The Importance of Down-regulation

Downregulation is a concept that not only can, but should be addressed in Physical Therapy. In this blog, we will discuss the concepts of downregulation that are related to sleep and pain, as well as the involvement of the central nervous system. 

Capacity and Sleep

Capacity and sleep are components of downregulation that are very closely related to physical therapy and injuries in general. One of the most compelling components for addressing pain involves consideration of the research about pain and sleep quality. This research shows that poor sleep leads to increased pain in those who are already experiencing pain and can also create pain in individuals who did not originally have any reports of pain when they were deprived of sleep. This means that injuries and pain can negatively affect your sleep quality as well as the fact that poor sleep can cause and worsen pain levels. This is important to consider when understanding the factors that contribute to pushing someone past their capacity. Here is one of our favorite illustrations to use with our patients here at Conquer Movement that highlights how just one variable can be the straw that breaks the camel's back when it comes to exceeding their capacity. 

Lighting and Sleep

In a world dominated by artificial lighting, understanding the impact of different light sources is essential. For instance, fluorescent lights, commonly found in offices and public spaces, can contribute to stress and discomfort as well as increased levels of cortisol, which is our stress hormone. Incorporating down-regulation strategies can include creating environments with softer, more natural lighting to reduce stress and promote a sense of calm. This is something I am particularly passionate about and if anyone reading this has been in my office specifically, you will notice the lack of fluorescent lights to promote a sense of calm and relaxation which can help downregulate the nervous system. Another topic related to lighting that comes up frequently with our patients is avoiding bright lights right before bedtime. This is because we have a gland in our brain that signals that it is time to sleep by producing melatonin. This gland is the pineal gland and melatonin is a hormone that promotes sleep. When we are exposed to bright lights and screens, the pineal gland interprets them as sunlight and does not release melatonin which can disrupt our normal sleep cycle. If you absolutely need to look at a screen before bed, we suggest blue light blocking glasses to mitigate the effect of the screens on melatonin production. We emphasize this because sleep is one of the most significant aspects of down-regulation. Quality sleep is fundamental for cognitive function, emotional regulation, and overall health. Establishing good sleep hygiene practices is crucial in achieving restful sleep. Avoiding caffeine intake late in the day, limiting light and screen exposure, and creating a relaxing bedtime routine are integral components of down-regulation. These practices help signal to the body that it's time to wind down, promoting the secretion of melatonin, a hormone responsible for regulating sleep-wake cycles.

Below is an infographic from the American Physical Therapy Association detailing Sleep Health Promotion. Use this as a reference for improving your sleep hygiene in addition to any of our other blogs about sleep which can provide more detailed information. 

Understanding the SNS and PSNS: Keys to Balancing Your Nervous System for Optimal Health

In the intricate dance of our body's systems, the nervous system plays a pivotal role in regulating virtually every function. To maintain balance and promote overall wellness, it’s crucial to understand the two primary branches of the autonomic nervous system: the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PSNS). Let’s delve into what these systems are, how they work, and why avoiding excessive stress on the Central Nervous System (CNS) is essential for health and wellness.

What is the Sympathetic Nervous System (SNS)?

The Sympathetic Nervous System is often described as the "fight or flight" system. It prepares the body for stressful or emergency situations by initiating a cascade of physiological changes. When activated, the SNS:

- Increases Heart Rate: This ensures that more blood, rich in oxygen and nutrients, reaches vital organs and muscles.

- Dilates Airways: Allowing more oxygen to enter the lungs to prepare for heavy oxygen demands as we escape danger. 

- Releases Glucose: From the liver to provide a quick energy source as we will need a large increase in energy to remove ourselves from a dangerous situation. 

- Reduces Non-Essential Functions: Such as digestion, to prioritize energy towards immediate survival. Blood flow is directed to areas of the body that need blood and oxygen to get you out of danger. 

This response is incredibly useful in acute, short-term stress scenarios, such as escaping danger or confronting a challenging situation.

What is the Parasympathetic Nervous System (PSNS)?

In contrast, the Parasympathetic Nervous System is often referred to as the "rest and digest" system. It promotes relaxation and recovery by:

- Slowing the Heart Rate: Allowing the heart to return to a calm state.

- Stimulating Digestion: Enhancing the process of breaking down food and absorbing nutrients.

- Promoting Energy Storage: Encourages the body to store glucose and fat.

- Encouraging Restful Sleep: Facilitating recuperation of energy, promoting tissue healing, and reducing waste. 

The PSNS is essential for long-term health, enabling the body to recover and maintain homeostasis after periods of stress.

The Balance Between SNS and PSNS

Maintaining a harmonious balance between the SNS and PSNS is crucial for overall health. Chronic activation of the SNS, due to continuous stress or anxiety, can lead to a host of health issues, including:

- Increased Risk of Cardiovascular Disease: Prolonged high heart rates and elevated blood pressure strain the heart and blood vessels.

- Digestive Problems: Persistent stress can lead to digestive disorders like irritable bowel syndrome (IBS) or ulcers.

- Weakened Immune Function: Chronic stress impairs the immune system, making the body more susceptible to infections and illnesses.

- Mental Health Issues: Long-term activation of the SNS can contribute to anxiety, depression, and other mood disorders.

- Sleep Disturbances: Persistent SNS activation can lead to insomnia or poor-quality sleep, further impacting health and wellbeing.

Strategies for Avoiding Heightened Aggravation of the CNS

To support a balanced nervous system and overall wellness, consider incorporating these strategies into your routine:

- Stress Management Techniques: Practices such as mindfulness meditation, deep breathing exercises, and yoga can help activate the PSNS and reduce SNS dominance.

- Regular Physical Activity: Exercise can help regulate the balance between SNS and PSNS by promoting the release of endorphins and reducing stress hormones. We recommend our athletes to find a low intensity physical activity to utilize for downregulation such as a gentle walk, as compared to their normal sports and recreational activities. 

- Healthy Diet: A balanced diet rich in nutrients supports both the CNS and overall health, providing essential components for neurotransmitter function and stress resilience.

- Adequate Sleep: Prioritizing good sleep hygiene ensures that the body has time to repair and rejuvenate, maintaining a healthy balance between the SNS and PSNS.

- Social Support: Positive social interactions and relationships can provide emotional support and buffer against chronic stress. At Conquer Movement we believe in providing support and accountability to help you reach your goals. 

- Mindfulness Practice: Engaging in hobbies, spending time in nature, or practicing relaxation techniques can help activate the PSNS and mitigate the effects of chronic stress. Look at our mindfulness techniques by reviewing this blog. 

Understanding the roles of the SNS and PSNS and the importance of their balance is key to maintaining overall health and wellness. By fostering practices that support the Parasympathetic Nervous System and mitigating chronic stressors, you can create a healthier, more balanced life. Embracing this approach not only enhances physical health but also contributes to emotional and mental well-being, allowing you to navigate life’s challenges with greater resilience and ease.

You may be asking yourself how this all applies to your sport. At Conquer Movement we believe the mental aspect of pain and performance is just as important as the physical aspect. You will also see various tools for recovery and downregulation throughout our office such as our redlight therapy, infrared sauna and compression boots. But if that is not enough to convince you, there is actually a breathing technique called the Wim Hof method that can not only decrease your stress levels and anxiety, but also, oxygenate the blood and thus improve performance in sport. Here is a link to a guided breathwork session. I have used this with multiple patients with great success!

In the fast-paced, technology-driven world, it's easy to overlook the importance of down-regulation. However, prioritizing activities that promote relaxation, such as meditation, deep breathing exercises, or engaging in hobbies, can counterbalance the stressors of daily life. By recognizing the significance of down-regulation and incorporating these practices into our routines, we can enhance our mental and physical resilience, ultimately leading to a more balanced and fulfilling daily experience. Here at Conquer Movement, we focus on many of the above mentioned components of down regulation with our patients. We have seen huge improvements in physical pain with the prioritization of downregulation, mindfulness and sleep hygiene. If you are looking to improve your pain and overall well being, look no further and schedule a free discovery call with one of our doctors here at Conquer Movement!

Dr. Kylie Miller

Performance Physical Therapist

Wilmington, NC

Follow here for more performance tips: @conquermovementpt