Filed under: Recovery
Why do some people with devastating injuries do well in their recoveries and others do not? People often focus on the negative fallout, but there can be positive consequences called post-traumatic growth. Scientists use the term “disability paradox” to refer to how some people with devastating illness or injuries are still able to enjoy a good quality of life. The characteristics of these folks describe someone with a “survivor mentality.” Characteristics include:
- Subscribing meaning to one’s disability or lot in life and sharing this meaning with others.
- Not choosing to live as a victim but instead to feel empowered and motivated to deal with struggles and come out as a victor.
- Being flexible, adaptable, resilient, and rolling with the punches.
Many factors play into developing a survivor mentality. Here are some tips to help:
- Create a strong support system: family, church, community, fellow Warfighters, healthcare providers, etc. A support system should be just that—supportive, encouraging, and a promoter of independence, not an enabler for being or feeling like a victim.
- Maintain a “can do” attitude. See challenges or setbacks as an opportunity to learn and grow. Focus on strengths and abilities, not on limitations. Survivors exhibit the 4 Cs of mental toughness.
- Maintain hope and optimism; focus on the future and move from thinking about the negative aspects of injury/illness to focusing on the positives or possibilities.
Need a great post-workout beverage? Try drinking a glass or two of chocolate milk during the first 15-60 minutes after exercise to replenish glycogen stores and repair muscles.
Why chocolate milk? The carbohydrate-to-protein ratio in chocolate milk is roughly four-to-one, the best ratio for replenishing glycogen stores while providing adequate protein for muscle building and repair. One eight-ounce glass of chocolate milk provides about 200 calories. It provides carbohydrate, protein, electrolytes such as potassium and sodium, and essential vitamins and minerals such as vitamin D and calcium in an easily digestible liquid form that is inexpensive and readily available, and it tastes good! But be sure to choose heart-healthy low-fat versions.
For those who are lactose intolerant or allergic to dairy products, or for those who simply prefer a plant-based diet, fortified chocolate soymilk is a great alternative.
Sleep is essential for optimal performance. Especially Warfighters, though, it can be hard to come by. Lack of adequate sleep, called “sleep debt,” can result in reduced mental and physical performance (see HPRC's "How much sleep does a Warfighter need?"). Use HPRC’s “Sleep & Warfighters” infographic to learn how sleep impacts your health and performance, as well as tips to get your best rest. For more in-depth information on optimizing sleep, visit our Sleep Optimization page.
The wounds of war also affect the family members of injured or ill Warfighters. The job of caregiving often falls to a family member, and while it can be a rewarding job, it can also be stressful. Taking time for yourself is important. You run the risk of burnout when your attention is directed solely towards others without time to recharge. Below are tips to help you find balance in taking care of both your loved one and yourself.
- View caregiving as if it were a team sport, not a solo one. Get other people to share the responsibilities.
- Encourage independence by supporting your loved one to do as much as possible for him/herself.
- Take a pro-active and positive perspective.
- Have a take-charge attitude for problems, and then reframe those problems into challenges.
- Avoid tunnel vision; find a balance between taking care of your injured loved one and taking care of yourself and others in the family.
- Create a care plan for yourself that includes fun time, down time, and relaxation methods. For some ideas, check out the Mind-Body Skills section of HPRC’s website.
- Seek professional help when needed.
For more information, read this handout on “Coping with Caregiver Challenges,“ which addresses common caregiver challenges such as stress and symptoms such as headaches and then suggests ideas for coping. Other strategies include keeping yourself healthy with exercise, rest, and eating well. For more ideas, check out the Traumatic Brain Injury website’s “Stress Busters” section. Building your stress-management skills can be a big help. Finally, assess yourself regularly to check on your well-being (to prevent burnout) can also be helpful. You can find assessments for caregiver stress at Afterdeployment.org (online) and Traumatic Brain Injury (for download).
Attention, all disabled service members and veterans! Staying active helps with recovery by rebuilding strength and endurance—and in so many other ways, as well. A positive mindset and a supportive community are as important as fitness, and getting involved sports such as snowboarding, cycling, wheelchair basketball, and others can build both physical fitness and mental resilience. Consider checking out the Warfighter Sports Program developed by Disabled Sports USA. It offers more than 30 winter and summer adaptive sports in more than 150 events nationwide. Instruction, equipment, and transportation are provided to Warfighters and their guests. Become a part of the team and find the events happening in your area today!
Physical and mental rehab for wounded warriors can come in the form of an undersea adventure. A 2011 study at Johns Hopkins University looked at the effects of a four-day scuba certification class on a group of veterans with spinal injuries. The benefits noted included improved muscle movements, reduction of post-traumatic stress disorder symptoms, and improved sensitivity/sensation for those with certain spinal cord injuries.
Being in the water offers a zero-gravity environment that enables Warfighters to develop the confidence and ability to do activities they may not feel comfortable doing on land. There are organizations that provide scuba lessons and outings for wounded veterans and their families free of charge, such as Adaptive Heroes, Soldiers Undertaking Disabled Scuba (SUDS), and Divers4Heroes, to name a few. Check for programs in your area and explore the great unknown!
Total Force Fitness requires optimal performance, and optimal performance requires optimal sleep. One way to get your best sleep may lie in some of the subtle sounds you hear every day. You may have heard of “white” noise, a type of random, constant sound that can filter or mask surrounding noises. Studies have now found that another kind of sound—“pink” noise—can help your sleep be even more restful than actual silence. Unlike white noise, the volume of pink noise is essentially the same regardless of its frequency. (For serious audio buffs, here’s an explanation from Georgia State University’s “HyperPhysics” department.) When you think of pink noise, think of rain falling or the rhythm of a heartbeat. This kind of noise regulates and synchronizes with your brainwaves, which enhances the percentage of time you’re in a restful, stable sleep. Pink noise might be another strategy to add to your arsenal for getting better sleep. You can get recordings of pink noise from a variety of sources online—some even free—for your smartphone or other mp3 player or cd/dvd player. A little searching should turn up something you like. And read more about the importance of sleep and how it affects your performance.
According to a recent report about post-exercise recovery and regeneration for athletes, men over 19 and women over 18 needs 8-10 hours of sleep a night (plus a 30-minute afternoon nap, as needed) for optimal athletic performance.
Continuing good sleep habits established earlier in adolescence such as regular meals, early morning light exposure, and a nightly sleep routine remain important. However, it’s also important to monitor the effects of stress and changes in sleep due to training/military operations.
Even if you’re not an athlete, the recommendations above still apply, except that your total sleep needs are seven to nine hours a night to keep you at your best.
Some additional tips for sleep:
- Regular exercise during the day can help you sleep better at night.
- If you have a question about whether to exercise more or sleep, choose sleep!
- During the night, if you wake up and after 20 minutes haven’t gone back to sleep, get out of bed, do something relaxing, and then get back in bed. You’ll probably fall right asleep.
Also, for a better understanding of your current sleep habits, afterdeployment.org has an online “sleep assessment” that you can take. For more information on how to optimize your sleep, visit the HPRC’s Sleep Optimization section.
In the military, physical activity is probably part of your daily routine, but do you also have a post-workout strategy? Good recovery is just as important as the workout itself. “Recovery” can mean what you do—or don’t do—right after exercise. It also can mean taking a day off from working out altogether. Either way, it’s a critical component of your overall fitness program that can help prevent injuries.
First, it’s important to rehydrate and refuel after exercise to replace the fluids and nutrients lost during exercise, heal damaged muscles, and build more muscle. A combination of protein and carbs are the key for recovery. Some suggestions for post-exercise snacks are:
- Low-fat yogurt with fruit
- Trail mix
- Turkey wrap
- PB&J sandwich
- Chocolate milk (For more information about chocolate milk as a recovery snack, see HPRC’s Healthy Tip.)
Sometimes, after a particularly hard workout, you need a day of rest with no exercise. Listen to your body. If you have some lingering aches and pains that could worsen with exercise, take a day off. Sleep and rest are also important for proper recovery, staying fit and healthy, and achieving overall readiness and resilience. Make sure you get all the important components of your exercise routine in order to achieve peak fitness and keep injuries at bay.
The cool-down—a practice so engrained in our exercise habits that we assume it’s important. But, the truth is, the topic is understudied, and evidence for or against cooling down is still up for debate. What is a cool-down and what is it supposed to do? The American College of Sports Medicine (ACSM) recommends a period of low- to moderate-intensity aerobic or muscular endurance activities after exercise to gradually reduce heart rate and blood pressure and remove metabolic byproducts from the system. For some, this may be a slow jog down the street, or an easy ride around the block after a workout with the hope of also preventing delayed onset muscle soreness (DOMS). The long-standing theory behind cooling down was that it helped to remove lactic acid from the system, a substance that could later cause muscle aches and soreness. However, it is believed that DOMS is the result of minor muscle damage due to novel or intense exercise, but we do know that lactic acid is not the culprit. During cool-down—active recovery—more lactic acid is removed from the system than during passive recovery, i.e., no cool-down. But is this a good thing? In a study of cyclists, researchers found that when subjects stopped exercise abruptly, lactic acid turned into glycogen, a fuel for the muscles. But when the cyclists gradually tapered off activity, less glycogen was made, leaving less energy for the muscles. These results indicate that cooling down might not be beneficial and may waste useful energy for the muscles.
On the other hand, a cool-down lowers elevated heart rates faster than passive recovery does and may prevent post-exercise dizziness. Stopping abruptly after exercise can cause blood to pool in the dilated vessels of the legs and feet, which may lead to a feeling of light-headedness and/or dizziness. Keep in mind, however, that these symptoms can also be related to other post-exercise conditions such as low blood sugar, low blood pressure, dehydration, or even hyponatremia. If you experience these symptoms, check with your doctor to find out if there are other causes.
Scientists agree that cooling down is also beneficial for people with cardiovascular conditions and heart disease where the coronary vessels are narrowed due to atherosclerosis (fatty deposits), as blood return to the heart may be compromised without it.
ACSM currently recommends at least 5-10 minutes of cool-down, with at least 10 minutes of stretching after exercise. However, more research is needed to determine the value and ideal recommendations for cooling down. If stopping exercise abruptly causes symptoms of light-headedness and dizziness, then a cool-down is a good idea.