from getting worse. Children undergoing treatment with orthopaedic braces can continue to participate in the full range of physical and social activities.

Electrical muscle stimulation, exercise programs, and manipulation have not been found to be effective treatments for scoliosis.

If a scoliotic curve is severe when it is first seen, or if treatment with a brace does not control the curve, surgery may be necessary. In these cases, surgery has been found to be a highly effective and safe treatment.

The most common surgical treatment for scoliosis is a spine fusion using special stainless steel rods, hooks, and a bone graft. The rods are attached to the spine with hooks and the curved portion of the spine is carefully straightened. Then, small strips of bone graft are placed over the spine to fuse it in a straight position.

As the bone graft heals over the next several months, the spine becomes solid and will not curve again. But the part of the spine that has not been fused will still be flexible, and allow nearly normal overall movement.

Reduction in pain can often be achieved by reducing the amount of stress of the back. This can be done by increasing hip flexibility through daily stretching of the ham-strings, quadriceps, hip flexor and muscles. Improving the strength of the back muscles can also help to reduce pain and improve tolerance for daily activities. This can be accomplished by performing vigorous strengthening exercises at home or in a fitness facility several times per week. It is recommend that if you are exercising to reduce pain you should stay away from exercise that is jarring to your joints and pick exercises like swimming or weight machines that are more gentle.

Kyphosis is an increase in the anterior curvature of the thoracic region. It commonly results from a collapse of one or more vertebral bodies. Thus, it presents itself as an outwardly curved convex thoracic spine.

The criteria for diagnosis is a thoracic kyphosis of greater than 40 degrees (Note: 25-40 degrees is normal) and a wedging of greater than 5 degrees of three adjacent vertebrae.

Look out for:

• Tight hamstrings.

• Poor posture.

• Back pain located over the apex of kyphosis (T7 - T8).

• Back pain involving the lower lumbar spine when excessive lordosis is present.

• Can be seen in patients who have had rickets when small. Kyphosis is often termed a hunch back because of the rounded flattened shoulders when viewed from the sides.

Since the lumbar curve/column supports all the weight above it, it is this part of the column that commonly adjusts to forward and backward movements and shifts in the line of gravity.

Kyphosis shifts the line forward, with the resulting tendency to fall forward and is most easily overcome by an increase in the lumbar region (lordosis). It may be noted that occasionally the cervical spine can have a kyphotic curvature.

Thoracic Kyphosis is usually seen with drooping of the shoulders and the head being carried too far forward, in front of the line of the body.

Lack of proper posture - lazy posture as well as poorly-balanced work with ones arms, can lead to kyphosis. However, the pain resulting from this is very slow to come manifesting itself across the top of the shoulders giving an unpleasant pain at the angle of the neck. This pain tends to be more severe on the dominant side of ones body. It is increased through stress and by carrying heavy items.

The greatest problem is to be found by carrying one's head too far forward in front of the line of gravity. Either side of the neck the trapezium muscles running down from the base of the skull across the shoulders, brace the shoulder blades, keeping the head back in line with the shoulders.

Thus, when the head falls forward they are acting like the reins of a horse, trying to pull back the head retracted in line with the shoulders. The constant postural strain causes the muscles to develop a low-grade persistent spasm, the long-term spasm of the trapezium muscles can cause immobility of the chest. The tension of the harness keeps the vertebra of the neck and the thoracic. Permanently tightened up so that the section of the spine underlying the muscles compresses and hardly even loses flexibility.

Powerful arm work may increase kyphosis, by compressing the mobility of the chest and cause the shoulders to permanently hunch forward. One may even observe a sunken chest in affected people. The pectoral muscles fan-shaped spread across the shoulders/chest walls are responsible for this affliction.

Tight pectoral muscles may also influence the ability of the chest to expand, thereby pinching the shoulders and accentuate the severe forward movement of the neck.

Stronger bones and exercise can help suffers of kyphosis:

• Children should begin exercising before adolescence, since bone mass increases during puberty and reaches its peak between ages 20 and 30. In fact, one study suggests that exercise may help develop bone mass in teenagers more effectively than high calcium intake.

• Weight-bearing exercise applies tension to muscle and bone and, in young people, encourages the body to compensate for the added stress by increasing bone density by as much as 2% to 8% a year. In premenopausal women these exercises are very protective. Careful weight training may also be very beneficial for elderly people. High-impact weight-bearing exercises, such as step aerobics, however, increase the risk for osteoporotic fractures.

• Regular brisk long walks improve bone density and mobility. In older women, even moderate exercise (as little as an hour a week) helps reduce the risk for fracture. (Everyone who is in good health should aim for more, however).

• Exercises specifically targeted to strengthen the back can be beneficial in improving posture and may even reduce kyphosis (hunchback) in people with osteoporosis.

• Low impact exercises that improve balance and strength, particularly yoga and tai chi, have been found to decrease the risk of falling; in one study tai chi reduced the risk by almost half.

The benefits of exercise for suffers are good because:

• Muscle inflexibility (can restrict the back's ability to move, rotate, and bend).

• Weak stomach muscles (can increase the strain on the back and can cause an abnormal tilt of the pelvis).

• Weak back muscles (may increase the load on the spine and the risk for disc compression).

• Obesity, associated with sedentary lifestyle (puts more weight on the spine and increases pressure on the vertebrae and discs). Studies report only a weak association between obesity and low back pain, however.

What is lordosis? A normal spine, when viewed from behind appears straight. However, a spine affected by lordosis shows evidence of a curvature of the back bones (vertebrae) in the lower back area, giving the child a "swayback" appearance.

What causes lordosis? The cause of lordosis is unknown. However, lordosis may be associated with poor posture, a congenital (present at birth) problem with the vertebrae, neuromuscular problems, back surgery, or a hip problem.

What are the symptoms of lordosis? Each child may experience symptoms differently. The major clinical feature of lordosis is a prominence of the buttocks. Symptoms will vary depending if lordosis occurs with other defects, such as muscular dystrophy, developmental dysplasia of the hip, or neuromuscular disorders.

Back pain, pain down the legs, and changes in bowel and bladder habits are not commonly associated with lordosis. A child experiencing these types of symptoms requires further medical evaluation by a physician.

The symptoms of lordosis may resemble other spinal conditions or deformities, or may be a result of an injury or infection. 

Stretching is very important for the relief of back pain. The key is to find what muscles or muscle groups are asymmetrically tight or imbalanced, causing postural problems and strain leading to back pain. One of the most common muscles associated with this kind of back pain problem is the rectus femoris. 

Good posture habits:

When sleeping on your back, place a pillow under your head and shoulders, a rolled up towel under your neck, and a pillow under your knees to support all three spinal curves. Never sleep on your stomach.

• When sitting place a rolled towel or chiropractic seat cushion to support your low back. Your knees should be level with, or slightly above the hips. If your feet do not reach the floor, use a footstool. Your buttocks should be against the chair, and your back straight, not leaning forward. Reading materials or computer screens should be at eye level.

• When writing, use one hand to support your head, and stretch often.

• When using the phone, use a speakerphone if possible, or hold the phone in your hand, never between your head and your shoulder.

• When exercising, do both sides of the body to prevent imbalance from one-sided strength.

• When driving, sit firmly against the seat back. Adjust the seat so you don't have to lean forward or stretch. Follow normal sitting good posture habits. Adjust the head rest so that it supports the middle of your head.

• When walking, keep your head up, your shoulders back and walk tall.

• Get plenty of sleep. Sleep is the bodies way of recharging itself.

Practice good posture. Making changes in your daily habits is not easy. Through practice you can make the changes necessary to prevent injury. Sitting hour after hour causes special problems and aggravates conditions that might not have otherwise been a problem.

STRESS: Although individual physical and emotional reactions to stress vary, the results are similar. A stress overload activates areas of your brain that then send involuntary impulses to organs elsewhere in your body. You can blame your general adaptation reflex -- an involuntary series of physical reactions -- as well as your ancestors for your biological inability to handle excess stress without getting sick. When you become frightened, your body switches into its emergency "fight or flight" mode. This is a completely natural, normal response involving your endocrine system, your autonomic nervous system, the hypothalamus in your brain, and your limbic system.

What the Hypothalamus Does: The size of a grape, your hypothalamus takes care of a multitude of responsibilities. Located in the center of your brain and linked to your pituitary gland, it stores hormones and reigns over your endocrine system, the network of glands all over your body. The hypothalamus sends messages to your nervous system and communicates directly with its neighbors in the brain. You can envision this structure as the ultimate link between your mind and body. The hypothalamus turns on the tap of your physical sensations when you respond to something emotional, whether in fear, love, anger, frustration, or anxiety. These intangible sensations soon become quite tangible as your body reacts.

Some researchers have called the hypothalamus "the master gland," because it produces at least nine different hormones triggering almost all of the other glands in your body to swing into action or quiet down. Extreme fear, for example, affects the body in many different ways. Your pupils will widen to let in more light. You will experience an increase in alertness because of more neurotransmitters in your brain. Your adrenal glands will begin to pump more adrenaline and other hormones into your bloodstream. Your heart races, your blood pressure rises, your muscles tense. Your liver starts converting starches to sugars for energy. Digestion slows. Experts have even determined that your blood's clotting powers will be enhanced during stressful situations. Sweat production increases and the hair on your body may feel prickly and actually stand on end. All these physical reactions were designed to save your life. Your body is getting ready to defend itself. But these reactions are no longer physiologically useful in modern life and can actually be harmful if you keep yourself in such an alert state for too many hours each day.

Not surprisingly, a daily regimen of racing heartbeat, pulsing blood, tensed muscles, undigested food stuck in your stomach, and elevated levels of hormones coursing through your circulatory system pose all kinds of potential health problems. Take the hormone cortisol, for instance. It is released under stress to inhibit inflammation at the site of any potential wounds, yet it is unlikely that you will need the assistance of cortisol. Your boss isn't really going to inflict bodily harm on you if you can't finish the paperwork on your desk. He or she may scream or fume or threaten disciplinary action, of course, but that cortisol coursing through your veins, getting ready to heal cuts, abrasions, or bruises from a real fight, isn't helping you at all. In fact, it's hurting you, because cortisol can boost your blood pressure and lead to hypertension.

Too much stress also affects your immune system, weakening it and making you more susceptible to colds, coughs, and infections. It has been traced as the culprit in flare-ups of arthritis and asthma. Your urinary tract can also be affected. There is a natural balance of friendly and unfriendly organisms that normally co-exist in our digestive and urinary systems. Constant anxiety can destroy this immunological balance, however, leading to an overgrowth of the harmful bacteria and an infection.

Why Women Are So Vulnerable: While it is true that men may face more immediate life-threatening occupational hazards, women appear to be more vulnerable to stress-induced illnesses, for a variety of reasons. First, they are socialized to being caretakers, and as such they almost automatically take on responsibilities that men might not even consider. This alone adds to the stress loads they carry. Second, women as a whole are less likely to be in positions of power and are not as able to control what's going on in their environment as most men. If you can't say no, the stress you feel can be doubly disastrous because you don't see any escape. The less power you have over the circumstances of your everyday existence, the heavier the stress load.

It may be obvious that what complicates a woman's stress is work. Men who are stretched thin at their work places often go home to relax. Women, on the other hand, go home and keep on working. In spite of the increasing number of women with careers and jobs, traditional roles in their homes still take precedence for many women. They can expect to be in charge of everything from child care to laundry, food preparation, social calendars, and runny noses. Delegating these duties to others in their households helps, but in the long run most women are still in charge. Given this situation, their minds as well as their bodies work overtime. When they become angry about too much to do in too little time with too little help, the anger only adds to their overstressed physical condition. Even women who sense their own need to slow down are programmed toward over commitment because they feel guilty about not being able to be everything to everyone in their lives. Time spent alone or nurturing their own mental and physical well-being might be construed as selfish, so they push even harder on all fronts -- home, work, and social. Sociologists speculate that many women today may be disadvantaged because they have incorporated a male standard for achievement in the work world with an old-fashioned female standard for perfection at home.

How to Cope With Stress: To get some control into your life and tame the stress that could be making you sick, a two-way approach is recommended. First, it is necessary to change your behavior so you can slow the emotional pace of your life. Second, learn how to turn off your general adaptation reflex. You can do this by using exercise and relaxation techniques.

How to Change Your Behavior: Allow yourself regular leisure time. Leisure time is a necessity, not a reward for having completed all your tasks. Deep psychic benefits come from forgetting your chores and what time it is. For example, take a magazine into the bathroom, fill the tub, climb in, and relax. The leisurely soak will give you the strength to do more later. Take an hour or half-hour to be by yourself each day. Many highly successful people have discovered that a key to keeping their minds sharp and their bodies healthy is to sit quietly and daydream a little each day. If sitting still makes you feel anxious or guilty, browse in a book store, walk around the block, or find some other undemanding yet pleasurable activity. A caution, however: Even leisure activities offer little refreshment if you run through them, squeezing in a quick bath, a little tennis, racing to the fast-food restaurant with kids, or are always considering what must be done next. The key is to plan -- don't wait for free time to suddenly appear. The only way to create time for yourself is to take it away from some other activity. Personal time for refueling and staying healthy will never be available unless you plan for it purposefully.

Set goals for yourself. This may mean reordering your daily priorities. When you give a little of yourself to everything, you commit a great deal of yourself to nothing. Think back to the days when you have been most fragmented. Were you trying to complete an impossibly long list of things to do? If you work, try to take work breaks that remove you physically or mentally from the office. If possible, don't take office work home with you.

Insist on help with regular chores. Learn how to delegate without guilt. Basic changes aimed at lightening your load can ease your stress considerably. Pick something in your life that you find hard to ignore -- unmade beds, dirty dishes -- and ask for help. If something can be ignored, however, let it be until you have more leisure time to tackle that particular chore. Don't be a perfectionist.

When you start to delegate items on your "to do" list, decide on tasks (1) that you can give to someone else, (2) that others (especially kids) can do for themselves, (3) that you're doing out of habit, (4) that are low-priority and a waste of your energy, and (5) that you are only doing to please others or to make them feel guilty. In the meantime, when you feel pressed for time, ask yourself, What will happen if I don't do this project? You may be surprised to find out how many chores can easily be dropped without any repercussions or anyone even noticing.

Don't combine too many activities. Some women can't resist the urge to talk on the telephone, reshuffle the daily demands clipped to their desk or kitchen counters, and cook a meal all at the same time. They may be experts at combining activities, and most of the time this ability gives them a great sense of satisfaction. However, one of the reasons many women end up feeling stressed is because they feel fragmented, worn down, and weary from having to respond to too many people and situations. Occasionally slowing down to focus on one thing is essential to keeping your emotions and those of the people around you balanced. If you really want to enjoy a meal or a conversation with someone, it is important to concentrate on that activity to the exclusion of everything else.

Take advantage of your natural body rhythms. There may be 24 hours in a day, but your mood and energy level can't keep up with the clock all day. The sooner you figure out when your prime time is, the less overwhelmed you will feel. Most people are at their peak between 10:00 a.m. and 2:00 p.m. , but you know your own body best. By adjusting your routine slightly you may be able to eliminate some of the stress from your life. For example, save routine tasks for periods when your energy is at its lowest point. Devote your peak hours to more demanding or enjoyable projects.

Stop running to answer every request. A ringing telephone, a doorbell, or the sudden demand of an impatient co-worker makes some women jump, no matter what else they have been doing. Even in midbite, midsentence, or midnap, you may feel obliged to answer all such calls for your immediate presence. Some experts believe that women who have trouble managing stress operate under the tyranny of believing that these demands on their life are always important. Often they are not. In fact, the really important matters in life don't always appear to be urgent. Prioritizing doesn't mean shirking your responsibilities. It does mean making a conscious effort to separate what's important from what's merely "urgent" at the time. Think first: Is this really important, or could it be done later? Then give your attention to the things that really count.

Learn how to say no. For many women, turning down someone who asks for a chunk of your time is never easy. It is nice to be needed, but adding extra burdens can wreak havoc on your day. These suggestions may help. (1) Say no fast, before they can anticipate a yes. Hedging with "I don't know" or "Let me think about it" only complicates your life, adding stress because you'll have to call back and beg off later. (2) Be as polite and pleasant as possible. (3) Offer a counterproposal. If you can't take on a complete responsibility for a new project, consider sharing with someone else or suggesting another person for the assignment.

Look at time as your life. When you stop trying to spend, save, and invest time, you'll feel less stressed out. Of course, your time is important. It's your life, after all. By looking at it from such a mercenary, rushed, overstressed viewpoint, you may be missing out on much that is truly enjoyable as well as the activities and people that make life worth living.

Locate the source of your stress. Sometimes women don't stop to focus on exactly why they feel overwhelmed. If you can analyze your day's load of stress, you may be able to pinpoint a particular problem and be able to deal with the stress more effectively. For instance, the next time someone in your office hands you several projects simultaneously and each one is dubbed an emergency, think before you panic. Instead of agonizing alone, go back to your boss and ask which one should be done first, second, and third. The more information you can gather and the more support you can pull together, the easier it will be to cope with the stress.

How to Turn Off the Physical Symptoms of Stress: You probably don't need medication or therapy to relieve the physical symptoms of stress. The first important step is simply to recognize the particular way you experience stress. The second step is to take any unwanted side effects seriously. Third, you need to learn how to turn off your body's "fight or flight" reflex by using breathing, exercise, or relaxation techniques. Use the following methods the next time you feel yourself being physically engulfed by stress.

Breathe deeply. Breathing is critical to dealing with stress effectively. A lack of oxygen restricts blood flow and causes muscles to tense. When you are panicked, you tend to take short, shallow gasps of air, hardly using your diaphragm at all. Your chest muscles and the accessory breathing muscles in your shoulders are overloaded and do all the work of respiration. The next time you are in a stressful situation, (1) sit up straight, (2) inhale through your nose with your mouth closed, (3) exhale through your mouth with your lips pursed (as if you were whistling or kissing), (4) make your exhalation twice as long as your inhalation (inhale for two seconds, exhale for four, for instance). Use your abdomen when you breathe, consciously pushing your belly out. Try putting one hand over your stomach, in fact, to see how it rises and falls. You are allowing more air to enter your body, and in the process you will slow down your heart rate, lower your blood pressure, and eventually break the stress cycle.

Practice progressive relaxation techniques. Sit in a quiet spot and take off your shoes or any uncomfortable clothing, including eyeglasses. Close your eyes, uncross your legs, place your hands in your lap palms up, and let your head rest easily. (You also can lie down.) Start by tightening the muscles in your feet and toes and then relaxing them. Gradually work this tightening and relaxing pattern up through your legs, back, chest, and head, including your face. Clench your jaws. Hold that tension. Then relax.

Another relaxation exercise is to picture yourself in a pleasant place. Perhaps it's a calm lake or a mountain view that puts your mind at rest. Visualize this scene in your mind as you slowly let each part of your body go limp. Breathe deeply. Aim for at least 10 minutes or more of progressive relaxation, if possible. To know if you are truly relaxed, feel the temperature of your hands. Warm hands mean a relaxed body. If your hands are still cool, you know you are still tense. (Put them on your neck to test the temperature.) Continue your relaxation until they warm up.

To get the most healthy benefit from any relaxation technique, you'll have to practice it often. Choose a time of day when you won't be interrupted. Turn off the radio, TV, and stereo. If you learn how to switch into this relaxation mode in private, you'll be better able to do it under stress.

Exercise your shoulders and neck muscles. We store stress in the muscles of the upper back, shoulders, and neck. Learn how to release this tension by gently moving that area of the body. The movements don't have to be complicated. To loosen up the tightness:

• Shrug your shoulders. Stand up or sit. Push your shoulders up around your ears and tighten the muscles as much as possible. Let them drop and relax. Repeat.

• Stretch up and overhead. While sitting in a chair, bring your arms overhead, holding them straight with fingertips pointing toward the
  ceiling. Elbows shouldn't be locked. Reach skyward with your right hand and then with your left hand. You should feel the stretch, but nothing should hurt. Breathe comfortably throughout.

• Swing your arms. Stand up. Let your arms stand loose at your sides. Lean forward slightly and swing your arms back and forth and from side to side across your chest. Relax. Stop swinging. Lift one arm up over your head, and look over your right shoulder. Hold that position. Relax and breathe deeply.

• Walk. Go out for a walk, but leave your pocketbook behind; if you carry a bag, you might throw your body off balance. Walk briskly and throw your shoulders back as you move. Don't race. Hurrying may make you slouch forward unconsciously, creating tension in the curve of your shoulders. Throw your shoulders back, expand your chest area, and breathe deeply.

Listen to Your Body: As our critical knowledge of the mind-body connection grows, it becomes even more apparent that you are your own best weapon in defending yourself against stress-related illness. Become a more active listener to the signals your own body may be sending. Don't deny or ignore symptoms of stress. A consultation with your doctor may be advisable. It may be that she will determine that the symptoms are indeed related to stress and reaffirm the importance of taking your leisure time seriously. If you aren't enjoying the responsibilities of your life, then you are probably overestimating your capacity to handle stress. It might be that the stress you experience at a particular time in your life is overwhelming. Don't be reticent about seeking professional help at those times. Such a move can be life-saving. So it was for Mary, the 55-year-old grandmother who was previously described. She arranged to see her doctor before her scheduled appointment. Her doctor found her blood pressure, previously controlled by medication, to be elevated to an alarming degree. Her medication was changed, and a referral was made to a mental health facility for an evaluation. This referral led to a therapeutic encounter that enabled her to resolve her anger and guilt about her daughter and to explore the possibility for assistance from social agencies. Mary accepted the therapist's admonition that she couldn't be all things to all people.

The Psychological Signs of Stress: Ask yourself the following questions:

• Are you nervous, anxious?

• Do you feel depressed or sad?

• Are you irritable or moody?

• Do you often become frustrated?

• Are you forgetful?

• Do you have trouble thinking clearly?

• Can you make decisions without agonizing?

• Is it difficult to learn new information?

• Do you have insomnia?

• Are you plagued by negative thoughts?

• Are you fidgety?

• Are you accident-prone?

• Do you bite your fingernails or cuticles?

The Physical Symptoms of Stress: These symptoms, if chronic, may be signs of extreme anxiety and stress. They may also relate to a physical disorder. If they are sudden, severe, or persist, see your doctor.

• Back pain

• Muscle tension

• Headaches

• Shaking hands

• Diarrhea

• Constipation

• Pounding heart

• Chest pain

• Sweaty, cold hands

• Shortness of breath

• Indigestion or gas pains

• Burping

• A burning sensation in your chest

• Feeling faint or dizzy

• A lingering head cold

• Ringing in the ears

• Grinding your teeth

• Hives or skin rashes

• Loss of appetite

• Feeling nauseated, vomiting

• Pain in your stomach

THE ENDOCRINE SYSTEM: Endocrinology is the study of chemical communication systems that provide the means to control a huge number of physiologic processes. Like other communication networks, endocrine systems contain transmitters, signals and receivers that are called, respectively hormone producing cells, hormones and receptors.

How is it that humans maintain quite constant blood concentrations of glucose throughout their lives despite wildly varying frequencies of meals? If your blood glucose concentration drops much below 1 mg per ml, your neurons will begin to misbehave, leading ultimately to coma and death. Yet skipping breakfast is rarely life-threatening. The answer is that a battery of chemical messengers - hormones - are secreted into blood in response to rises and falls in blood glucose concentration and stimulate metabolic pathways that pull glucose concentrations back into the normal range.

The body has two was of control this type of electrical/chemical information: 

• The nervous system exerts point-to-point control through nerves, similar to sending messages by conventional telephone. Nervous control is electrical in nature and fast.
  
  

• The endocrine system broadcasts its hormonal messages to essentially all cells by secretion into blood and extra-cellular fluid. Like a radio broadcast, it requires a receiver to get the message - in the case of endocrine messages, cells must bear a receptor for the hormone being broadcast in order to respond.

Hormone, is a chemical organic substance. Derived from the Greek word for excitation horomao, it means to "excite" or "spur on" and that's exactly what hormones do. They cause other things to start happening. It's as if they were keys which not only unlock the doors to other activities, but also regulate those other activities that they've initiated.

You've got over 30 of these amazing hormones busily orchestrating and regulating such things as: when you feel hungry or full; how you sleep; your body temperature; how you break down and utilize the food you eat and whether you are fat or thin; when you start puberty and how long it takes; how you handle stress; how much adrenaline you have in an emergency situation...even how and when you grow. 

Often it is thought that it was genes that determined things like how tall you're going to eventually grow. But when, and if, you grow as tall as the instructions from your genes would suggest depends on hormones - - in this case growth hormones.

Hormonal communication systems augment the nervous communication systems within the body. Hormones are chemical signaling molecules produced in one site of the body that then travel to another site to have an effect. In this way one cell can effect other distantly located cells.

Hypothalamus: Anterior pituitary functions are controlled by the region of the brain called the hypothalamus via the secretion of  releasing and inhibiting factors. Specialized neurons in the hypothalamus, controlled by feedback and other communication methods release factors that cause the release of hormones from the anterior pituitary. The pituitary trophic hormones then control the release of other hormones from a target gland. With the exception of prolactin, release promoting factors are more important to the release of pituitary hormones. Somatostatin (inhibits GH release),  prolactin inhibiting factor (PIF, dopamine), LH releasing factor (LHRF), FSH releasing factor (FSHRF), prolactin releasing factor (PRF), corticotropin releasing factor (CRF), thyrotropin releasing hormone (TRH) are all hormones that control the release of anterior pituitary hormones. The release of these factors is controlled by feedback from the target organ hormone to maintain the proper hormonal balance.

The endocrine system displays an elegant system of checks and balances in the form of feedback loops to facilitate the normal functioning of all bodily systems. Hormones may be made and have an action locally or may be made in one endocrine gland and have an effect at a distant site. 

Glands are functional units of hormone secreting cells located in various regions of the body making up the endocrine system. Each gland has specific functions that help to maintain the normal internal environment and promote the survival of the organism.  

Pituritary: Six peptide hormones are secreted by the adenohypophysis: Growth hormone (somatotropin, GH), corticotropin (ACTH), thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), Luteinizing hormone (LH), and prolactin (PRL). All except growth hormone and prolactin regulate the activities of other glands.  Somatotropin, PRL and ACTH are polypeptide hormones and LH, FSH, and TSH are glycoproteins having very similar structures.

• Growth hormone has no specific target tissue. All cells of the human body are affected by this hormone. It is very important in the growing child but it remains essential to many bodily functions throughout life. GH has effects on the growth of bone and cartilage, protein metabolism, RNA formation, electrolyte balance, fat and glucose metabolism.

• ACTH    This trophic hormone stimulates the production and release of suprarenal steroids. Normally the amount of circulating ACTH is controlled by the levels of cortisol in the blood, individual biorhythms and stress.

• TSH    This hormone stimulates the synthesis and secretion of thyroid hormones. It is a glyco-protein hormone controlled by feedback from thyroid hormones.

• FSH    The target organs for FSH are the testes, in men, and the ovaries in women. The hormone stimulates the germinal epithelium in the testes to cause and facilitate the making of sperm. In women it stimulates the growth and development of the follicle. It stimulates the production of testosterone in men and estrogen and progesterone in women. Its release from the pituitary is governed by a negative feedback mechanism involving these steroids.

• LH    The male target organ is the testes and the testosterone producing interstitial cells of Leydig in particular. In women the target of LH is the developing follicle within the ovary where it is necessary for ovulation to occur and a corpus luteum to develop.

• Prolactin- This hormone is involved in breast development and lactation. In concert with estrogen, it prepares the mammary gland for lactation and then causes the synthesis of milk. Secretion is regulated by a release inhibiting factor and suckling may cause the release of prolactin from the pituitary.

Thyroid: The thyroid is a large endocrine organ that functions mostly to control metabolism. It is located in the neck between the trachea and laynx and is bi-lobed with a connecting isthmus. The gland is composed of many tiny follicles, that are in effect, each a separately functioning gland with a single-layer epithelial lining. Each follicle accumulates a storage form of the circulating thyroid hormones, thyroglobin. Thyroglobin is a large protein molecule that contains multiple copies of the amino acid tyrosine. The thyroid hormones are very simple modifications of the amino acid tyrosine. Iodide is added to one or two spots on the amino acid and then two of the modified tyrosines are combined to form one of the two thyroid hormones, thyroxin (T4) or triiodothyronine (T3).  The thyroid hormones are then cut off the thyroglobin as needed and released into the circulation. The thyroid follicles accumulate iodine by extracting it from the blood and trapping it within the lumen of the follicle. This ability to store homone in a large molecule is unique to the thyroid.

Both T4 and T3 enter cells and bind to an intracellular receptors whereby they increase the metabolic capabilities of the cell. Mitochondria and mitochondrial enzymes are increased thereby influencing cellular metabolism. Thyroid hormones are necessary for normal growth and development. They have metabolic effects on protein synthesis, lipid metabolosm and carbohydrate metabolism.