How the Body Responds to and Heals From Trauma

When the body experiences trauma, it undergoes a series of physiological responses in order to seek safety and healing. Although every system in the body is affected, the nervous system has the greatest influence on the rest of the body. Restoring health to the nervous system is possible through a concept known as neuroplasticity where nerve cells, or neurons, find new connections. Similar to blood vessels that grow new branches to injured tissues after an injury, neurons can grow, adapt and find new neural pathways. Because of neuroplasticity, it is possible to heal from trauma, learn new skills, adapt to sensory or cognitive deficits and recover from injuries. This is why a person with a stroke or other neurological disorder can benefit from therapeutic interventions and is the basis of what we do as physical therapists.

If you watched television in the 1980s you might be familiar with a commercial discouraging kids from trying drugs. The narrator splatters an egg in a frying pan and says, “this is your brain. This is your brain on drugs. Any questions?” While we all might understand the negative impact of drugs on the brain’s function, far less is understood about the effects of trauma. We want to attempt to explain it similarly: “This is your brain. This is your brain on trauma. Any questions?” However, unlike the permanent effect of taking drugs, trauma can be healed through the three Rs: RESPONDING to the body’s internal signals known as interoception, RECALIBRATING the nervous system with the help of the limbic system and RESTORING homeostasis and optimal function to these critical neural pathways. Understanding the anatomy and physiology of the brain and nervous system and the effects throughout the body helps to empower a person in their own healing. There is a predictable cascade of events that follows trauma:

1. Immediate Response: The brainstem, located at the base of the skull, houses the cranial nerves responsible for social engagement, including the vagus nerve and operates automatically to keep the body running. Located above the brainstem, a group of interconnected brain structures known as the limbic system helps to regulate emotions and behavior. Structures in the limbic system include the thalamus, amygdala, hypothalamus, hippocampus and cingulate gyrus. Sensory information enters the thalamus at lightning speed, where it is processed and then passed onto the amygdala to warn of impending danger. The amygdala, a paired almond-shaped group of neurons in the brain immediately activates the fight, flight or freeze reaction. Bessel Van Der Kolk, M.D. refers to the amygdala as the “smoke detector” in his book, The Body Keeps the Score. The input then goes to the hippocampus, comparing it to past experiences and categorizes the input similar to a filing cabinet. The hippocampus is a complex brain structure embedded deep inside the temporal lobe that has a major role in learning and memory and is affected by many factors, including trauma, lack of exercise and aging. If the trauma is not quickly resolved, defense movements and stress hormones, adrenaline and cortisol, are secreted and continue to circulate until the threat is over. However, in a person with unresolved trauma, this cycle keeps repeating when there is no longer a life-threatening event. This is like sounding the alarm when there is no fire or smoke. Running from a tiger when there is no tiger is not healthy. This can increase the risk of misinterpreting whether a situation is dangerous or safe, creating a faulty alarm system and a chain reaction of physiological responses in the body. In addition, the response to trauma is determined by the role of the thalamus in regulating consciousness, sleep and alertness. The thalamus, a large mass of gray matter located on the third ventricle of the brain, acts as a gatekeeper to interpret the alarm coming from the amygdala, determining if the sensory information is relevant or can be safely ignored. Furthermore, the primitive centers of the brainstem take over and there is a loss of executive function in the prefrontal cortex (PFC) located in the frontal lobe of the brain. The left side of the brain that is responsible for language and sequential, logical organization becomes deactivated. The person can be left speechless, losing the ability to express language (Broca’s area) as well as comprehend and understand language (Wernicke’s area). It is as if the person had a stroke. This explains what happens when an individual experiences abuse and cannot verbally express what happened or tell anyone. This can cause them to replay the event or act it out on another child or person. I believe this is the reason sex abuse can go unreported, cause shame and get embedded deep in the subconscious. As an adult, the individual might feel like they don’t have a voice or they might have trouble communicating how they feel. The same physiological response can be triggered by a memory of past trauma, where a person can react as though the event is happening in real time. The left side of the brain goes offline, shutting down logic and reason, allowing the right side of the brain to become more dominant, adding emotion and creativity. The person may not be aware they are experiencing the past and may be confused about what is happening to the extent of being terrified, angry, ashamed or frozen.

2. Inflammatory Response - After the immediate danger has passed, the body heals through an inflammatory response. Blood flow increases to bring more nutrients and oxygen to the injured area and white blood cells migrate to the site to fight infection and clear debris. Signaling molecules known as cytokines promote healing and regulate inflammtion. Fascia, the body's scaffolding connective system, contracts to protect organs and tissues. This can be experienced by pain, muscle tightening or visceral sensations from organs. Inflammation is a necessary stage of healing, although should resolve and not persist.

   
   

3. Tissue Repair - Continuation of healing includes collagen formation, regeration and scar formation. The physical wound heals, but the effects can linger inside the nervous system, creating a perpetual cycle. This is explained by pain science, where the tissue has healed but the signal remains. Chronic pain is an example of nervous system inflammation, long after the injured tissue has healed.

   
   

4. Mental Recovery and Healing - Individuals may experience shock, denial, anger or sadness. The proper social support from friends, family and professionals is important for recovery. Therapeutic interventions like counseling may be necessary to address PTSD or other trauma-related conditions. The body holds onto trauma within the fascia scaffolding system as a result of its connectedness to the nervous system. Healing the nervous system may be necessary for full-body recovery.

As pelvic health physical therapists, it is imperative that we are trauma-informed. This means when a person comes in for a physical dysfunction, we need to be mindful of the state of their nervous system and any history of trauma, whether the person verbalizes it or shows stress in their body through nonverbal communication, posturing and facial expression. This means active listening and affirming the individual in what they are experiencing. We have a tissue box available as tears can flow when someone realizes that they are being heard and that we understand what they are going through. I think it was my own experience of needing to be healed and being gaslighted by health professionals that drove my intuition of this even before it was considered evidence-based. 

The autonomic nervous system can be recalibrated through both a top-down and bottom-up approach. In addition to having credible evidence of safety, mindfulness is an effective tool utilizing the body’s sensations to strengthen the capacity of the prefrontal cortex. Mindfulness is an evidence-based tool to bring awareness to sensations inside the body known as interoception. This can be accomplished by deep, abdominal breaths and therapeutic touch of the abdomen, face and neck. Breathing is one of the few body functions under both conscious and autonomic control but is the most difficult to master. This is the foundation of our work as physical therapists, treating individuals who have chronic pain and pelvic floor dysfunction. If there was one common denominator or common theme that most people have, it is a faulty breathing pattern. It is often both a mechanical issue where a structure is preventing good rib expansion or the ability to take a deep breath and also an emotional or stress issue. It is difficult and almost impossible to take a deep breath when you are experiencing fight or flight inside your body. Recognizing this, we use manual techniques to reset the nervous system and help bring awareness to breath. It is like a light switch activating safety centers to quickly sooth a dysregulated nervous system.

The physiological effects of a faulty alarm system can alter all of the systems in the body. Chronically living in a sympathetic dominant state has negative consequences and most health issues can be traced back to nervous system dysfunction. Some examples are heart disease, anxiety, insomnia, addictions, digestive diseases, organ diseases, diabetes and obesity. In addition, a suppressed immune function from nervous system dysfunction can lead to infection, cancer and other illnesses and diseases. Decreased growth and sex hormone levels can lead to premature aging. Increased muscle tone can lead to chronic pain or fibromyalgia and the list goes on. Understanding how your body responds physiologically to trauma and stress is the first step to healing. Signs and symptoms inside your body signal the alarm that something is wrong and needs to be addressed. Learning to interpret these signals and responding with therapeutic methods is essential, whether it is through physical touch, self care, mindfulness or intentionally seeking and doing nerve health exercises.

The body's response to trauma is complex and multifaceted, involving physiological processes that affect physical and mental health. Treating the root issue of nervous system dysfunction is at the heart of full-body healing and wholeness and unfortunately not typically addressed by healthcare providers. This is a problem that we believe can be changed through improving vagus nerve function known as vagal tone. Being in the ventral state of the vagus nerve, known as social engagement, can reduce the negative response to stress held within the body and we will show you how to achieve it! Click here to read more on tips for improving vagal tone or call our office at (330)528-0034 to schedule an appointment with one of our physical therapists to get started on improving nervous system regulation.

written by: Janine Laughlin - May 2025