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I know, I know…exercise, lose weight, and take some antidepressants…there! Now you should feel better.

If you’re someone who struggles with physical pain, you may be thinking, “oh no, not another, ‘try yoga’ advice from someone who has no idea what it’s like to live in daily pain.”

Woman doing yoga | online trauma counseling Columbus Ohio | Blue Boat Counseling | October 2020 | therapist in Columbus

Well, actually, I do. 

Today, my goal is to share with you why that advice just might make sense.  

So, what do physical pain, mental health, and exercise all have in common?


I know, it sounds like some woo-woo stuff. I would hear, “Oh yeah, I used to have chronic pain too” and immediately think that this isn’t someone who’s going to understand me. Your chronic pain must not have been real chronic pain if it went away. But today, I’m not so sure I was right. Stick with me for a little while, and I’ll explain.

Exercise helps with chronic pain – but why?

As someone diagnosed with chronic pain, I spent a lot of time trying to understand my condition, fix it, manage it, medicate it. Nothing seemed to work. But repeatedly, [and annoyingly], doctor after doctor would say that exercise of some kind seems to help patients with chronic pain, and so does counseling. “You want me to do what? I can barely get out of bed in the morning!”

But here’s something that was never explained to me: why exercise helps. And so, time after time I left feeling frustrated, misunderstood, and hopeless about ever feeling better. 

Many patients with chronic pain are told to lose weight and exercise. Some are even told that their pain is the result of being overweight. I’m not sure which came first here, the pain and then the weight gain, or vice versa, but I do know that exercise actually makes sense as the answer to some of these pains. Unfortunately, I’m not talking about chronic pain that comes as a result of surgery, degenerative disease, genetic abnormalities, accidents or physical trauma, or hereditary factors. What is astonishing is that although we think that most chronic pain comes from such factors, on the contrary, research shows a large number of patients with chronic pain have no clear identifiable cause for it. This doesn’t mean your pain isn’t real. Here’s why…

Fight, flight, freeze in response to chronic pain

If you are someone who struggles with chronic pain – such as fibromyalgia – you’ve probably noticed the pain gets worse with increased stress. What do you attribute this to?


Man in pain | online mental health therapy for depression | depression therapist in Columbus | 2020 | Blue Boat Counseling

Over the last few years, study after study has looked at the link between chronic pain and trauma. In 2014, a peer-reviewed article that appeared in the Journal of Women’ Health linked severe premenstrual syndrome (PMS) and premenstrual dysmorphic disorder (PMDD) with early-onset abuse. The Institute for Chronic Pain states that up to 90% of women with fibromyalgia and up to 60% of patients with arthritis report experiencing traumatic events at some point throughout life. A study published in Clinical Rheumatology (2004) compared patients with fibromyalgia and rheumatoid arthritis. Fibromyalgia patients showed higher anger directed inward (at themselves) and concluded that “it is the behavioral expression of anger, together with anxiety, that predicts the severity of the pain.” 

I believe this has to do with our fight or flight response, but more specifically fight, flight, or freeze. Our fight, flight, or freeze response is activated when we’re in some kind of danger. In these moments parts of our brain [literally] shut down, such as those that control hunger or thirst. We go into a “survival” mode and will typically attempt to either fight or flee at that moment. However, sometimes when we cannot decide whether to fight or flee, or when the danger is too high, our bodies go into the ultimate survival mode – what we would see in animals as the “play dead” response – and freeze (Levine, “Waking the Tiger”). 

We know that as a result of ongoing stress or trauma, our bodies can release toxic stress hormones. This happens as the stress response is repeatedly activated without an energy release, calmness, or a way out of the danger. Toxic stress can damage our neural connections, and studies show that our brain structure can actually alter as the result of traumatic experiences (Van Der Kolk, “The Body Keeps the Score”). 

Stressed woman | anxiety therapy Columbus | online therapy Ohio for PTSD | Blue Boat Counseling | October 2020 | 43085

The Adverse Childhood Experiences study (1998) gathered health data among individuals who experienced adversities as children (death of a parent, poverty, abuse, violence, etc). This study found that the more such adversities individuals experienced as children, the more negative health outcomes they were likely to have – anything from the common cold to cancer and heart disease. This was even the case for individuals who never smoked or drank and reported taking good care of themselves. 

The mind and body connection with mental health

If you had told me some of these things 10 years ago, I would have really rolled my eyes. The idea that our bodies and minds are connected like this was such a foreign concept. But I find that if you look around, you may notice if someone is feeling anxious or depressed or even hypervigilant (on edge, looking over their shoulder). A depressed individual might be slumped over, with their gaze on the ground. 

Depressed woman | depression counseling Columbus | online therapist in Columbus | Blue Boat Counseling | October 2020 | 43085

An anxious individual might fidget or ramble. Likewise, negative experiences from the past and unresolved emotions build up as energy in our bodies. If we do nothing with this energy, it only stays in our system and grows bigger and louder. 

Somatic therapists believe we need to release this energy and that in fact, that is what some of the symptoms of trauma or overwhelming stress are trying to tell us. For example, intrusive thoughts/memories, flashbacks, and nightmares, might be the way that our bodies are trying to find a different outcome to an unspeakable event. Perhaps we couldn’t escape our abuser for years and now those same scenes of abuse replay in our heads. This can be explained as your body and brain trying to create a scenario where you do escape your abuser. And so, we get stuck in these never-ending loops of looking for a different outcome – through nightmares, flashbacks, intrusive thoughts. This makes sense, because sometimes simply re-writing one’s story or ending can start to help them move forward after a traumatic event. 

This is where the idea of energy comes in. If instead of holding onto our pain (or energy), we share it with someone or in other ways start to release it, we may be able to find relief, or symptoms might even disappear altogether. All it takes is a movement of some kind to get the energy flowing. This can be anything from exercising at the gym, swimming, swinging at the batting cages, or walking. 

Girl walking in woods | depression therapist in Columbus | online counseling Columbus Ohio | Blue Boat Counseling | 43085

You can start anywhere…no step has to be huge here. I started with 2 push-ups. Seriously, 2 push-ups. But eventually, 2 turned into 3, 3 turned into 5, 5 into 10, and so on. And…I started to feel better. In conjunction with therapy, exercise, movement, or flow can help release negative energy we have been holding onto.  

I can’t tell you that I cured all of my pain with exercise. I do, however, notice a drastic change in how I feel daily. No matter what “caused” your pain, your pain is still valid. A link to trauma does not mean your pain is not real or “all in your head.” In fact, it gives hope that more options may be available for treatment than we previously thought. 


If you’re dealing with chronic pain that’s linked to trauma, you’re not alone. Blue Boat Counseling offers online therapy for those living in the state of Ohio, and in-person sessions for those living in or near the Columbus Ohio area.  Contact us today to schedule an appointment with one of our therapists; they’re here to help.