How Exercise Improves the Quality of Life for People with Post-Traumatic Stress Disorders (PTSD)

Last Updated July 31, 2026

In 2015, a study by Rosenbaum et al. concluded that combining a structured exercise program of resistance training and walking with usual care will improve symptoms for people with post-traumatic stress disorder beyond usual care on its own. Also, "exercise improves symptoms of depression and cardiometabolic risk in people with PTSD."

Recent research shows that a combination of regular resistance training and walking can enhance the usual treatments for post-traumatic stress disorder (PTSD).  PTSD affects about 1 in 10 Canadians in their lifetime.

In the news, it is most often associated with those serving in the military or first responders (police, firefighters and paramedics).  However, anyone can experience PTSD.

On January 1st,  2016, new legislation in Manitoba finally recognizes PTSD as a work-related condition. This legislation gives workers of all occupations access to better care under the Workers' Compensation Board, even if PTSD doesn't manifest from a single event. 

Injuries leave their psychological imprints (residual memories) even once the physical trauma has healed.   A dysfunctional emotional and physical healing process can lead to PTSD and depression if those injured are not resilient enough. Injured clients who seek physical rehabilitation also need to address the emotional memory for long-term success.

We have seen clients with whiplash from a car accident who have constant neck tension.  Clients in motor vehicle collisions can end up suffering from PTSD.  Another example is someone who has fallen, fractured a hip and is scared of getting on a bicycle because they fear falling and re-fracturing. Sometimes chronic pain and lack of ability to function well lead to depression. 

What is Post-Traumatic Stress?

In their recent update to the Diagnostic and Statistical Manual of Mood Disorders (DSM-IV), the American Psychiatric Association reclassified post-traumatic stress from an anxiety disorder to a Trauma and Stressor-Related Disorder.

Regardless of the cause, it results in a great deal of suffering and significantly impacts an individual's ability to function socially; it reduces their work capacity as well as their ability to complete daily activities.  PTSD is often also associated with depression, and when not treated properly, can lead to suicide. 

How Does Our Body Respond Physically to Stress?

The somatic nervous system is responsible for sending external stimuli from our environment to our central nervous system so we can respond appropriately.  When there is danger, there is a natural "flight or fight" response which is called upon. We become vigilant during this situation by automatically changing our breathing rate, heart rate and neuromuscular tension so that we can respond appropriately - freezing or running.  In someone who is resilient, these are transient and reverse once the danger has passed. 

One symptom of PTSD is arousal or hypervigilance, where the defence mechanism is activated with non-dangerous events such as a car backfiring, smells or other environmental cues, which in someone with a healthy response are non-events.  With PTSD patients, the somatic nervous system is on overdrive.  

In the clinic, we have seen this constant turned-on mode lead to chronic pain, fatigue, dizziness, stiffness, lack of appetite,  weakness and difficulty sleeping.   Sleep is very important for healing.

How is Post-Traumatic Stress Usually Treated?

The usual care for post-traumatic stress disorder is a combination of medicine and counselling, psychiatry or visits with a psychologist.  There are several types of counselling, including cognitive behaviour therapy, eye movement and desensitization (EMDR) and reprogramming and exposure therapy (WebMD). There is also Somatic Experiencing.

Dr. Peter A Levine,  the developer of Somatic Experiencing  believes that exposure therapy does more harm than good.  His book "Trauma and Memory: Brain and Body in Search for the Living Past" is an excellent read that explains how our brain and body respond to trauma and how we can recover from it.

What  Does the Research vs Clinical Experience Say About Improving Your Quality of Life with Exercise If You Have PTSD?

There wasn't a lot of research available about the effects of exercise on PTSD symptoms when this article was first written in 2016. The author will be taking another look at this.

What Changes Have Physical Active and Exercise Had on PTSD Symptoms in the Clinic?

We have had success by closely observing how our clients' bodies respond during and after each session, as well as how quickly they recover and progress from each exercise intervention.  Clinically, it is important to communicate verbally while paying attention to non-verbal cues such as increased breathing rates, heart rates, changes in blood pressure and dizziness.

What we've found to work clinically is to base the exercise program on the client's daily capacities. Some days they might have more energy, while on other days they will have less.

 Fatigue accumulates during the session and week. Physical and social activities can be very taxing for someone who also may be deconditioned due to previous physical injuries and/or lack of physical activity.

What Does Research in 2016 Say About Exercise and PTSD?

In the May 2015 issue of Acta Psychiatrica Scandinavica, researchers compared usual care for post-traumatic stress disorder with a 12-week exercise program and usual care. They studied 81 primarily men (84%) with a mean age of 47.8 years and a diagnosis of DSM-IV-TR PTSD.  While they were focused on symptoms of PTSD, they also assessed secondary outcomes that "included symptoms of depression, anthropometry (body fat and measurements), physical activity, mobility, strength, and sleep quality" (Rosenbaum S, Sherrington C, Tiedmann A, 2015).

Usual treatment included pharmaceuticals, group therapy and psychotherapy. The exercise group was given a 30-minute resistance training program three days per week based on the American Council on Sports Medicine's guidelines: 3 sets of 10 repetitions for 6 exercises. Intensity was increased by 10% when they were able to complete the exercise with 1-2 reps above desired.

 They were also given a pedometer with a goal of achieving 10,000 steps per day.  Their programs were adjusted for each individual to account for severity of PTSD and to gain more adherence.

What they found was that there was a moderate difference between the exercise group and the usual care group post-intervention for the PTSD checklist. There were no differences in grip strength and cardiorespiratory fitness. Improvements in other secondary outcomes such as reduction in PTSD sleep disturbances, body measurements and symptoms of depression and anxiety were also significant for the exercise group compared to those with only usual care.

This study is believed to be the first to directly investigate exercise and PTSD. Many studies positively associate physical activity with reduced mood disorder symptoms.  

Rosenbaum et al.'s conclusion is that combining a structured exercise program of resistance training and walking with usual care will improve symptoms for people with post-traumatic stress disorder beyond usual care on its own. Also, "exercise improves symptoms of depression and cardiometabolic risk in people with PTSD."

References

Rosenbaum S, Sherrington C, Tiedemann A. Exercise Augmentation Compared to Usual Care for Post-Traumatic Stress Disorder: A Randomized Controlled Trial. Acta Psychiatr Scand 2015: 131: 350–359