Lots of studies show that exercise is an effective treatment for many post-traumatic stress disorder (PTSD) symptoms, including insomnia (which affects 90% of PTSD sufferers), anxiety, and depression. But few studies have looked into the effect of exercise on actual combat veterans, a research gap that was recently filled by the Veterans Group Exercise project, a collaborative effort between the University of California, San Francisco Osher Center for Integrative Medicine and the San Francisco VA Medical Center. The 12-week pilot study—the first part of a larger investigation—looked at the impact of aerobic exercise, strength-training, and mindful breathing on vets with PTSD.
Preliminary results showed that gains in aerobic fitness correlated with gains in overall quality of life, psychological health, and PTSD symptom relief, but the exercise program used in the project—devised by Wolf Mehling, MD, associate clinical professor of family and community medicine at UCSF and expert in manual medicine at the Osher Center—included another element that often isn’t part of exercise programs for PTSD: mindfulness.
“One symptom of PTSD is dissociation from bodily sensations and emotions,” explains Mehling. “This is a good skill if you are in a war, but in peacetime, dissociated emotions haunt you in nightmares and flashbacks, and are often linked with chronic pain. Exercise that’s simply exhausting and aerobic stimulates bodily sensations, but exercise that’s more in the tradition of yoga or tai chi adds mindfulness to the mix. It brings vets with PTSD into the present and out of a difficult past or uncertain future.”
Further studies are planned to more accurately measure the impact of mindfulness as part of an exercise program for PTSD, but the researchers feel that it was a key part of their program’s success. If you’re working with vets, consider adding a mindfulness element—and try the following ideas too.
• Form a group. In the Veterans Group Exercise project, vets with PTSD worked out in small groups of three or four, and the group setting may have enhanced the effects of the exercise. “Isolation is a hallmark of PTSD, but our vets still wanted to affiliate,” says lead investigator Thomas Neylan, MD, professor of psychiatry at the University of California, San Francisco School of Medicine and director of the PTSD Program at the San Francisco VA Medical Center. “They just loved to see each other, and that in and of itself is remarkable.”
• Add some slow yoga moves and stretching to your aerobic and strength training. Ask your client to coordinate his or her movements and breathing and to focus on the bodily sensations in the muscle groups he or she is working. “This isn’t a coping style of distraction but an exercise in being fully present,” says Mehling.
• Head out into the great, green gym. A British study published early this year found that surfing gave combat veterans significant respite—described as “a fully embodied feeling of release from suffering”—from PTSD. The study authors point to physical activity in a natural setting to further help combat vets with PTSD. And you don’t have to take up surfing to ride this particular wave. Do your workout, if possible, outside to maximize its effect.