"I tell my patients that managing mental stress and load are non-negotiables for improving health and wellness and dealing with pain."

By Frank Rosenthal PT, DPT, OCS, CSCS

At the beginning of each new year, the collective focus shifts to wellness and health. Millions of people make commitments to exercise and improve their nutrition. Mental health is a necessary ingredient of wellness that often receives less attention. The stresses and strains of the modern world (constant access to technology, work, and social media) can easily lead us down a path of unhealthy mental health behaviors and habits. These behaviors have negative health consequences including poor sleep, depression, and chronic pain.

I was having a discussion with a patient recently about her road to recovery and the impact of “stress.” Everyone has a certain amount of stress or load they can tolerate, both physical and mental. Physically, we experience stress to individual tissues (strain on the back from sustained sitting) as well as systems (the cardiovascular system is stressed when you run). Mental load from work, school, family situations, and life in general is another form of stress to the system. In the course of rehabbing an injury or increasing performance, load management is crucial.

Stress is Good

Some amount of stress is needed for improvement – when you exercise, you place stress on muscles that leads to biological processes that improve strength.  When you overcome a challenging situation, you undergo mental stress that improves your future stress response and resilience. However, when physical and mental stresses start to pile up, your body and mind are unable to keep up and things start to break down. This has played out countless times with patients – a high school student is progressing well but then goes through exams at the same time they increase the volume of sports practice and pain flares. Or, an individual is recovering from a surgery but has physical setbacks after dealing with a death in the family.

I tell my patients that managing mental stress and load are non-negotiables for improving health and wellness and dealing with pain.

Two easy ways to start improving mental health and strain are by practicing gratitude and mindfulness every day. Today I want to highlight gratitude.

Gratitude has been shown to:
  • Improve physical health – those who practiced gratitude had fewer aches and pains, exercised more, and attended regular check ups
  • Lower blood pressure
  • Improve psychological health through reduced negative emotions (envy, resentment, frustration, regret) and decreased depression
  • Increase healthy relationships
  • Help you sleep better – Check out our fountain of youth sleep post!
  • Improve self-esteem, which is a key component to overall mental health and performance
  • Reduce social comparisons (social media!)

Here are 5 easy ways to build gratitude into your daily habits:

  1. Keep a gratitude journal everyday – once a day, spend 5-10 minutes writing about several things for which you are grateful. These can be people, objects, opportunities, memories, etc. This alone has been shown to improve sleep, lower blood pressure, and improve mood.
  2. Volunteer – Volunteering has been shown to lower depression, give a sense of purpose, and reduce stress while enhancing social connections.
  3. Make a conscious effort to smile more often – simply smiling more can lower your blood pressure, improve relationships, and relieve pain.
  4. Tell someone you love them
  5. Nurture good friendships


This is the first post in our wellness series. Check out part 2, all about sleep.