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Sympathetic Up-Regulation: How PT Can Help Calm your Fight-or-Flight Reaction

Do you feel like you are constantly stuck in “fight or flight” mode? People with chronic pain conditions can experience Sympathetic Up-Regulation. This means the sympathetic nervous system is firing more frequently than necessary. For example, instead of just getting turned on when you are being chased by a bear or in “fight or flight” situations, it’s active during everyday activities such as pushing a shopping cart or walking your child to the bus.

What is the Sympathetic Nervous System?

Our nervous system is the control center for almost all of our organ system actions, including the muscles of the musculoskeletal system. Our nervous system is divided into three major divisions:

  • 1. Motor system – Controls muscles and movement
    2. Sensory system – Processes sensory information such as vision, hearing, taste, smell, equilibrium, and touch
    3. Autonomic nervous system – Regulates the function of all our organs – such as heart, stomach, and intestines

The autonomic nervous system is often called our automatic system because we aren’t aware or in as much control of it like the motor system. The autonomic system has three divisions:

1. Sympathetic system: “Fight or flight” system
2. Parasympathetic system: “Rest and digest” system
3. Enteric system: Gastrointestinal system

What is Sympathetic Up-Regulation?

When you have sympathetic up-regulation, your sympathetic system is firing in overdrive! It won’t slow down and allow the parasympathetic (rest/digest) system to kick on. People who have sympathetic up-regulation often have:

• Difficulty sleeping
• Tightening of the muscles and fascia
• Heart palpitation or fluttering, increased sense of anxiety
• Blood also tends to be shunted away from the intestines, so there may be more constipation or difficulty moving bowels.

How can physical therapy help with Sympathetic Up-Regulation?

1. Breathing

Learning proper breathing techniques to help quiet the sympathetic system can be very beneficial. The sympathetic nervous system is located in the thoracic and lumbar regions of the spine. By taking a deep breath that expands your diaphragm and opens up your rib cage, you can gently glide and massage the sympathetic chain of nerves, telling them to calm down.

2. Skin rolling or connective tissue/fascial release techniques over the thoracic region.

During sympathetic up-regulation, fascia all over the body tends to be more “sticky” or restrictive and muscles tend to be tighter and more tender from overactivity. Myofascial release all over the body can be very beneficial to help release these tightened structures and decreased pain associated with the up-regulation or chronic pain condition.

3. Massage for Vagus nerve stimulation.

The Vagus nerve makes up 80% of parasympathetic input. If you can stimulate the parasympathetic (rest/digest) system, this can help to shut off the overactive sympathetic system. Systematic abdominal massage and visceral mobilizations can be very beneficial to stimulate the Vagus nerve. Also, massage and myofascial techniques around the head/neck and feet have been shown to increase Vagus nerve input.

Other modalities that can also be very helpful include acupuncture, mindfulness meditation, psychotherapy or counseling, and certain Yoga practices. If you are concerned that you may have sympathetic up-regulation, click here to schedule a complimentary phone consultation to speak to one of our physical therapists.

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