Trauma can profoundly affect people’s psychological wellbeing. That’s not controversial. But when we move from psychology into physiology and fitness, many claims start circulating that simply aren’t supported by scientific evidence.

Trauma-Informed Fitness - Fitness articles | Trainerize.me

I’m no mental health professional (although I’ve written a book about how to improve anxiety using exercise, nutrition and supplements), so when I hear people talk about trauma, I just shut up. But when I hear about how mental/emotional trauma affects fitness, my ears perk up, and my skeptical brain starts asking questions, namely, the ultimate questions of the skeptic:

  • Is this claim BS?
  • Is it being spread due to sheer ignorance (blind leading the blind), wishful thinking (“I’m a compassionate person, and this claim sounds compassionate”) or does someone stand to profit from spreading a specific myth?

As a skeptical geek, my next instinct is to pull up scientific research to answer those questions.

In this article, we’ll bust several of the myths pertaining to how trauma affects fitness. And no, this article is not at all about how to deal with trauma. Again, I’m not a mental health professional, but if you’re looking for a great psychotherapist, reach out to my buddy, Mike MacKinnon. And no, I don’t get paid for saying that. He’s just a good dude.

With that out of the way, let me crack my knuckles, and start busting myths.

 

Myth #1: Trauma Elevates Your Cortisol Levels

On the surface, this one seems logical: trauma is stressful. Cortisol is the stress hormone. So cortisol rises in times of stress. Nice, clean logic. Let’s put a bow on it and ship it.

But the research tells a more nuanced story:

  • One study did indeed show that some (not all, and not the majority) trauma survivors do indeed have elevated cortisol levels.
  • Another study actually showed the opposite: that trauma survivors have lowered cortisol levels.
  • A third study showed no difference in cortisol levels between trauma survivors, and those that don’t have trauma (and this study used genocide survivors to study trauma. That’s serious business).

Besides the inconsistencies in the research in regards to what happens to the cortisol levels of trauma survivors, there’s the much bigger problem of cortisol testing. For instance:

  • Cortisol naturally fluctuates wildly throughout the day. Even in a person who hasn’t been through trauma, cortisol peaks about 45-50 minutes after awakening, and drops sharply afterwards. One study showed that even waiting 60-65 minutes after awakening, it’s no longer the same cortisol level, or even close.
  • Another study also showed that there are so many things that affect cortisol, like:
    • If it’s measured on a weekday or a weekend
    • The time that you wake up
    • Caffeine
    • Exercise and activity levels
    • Your mood
    • Your body mass index/body fat percentage
    • If you had a nightmare
    • If you’re experiencing joint pain

…and more.

  • Even within the same person who has the same routine from day to day, cortisol fluctuates wildly, according to this study.

All in all, cortisol is an interesting hormone to study on a population basis, where you take a lot of people and it smoothes out any anomalies. But on an individual basis, it varies so much, so to be mostly meaningless, unless you take 3 measurements per day for 2-6 days as suggested in this study.

If scientists still haven’t figured out what happens to the cortisol of trauma victims, what hope does the general public have in claiming with certainty that trauma increases cortisol? Virtually none. Yet, they declare it, and they do so confidently. Yet, the very scientists studying this stuff aren’t even confident.

Some trauma survivors have higher cortisol, some lower, and many show no difference at all.

 

Myth #2: Trauma Damages the Metabolism

I believe that this one comes from the observation that some people who suffer from mental/emotional trauma have excess body fat. But the thing is that there are plenty of people with no trauma who have high body fat levels as well.

The only study that directly looks at the metabolisms of people with PTSD (post-traumatic stress disorder) showed that their metabolism is going at the same speed as people without PTSD.

Your metabolism is largely determined by only 2 factors:

  • Your body weight (especially your lean mass – which is everything that isn’t fat)
  • Your thyroid hormone levels

Your emotional state has nothing to do with your metabolism.

 

Myth #3: The Body Stores Fat as Protection After Trauma

I think this myth comes out of trying to be compassionate to the person going through trauma, with mantras like:

  • You don’t have to lose body fat – you’re beautiful just the way you are
  • You don’t have to work hard at fat loss. There’s no point. You have to heal your trauma first, and then you’ll lose body fat (we’ll talk about that one in myth #4).

Trauma is indeed associated with higher body fat levels, but you’re a savvy reader of my articles. You already know that correlation does not mean causation. And trauma is not the cause of fat gain. Trauma may make you engage in downstream behaviours that lead to fat gain, like:

  • Eating more/emotional eating
  • Stress eating
  • Less exercise
  • More alcohol use
  • Worse sleep

However, if you’re both a trauma victim and overweight, but you start engaging in behaviours that promote fat loss, you’ll lose body fat. It’s that simple.

Now, yes, dealing with your trauma may make it easier to engage in those behaviours, but the point I’m making is that the trauma itself is not the ultimate cause of fat gain. The downstream consequences of trauma might be – for some people. There are plenty of people who go through trauma, and actually lose their appetite, and as a result, lose weight (including muscle mass).

 

Myth #4: Trauma Means You Need Gentle Workouts

This one comes from misguided compassion. The thinking goes “if you’ve been through trauma, you need to take it easy on yourself.” But another school of thought says that if something really bad happened to you, you need to exorcise those demons. You do that with high-intensity exercise, especially boxing, kickboxing or martial arts.

Which one is right? It turns out that both are right.

In one study, low intensity exercise was used (although they didn’t have a second group doing high intensity exercise) as a treatment for PTSD, and indeed, it was effective.

In another study, researchers recruited 40 people with PTSD, and divided them into 2 groups:

  • Group 1: high intensity training
  • Group 2: low intensity training

At the end of the study, both groups improved their symptoms of anxiety and depression by very similar amounts.

Finally, a third study paints a more nuanced picture for us. There are times when low intensity exercise is better for trauma, and times when high intensity exercise is better for trauma.

Low intensity is more appropriate when:

  • The trauma is very recent
  • Somebody feels dissociated (kind of like they’re watching their own life from a third person perspective)
  • They have problems with emotional regulation
  • They have low starting fitness levels.

High intensity exercise is more appropriate when:

  • Someone has symptoms of hyperarousal (hypervigilance, exaggerated startle response, irritability, sleep disruption, etc.)
  • Someone past the recent stage of trauma

 

Myth #5: You Must Heal Trauma Before You Can Get Healthy

A lot of times, when we hear that someone’s been through trauma, we put on the baby gloves around them. Sometimes it’s justified, and sometimes, it isn’t.

For example, one meta-analysis saw that treatment for PTSD improved insomnia. There were fewer nightmares, less interrupted sleep, and more of the time in bed was actually spent asleep (that’s called “sleep efficiency”).

Another study found that treatment for PTSD improved chronic pain. In this study, treatment involved psychiatric medications and pain medications.

But trauma treatment doesn’t directly help other health problems, like:

  • Obesity
  • Dyslipidemia (poor cholesterol and triglyceride profiles)
  • Diabetes
  • Osteoporosis
  • Inflammation

 

Perhaps the biggest story of trauma is the story of resilience. There are no direct negative physical consequences (they appear indirectly, or downstream). In one study, the researchers recruited 753 women who reported having traumatic experiences. Yet, the majority of them had no negative health changes post-trauma. They didn’t gain body fat, their inflammation levels didn’t rise, they didn’t develop diabetes or other health issues. They were able to compartmentalize the trauma, without engaging in negative health behaviours.

Here’s another perspective: perhaps if someone was unhealthy before the traumatic experience, maybe working on their physical health is the treatment for trauma itself. A healthy (and fit/strong) body makes it easier to deal with negative mental and emotional experiences.

In some people who have had negative health consequences as a result of the trauma, perhaps treating their trauma makes it easier to start engaging in positive health behaviours.

But there’s no reason why healing trauma and getting healthy can’t happen concurrently. They don’t have to be sequential.

It’s not like trauma makes someone completely unresponsive to positive health behaviours just because they’ve gone through trauma. The approaches that work for people who’ve never gone through trauma also work for those who’ve gone through trauma. Regardless of someone’s traumatic experience, if you’re trying to lose body fat, you’ll have to lower your calories (or raise your activity levels), eat more protein, and engage in strength training. That’s true no matter if someone’s been through trauma or not.

Want to improve your cholesterol levels? Do strength training, eat the appropriate amount of fibre, eat 50 grams of nuts/day, and either eat fatty fish or take fish oil. That’s true regardless of whether someone has trauma or not.