Physiotherapy and the Polyvagal Theory: Supporting Your Nervous System

Have you ever wondered why a calming touch or a safe environment can make you feel so much better? The answer lies in your nervous system, and specifically in what’s known as the Polyvagal Theory. At At Ease Physio, we integrate this understanding into our manual therapy approach to help your body find its way back to balance.

What is the Polyvagal Theory?

Developed by Dr. Stephen Porges, the Polyvagal Theory provides a framework for understanding how our autonomic nervous system responds to safety and threat. Unlike the traditional view of the nervous system as simply “fight-or-flight” versus “rest-and-digest,” Polyvagal Theory reveals a more nuanced picture with three distinct states.

The theory focuses on the vagus nerve—the longest cranial nerve in your body—which connects your brain to your heart, lungs, and digestive system. This nerve plays a crucial role in regulating your body’s stress response and overall well-being.

The Three Nervous System States

1. Ventral Vagal State (Social Engagement)

This is your optimal state of calm, connection, and safety. When your nervous system is in this state, you feel:

• Relaxed yet alert
• Socially connected
• Able to think clearly
• Good digestion and sleep
• A sense of ease in your body

2. Sympathetic State (Fight-or-Flight)

When your nervous system perceives danger, it shifts into this mobilized state. Signs include:

• Increased heart rate
• Shallow breathing
• Muscle tension
• Anxiety or restlessness
• Digestive issues
• Difficulty concentrating

3. Dorsal Vagal State (Shutdown)

When the threat feels overwhelming, your nervous system may move into a protective shutdown. This can manifest as:

• Feeling disconnected or numb
• Fatigue and low energy
• Depression
• Feeling “frozen” or stuck
• Social withdrawal
• Slow digestion

How Manual Therapy Supports the Nervous System

Manual therapy is more than just treating muscles and joints—it’s a powerful tool for nervous system regulation. Here’s how our approach works:

Targeting the Vagus Nerve

Through specific manual therapy techniques, we can influence the vagus nerve and its branches. Work around the neck, jaw, and cranial base directly affects vagal tone and can help shift your system toward a more regulated state.

Cranial Nerve Integration

The cranial nerves—particularly those involved in facial expression, hearing, and swallowing—are closely tied to your sense of safety. Craniosacral therapy and manual techniques that address restrictions in these areas can help your nervous system feel more secure.

Creating Safety Through Touch

Skilled, attuned touch sends signals of safety to your nervous system. When your body feels safe, it can begin to release tension patterns that have been held for years.

Releasing Held Tension Patterns

Chronic stress leaves its mark on the body. Through gentle, targeted work, we help release fascial restrictions and muscular tension that keep your nervous system stuck in protective states.

Conditions That Benefit from This Approach

Long COVID

Many people recovering from COVID-19 experience ongoing fatigue, brain fog, and dysautonomia (nervous system dysregulation). Our approach helps:

• Improve vagal tone
• Reduce fatigue
• Support cognitive function
• Address breathing pattern disorders

Mental Health Conditions

Anxiety and depression often have a strong nervous system component. Visceral manipulation and manual therapy can also help with headaches and migraines that are often connected to stress patterns:

• Calm an overactive stress response
• Help lift the body out of shutdown states
• Support emotional regulation
• Complement counselling and other therapies

Digestive Disorders

The gut-brain connection is real, and it runs through the vagus nerve. Conditions that may benefit include:

• Irritable bowel syndrome (IBS)
• Functional dyspepsia
• Constipation
• Bloating and discomfort

Hormonal Imbalances

Your nervous system directly influences your endocrine system. A regulated nervous system can support:

• Better sleep
• Improved stress hormone balance
• Menstrual cycle regulation
• Thyroid function

Practical Steps You Can Take

While professional treatment is valuable, there are things you can do daily to support your nervous system:

Breathing Practices

• Extended exhale breathing: Breathe in for 4 counts, out for 6-8 counts
• Humming or singing: Activates the vagus nerve through the vocal cords
• Sighing: Natural nervous system reset

Cold Exposure

Brief cold water exposure (like ending your shower with 30 seconds of cold) can stimulate vagal tone. Start gently and build up gradually.

Social Connection

Feeling safe with others is medicine for your nervous system. Prioritize quality time with people who help you feel at ease.

Gentle Movement

Practices like yoga, tai chi, and walking in nature support nervous system regulation. The key is movement that feels nourishing, not depleting.

Orienting to Safety

Take moments throughout the day to notice that you are safe right now. Look around your environment, feel your feet on the ground, and let your nervous system register the present moment.

What to Expect in Treatment

When you come to At Ease Physio for nervous system-focused work with Susannah Reid, your session may include:

• A thorough assessment of your nervous system patterns
• Gentle manual techniques to the neck, jaw, and cranial base
• Work with breathing patterns
• Education about your nervous system
• Take-home practices to support your progress

Many people notice a shift within the first few sessions—a sense of feeling more grounded, sleeping better, or experiencing less anxiety.

Is This Approach Right for You?

This work may be particularly helpful if you:

• Feel stuck in a state of chronic stress or anxiety
• Experience unexplained fatigue or brain fog
• Have digestive issues that haven’t responded to other treatments
• Are recovering from COVID-19 or another illness
• Want to support your mental health through bodywork
• Feel disconnected from your body

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Ready to explore how nervous system-focused physiotherapy can help you? Contact us to book an initial assessment.

References

1. Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. W. W. Norton & Company.

2. Dana, D. (2018). The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. W. W. Norton & Company.

3. Rosenberg, S. (2017). Accessing the Healing Power of the Vagus Nerve: Self-Help Exercises for Anxiety, Depression, Trauma, and Autism. North Atlantic Books.