Pelvic Health Blog

Get out of fight or flight with the vagus nerve

4/4/2022

By Karen Bruno, PT

Ever get queasy from a shot or the site of blood? Or experience something and feel like fainting? Sometimes, those feelings are due to the overstimulation of the vagus nerve. And on the other end, the vagus nerve can also initiate relaxation after stress. So it makes sense that when we’re in fight or flight mode, the vagus nerve comes into play.

Fun fact: the vagus nerve is responsible for our “gut feelings”.

So how can we use the vagus nerve to our benefit? Well, once we understand what it is, we can control it to breathe more easily, and control our heart rate when we’re in tense conversations or high-pressured situations at the office.

What is the Vagus Nerve?
The vagus nerve is part of our central nervous system, which is made up of our brain and spinal cord. The central nervous system communicates with the body and processes information. The vagus nerve, also known as the tenth cranial nerve, starts in the brainstem and travels into the neck, trunk and abdomen. Having extensive reach and influence, the vagus nerve is responsible for the functioning of our internal organs and processes such as:

digestion,
elimination,
heart rate,
respiration,
immune health,
inflammation,
physical tension,
our response and adaptability to stress,
and social and emotional engagement.

In short, our vagus nerve has a central role in every aspect of our lives. Our well-being is dependent upon our ability to adapt and on our nervous system’s capacity to function properly. Vagus nerve exercises help us get out of the stress related fight, flight and freeze response and move us into a calmer state of rest, restore, relax and digest. So, whether you have pain, a bowel, bladder or sexual condition, an issue with digestion, anxiety, trauma, or any combination these, your vagus nerve could use a boost.

Sample exercise
There are numerous ways to support optimal function of your vagus nerve. Here is a simple, 2-step exercise you can perform. This technique comes from Stanley Rosenberg’s "Accessing the Power of the Vagus Nerve, Self-Help for Anxiety, Depression, Trauma and Autism."

Step 1 - Place both hands behind your head, right at the bump behind your head.

Step 2

Turn your eyes to the right and hold them there for 30 to 60 seconds OR until you take a deep breath, swallow, sigh, or yawn.
Then, turn your eyes to center.
And finally, turn your eyes to the left and do the same thing, holding them for 30 to 60 seconds OR until you take a deep breath, swallow, sigh, or yawn.

Modifications

If you can't get both hands behind your head, just use one hand behind your head.
You can also do the same exercise with your arms at your side.
A third modification is taking your middle fingers and placing them gently behind your ear.

Here are some practical application suggestions to use the simple vagus nerve exercise.

If you are feeling neck pain, back pain, or pain of any kind, use this exercise.
Use it before doing an exercise routine.
Use it whenever you want to calm and relax your body and mind.
Use it to calm your body when you are experiencing urinary issues such as incontinence, urgency or frequency, or to relax your muscles when you are feeling constipated.
Use it before or after eating a meal to boost your digestion.
Use it before you go to sleep to get to sleep easier.
If you are prone to lightheadedness when you change positions, use this prior to changing positions.
Use it frequently if you experience ringing in the ear (tinnitus).
Use it to calm your nerves before meeting a new person, or engaging in a new activity or if you are feeling anxious.
Use it when you feel frustrated, irritated, angry, stressed, upset or sad.
Use it if you feel a headache beginning.
Use it to shift out of an anxiety state.
Vagus nerve exercises can be used for a rapid heart rate and for high blood pressure
If you get short of breath easily, use it before any activity such as walking up a flight of stairs.

Practice it daily and as often as needed throughout the day.

References:

Rosenberg, Stanley, Accessing the Power of the Vagus Nerve, Self-Help for Anxiety, Depression, Trauma and Autism (Berkeley, California: North Atlantic Books, 2017).
Front. Psychiatry, 13 March 2018 | https://doi.org/10.3389/fpsyt.2018.00044
Tap Into Your Vagus Nerve’s Healing Power to Rewire Your Nervous System for Optimal Health, Energy Medicine to Restore Your Physical, Mental and Emotional Wellbeing, with Dr. Melanie Smith/Theshiftnetwork.com

Body Talk

4/8/2021

by Karen Bruno, PT

It has been recognized for a long time that there are interactions between the mind and the body. Our thoughts inform our emotions and that triggers a cascade of events in our bodies. (1) Emotions that are expressed freely and without judgement can uplift us, make us feel happier and improve our overall health. Repressing our emotions, especially anxiety and anger, can produce a physical reaction of tension in the body (Tension Myositis Syndrome). Prolonged tension can lead to pain disorders, stiffness and loss of function. (2)

If you are experiencing chronic pain, stiffness or discomfort, what is your body trying to tell you? Here is a short, fun practice to begin dialogue and partnership with your body.

Allow yourself to acknowledge your body’s wisdom.
Acknowledge anything that feels like discomfort or pain is really not discomfort or pain, but rather your body’s desire to call your attention to it and give you information.
Talk to the pain or discomfort. Acknowledge the part of the body from where the pain is coming and speak to it directly.
You may choose to use a mirror and look in the mirror as you speak to that part of your body or you may talk to the body and say, ”Body part, I love you. I am grateful for what you are doing for me. Tell me what you would like me to know”, and then listen.

This may seem awkward or strange at first; it may seem silly or even uncomfortable, but if you do this more and more, you shall receive the answers and your body begins to trust you and you begin to trust your body, thereby creating a partnership for health. Through practicing this over and over you may notice that the pain begins to subside and may eventually be gone.

You may choose to combine this with a very clear intention that it is your intention to 100% enjoy your body fully, and that your body enjoys you inside of it fully and completely. This supports your collaboration with your body for a maximum amount of enjoyment.

Although the pain may not leave immediately, recognize that the physical form takes longer to change, but the change starts once you make a connection and change your thoughts. It is new energy; it is new consciousness; it is new awareness. Your job now is to stay in a mode of receiving and know that you have started the process of feeling better, and while it might not be an overnight healing, it will be steadfast and continuous, and with ease and grace. We want this with ease and grace in the most gentle way for you.

According to Dr. John Sarno, in his book, Healing Back Pain, for a condition like chronic back pain, once you call out the emotion that your body is repressing, there is no longer any need for the pain and the body will no longer need to generate tension. (2)

All of us here at Connect Physical Therapy are here to support you to feel your best.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585554/
Sarno, John (1991), Healing Back Pain, Grand Central Life and Style, New York

Self-compassion and pain management

9/9/2020

By Karen Bruno, PT

Can self-compassion really help when you are in pain?
Let’s explore this. First, what is self-compassion? Self-compassion is giving yourself kindness, forgiveness and understanding when confronted with personal failures or discomfort. Basically, it means giving yourself the care and gentleness that you would give to a beloved friend or a child who is in need of support. In the words of Dr. Kristen Neff, a self -compassion expert and teacher, "Instead of mercilessly judging yourself for various inadequacies or shortcomings, self-compassion means you are kind and understanding when confronted with personal failings – after all, who ever said you were supposed to be perfect?" (1) It is an acceptance of your humanness even when things don’t go your way.

So, what does self- compassion have to do with chronic pain? Recent research suggests that self-compassion is associated with better outcomes, such as lower levels of depression, pain-anxiety, physical and psychosocial disability, and higher levels of pain acceptance. Higher levels of self-compassion supports engagement in meaningful activities and use of pain coping strategies. (2)

What does that mean for you?

Lower levels of depression, sadness and anxiety.
Less physical and psychological stress.
Higher levels of pain acceptance and engagement.
Improved ability to perform meaningful activities and use pain coping skills.
Better overall outcomes, function and quality of life.

Self-compassion has been found to be beneficial in situations related to the ineffective way we respond to things, how we talk to ourselves and the behaviors we engage in. So, when you notice yourself worrying, thinking or talking negatively, isolating yourself, or beating yourself up, choose to use a better approach of treating yourself with care, gentleness and kindness. (3)

What can you do?

Meditate. Practices such as mindfulness, breath meditation or any other physiological quieting methods help us to reduce tension and train us to tune into our needs to better take care of ourselves. Here is a link to some guided meditations: https://self-compassion.org/category/exercises/
Consider treating yourself the way you would treat a close friend or a small child. How might you respond to them with kindness and gentleness?
Remind yourself that you are worthy of kindness and compassion.
Take a self-compassion break. What do you need to hear? What do you need to give yourself? How can you encourage yourself and be patient, kind and forgiving to yourself?
Explore self-compassion through writing. Start by writing about your concerns. Next, write yourself a letter from the perspective of a loving friend. The last step is to let yourself receive those kind words, allowing love and compassion to soothe and comfort you.
Practice supportive touch.
1. Putting your hands on your body and taking some conscious breaths can be relaxing.
2. Place your hands over your heart and breathe comfortably. Notice the rise and fall of your chest as you breathe. Do this for as long as needed to calm your nervous system.
3. If it is convenient, put your hands over the area of pain and breathe love and nourishing oxygen into the region.
4. Place one hand over your heart and one hand over the abdomen. Breathe gently and consciously- 4 seconds in and 4 seconds out. This is a great way to relax as you drift off to sleep.

This PDF download summarizes the relationship between self-compassion and pain.

Self-care is also an integral component of self-compassion.
We have heard it before from the airlines, "“put your own mask on first, then help someone else." Remember that you are your own best advocate and as you care for yourself, you model for others how to care for themselves, you teach others how you want to be treated, and you harness the resources to be of service to others. Just do it! You are worth it.

"Life is full of disappointments, failures and setbacks. None of those things can permanently stop you. You have the power within you to overcome anything that life throws at you. There is nothing more powerful than a made up mind. Surround yourself with people who remind you that you matter, and support you in ways that matter most to you. No person, situation or circumstance can define who you are. Don't give up, cave in or stop believing that it's possible. It's not over until you win."
-Unknown

Notes

Website: selfcompassion.org
Paper: The relation of self-compassion to functioning among adults with chronic pain. Eur J Pain. 2019 Sep;23(8):1538-1547. doi: 10.1002/ejp.1429. Epub 2019 Jun 11.
Audio: Integrative Pain Science Institute podcast

Front lunge stretch

7/29/2020

with Karen Bruno, PT

Take a break from sitting at your desk or homeschooling by doing a Front Lunge Stretch with Karen. Sitting for long periods of time shortens the muscles and tissues on the front side of the body. Turn a chair sideways and perform this combination stretch for the upper body, lower body, and trunk. The Front Lunge Stretch can help with breathing, mobilize abdominal scars, assist with digestion, and facilitate pelvic floor lengthening to decrease pelvic pain.

Check out more exercises to break up sitting time on the Connect PT Patient Cheat Sheet.

relax and renew meditation

2/4/2020

Only have 5 minutes?

Listen to this relaxation meditation that uses the nourishing breath to help build a healthier state during this winter season.

Spring into detoxification

4/18/2019

by Karen Bruno, PT, DPT

Detoxification can be one way to heal your body and set the stage for sustainable weight loss and pain management because it assists in decreasing inflammation. It helps to reboot your hormonal system, cleanse your liver, cleanse your intestines of unfriendly bacteria, reduce chronic inflammation, and all of that helps with weight reduction and minimizing the inflammatory response that creates pain.

There are many different cleanses out there, and you may or may not choose to do one, however, here is a short visualization to pave the way for creating a healthier you and rejuvenate your body. Visualization can be used to communicate with your body and put it in a calm, relaxed state so it can rebalance itself and become healthy. It is a gentle and natural approach to allow your body to restore and repair itself.

Find a quiet place and sit or lie down in a relaxed, comfortable posture.
Begin by taking a deep breath in and then breathe out, allowing tension to release. Repeat this 2 more times.
Imagine a beautiful ball of bright, white light in your navel.
Imagine this light circulating inside and around you, getting bigger and brighter.
Imagine yourself in an infinite ocean of beautiful, bright, white, healing light.
Allow all of the pores of your skin to open up to allow this beautiful, bright, white, healing light to come in from all directions.
Feel the light in your chest, lungs, heart, stomach, intestines, pelvis, back, arms, legs, neck and head.
Let every cell in your body be filled with this beautiful, bright, white, healing light.
Everywhere this bright light touches, it cleanses your body, nourishes your body and heals your body. You feel every cell in your body saying “cleanse”. All 70 trillion cells are saying at the same time, “cleanse”.
Feel all the cells in your body starting to cleanse and getting ready to let go of any excess weight and any excess toxins. These are all being flushed out of your body, illuminated and evaporated into that infinite ocean of white light.
Imagine every cell of your body feeling clean and light.
Feel yourself and your system going into a better state. You are filling yourself with health and vibrancy, feeling purified, healthy, light and clean. You are feeling calm, centered and relaxed. This is easy and effortless for you.
Enjoy this feeling of well being for as long as you would like.
When you are ready, take a final deep breathe and know that your body has switched into a detoxification mode and you can lose weight easily and effortlessly, and eliminate excess toxins to bring more comfort to your muscles and joints.

Adapted from The Gabriel Method.

The Self-Care Corner

11/18/2018

By Karen Bruno, PT

The old healer to the soul:
It's not your back that hurts, but the burden.
It's not your eyes that hurt, but injustice.
It's not your head that hurts, it's your thoughts.
Not the throat, but what you don't express or say with anger.
Not the stomach hurts, but what the soul does not digest.
It's not the liver that hurts, it's the anger.
It's not your heart that hurts, but love.
And it is love itself that contains the most powerful medicine.
Author: Ada Luz Marquez

As we sink deeper into autumn, the leaves are changing colors, the daytime light is decreasing and the temperature is getting cooler. This can be a difficult time for many people. In addition, there is much to do in preparation for the upcoming holidays. Here is a quick "go to" exercise to restore coherence and calm.

Place one or both hands over your heart.
Begin to take some deep breaths in and out through your nose. One to three breaths is sufficient.
Shift your attention to your heart. Imagine breathing in and out through your heart.
Imagine breathing in love, and as you exhale, let that love expand in, through and around you. Surround yourself in a field of loving and compassionate, heart-centered energy. Take it in. Allow yourself to receive this gift.

For extra-credit: put a smile on your face.
For double extra credit: Smile into your heart.

Use this exercise anytime you want! Here are some suggestions for convenient uses:
As you awaken in the morning.
When you to go to bed.
Anytime you need or want a boost of energy, nourishment or connection to yourself or others.
When you are driving.
Anytime you are feeling upset or stress.
Anytime!

The overarching benefit of heart-centered practice is to live a fuller, healthier and happier life, even in the midst of the day to day demands.

My intention for each of you is to have a happy, peaceful, joyful and healthy holiday season.

Mini-relaxation exercises for everyday use

10/8/2018

By Karen Bruno, PT

Mini-relaxation exercises are focused breathing techniques which help reduce anxiety and tension immediately. You can informally cultivate mindfulness by focusing your attention on the moment to moment sensation during ordinary activities. You can simply do this by single tasking - the art of doing one thing at a time and giving it your full attention. As you wash your hands, pet the dog or eat a meal, slow down the process and be fully present, using all of your senses.

As you awaken, bring your awareness to your breathing. Take a few deep, mindful breaths, sensing the effects in your body. You should feel your belly rising about an inch as you breathe in, and falling about an inch as you breath out.
Instead of hurrying into your usual routine, slow down and enjoy something special about the morning: a flower that bloomed, the sounds of the birds, the face of a friend or family member.
Give yourself 10-20 minutes to elicit the relaxation response through meditation, stretching, or your favorite way.
On your way to work, attend to how you walk, drive, or ride. Breathe mindfully, relaxing throughout your body. Perhaps you would benefit from listening to soothing music.

When stopped in traffic, check your body for signs of physical tension. Drop your shoulders, release your hands on the wheel, soften your facial muscles. Can you break the cycle of running yellow lights and passing cars?
Look for people, places and things which remind you to relax. Use the repetitive events of the day--the ringing telephone, a knock on the door, walking down the hall--as cues for mini relaxations. Can the clock on your watch or phone remind you to take a deep, easy breath and let go?
Practice “news and goods” together. A pleasant experience, no matter how small, can be a stepping stone to feeling better. Have a buddy system and practice focusing on things you like about each other. Reward each other with well-deserved appreciation we so rarely get during our work day. Notice how good it feels to empower another with your appreciation.
When you start a project or feel overwhelmed by what you need to accomplish in the near future, take a few moments to orient yourself, breathe consciously and calmly, relax and then begin. Organize your work. Set priorities. Be realistic with your goals.
Find a few moments during the day to take a break. Breathe consciously, meditate, listen to something relaxing, go out for some fresh air or take a walk.
Whenever you eat, listen to the wisdom of your body. Begin to choose healthier alternatives to quick-fix items like caffeine, sugar and prepared foods.
Acknowledge that you don’t have to remember to do this all the time or be a perfect stress manager. Notice the temptation to turn even stress management into a way to set up unreasonable expectations. Instead appreciate yourself for your successes. Forgive any relapse, laugh, and enjoy this moment. The past is gone; the future is not here; this is your moment. Savor it.
Walk mindfully to your car, bus, train or vehicle of transportation, coordinating your breathing with your steps. Can you see something new in the environment? Can you enjoy walking without rushing?
Use the time in commuting, when waiting in lines or when put on hold during a phone call to turn your awareness within. Breathe deeply, calmly, consciously; release tension. Enjoy the moment.
As you return home, can you consciously make the transition from work to home? If possible, give yourself a few minutes alone to ease the transition.
As you go to sleep, let go of today and tomorrow and take some slow, calming, mindful breaths. Place one hand on your abdomen and one hand over your heart to deepen the relaxation.

Mini Version 1: count very slowly to yourself from ten to zero, one number for each breath. With the first breath you say “ten” to yourself, with the next breath, you say “nine, etc.

Mini version 2: as you inhale, count very slowly up to four; as you exhale, count slowly back down to one.

Mini version 3: after each inhalation, pause for a few seconds; after each exhalation, pause again for a few seconds. Do this for several breaths.

Meditation: bridging the mind/body connection

1/25/2018

Written by Karen Bruno, PT

“Meditation fuses your inner and outer selves, making you one with your body. It allows you to receive and experience the Divine Presence.”

- Steve IIg, from Be Good to Your Body Therapy

Meditation - bridging the mind body connection

We often hear the term mind/body used in various wellness, medical and healing platforms. What this means is that there are powerful and complex interactions that take place between our thoughts, our bodies and the outside world and these factors can directly impact our health. Our thoughts, feelings emotions and attitudes can affect the health of our body and our physical body (what we eat, our posture, and how we move) can positively or negatively affect our mental and emotional states. Simply put, the body can affect the mind and the mind can impact the body. Meditation, a practice of focused awareness, is a mind/body technique that can mitigate the effects of stress on our bodies by bringing calm to our bodies through calming our minds.

Benefits of meditation closely resemble and often overlap with the benefits of deep breathing and exercise. Some benefits of meditation include:

Relaxation
Eases pain,decreases muscle tension
Improves metabolism, assists in weight loss
Reduces perception of stress and anxiety
Improves concentration
Increases self awareness and self acceptance
Supports healthy living
Increases happiness
Fosters well being
Benefits lungs and heart-slows respiratory rate and lowers blood pressure
Benefits immune system so you stay healthy
Slows aging

People often get anxious about the thought of meditating, perhaps because they think they can’t do it, or they don’t have enough time, or for a myriad of other reasons. Meditation can take many forms and is practiced in a variety of ways. Even a few minutes of deep breathing, relaxation or meditation can elevate your mood, sharpen your focus and improve your physical and emotional state of well being. The following are two examples of simple ways to comfort your mind and receive the benefits of meditation.

Sit quietly in a comfortable position with your feet on floor and your back supported.
Close your eyes.
Focus on your breathing, the gentle rising and falling and your abdomen as you inhale and exhale. Breathe comfortable breathes-inhaling to a count of 4 and exhaling slowly to a count of 5-8.
Become aware of any tension you are holding in your body.
Invite the beautiful, healing, nurturing energy of the breath into every area of your body. Allow these breaths of love to fill your cells, molecules, atoms and the space in between these particles with appreciation and love.
Continue this exercise for as long as you like, then gently open your eyes and enjoy the positive and loving feelings you have created as you go about your day.

Here is another quick meditation technique to expand your heart energy:

Breathe in through your nose and direct your breath down into your heart .Slowly breathe out, allowing the breathe to radiate out from your heart.
Additionally, you can envision a beautiful emerald green light flowing into your heart and expanding out from your heart.
Place your hands over your heart and hold yourself in love, reverence and honor.

I wish you well. I wish you peace.

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