Stress is a common experience and can influence both physical and mental wellbeing. In physiotherapy, it is recognised as one of several factors that may affect symptoms, function, and recovery.
Stress involves both physical and psychological responses
Stress is not only a psychological experience. It is associated with physiological responses such as increased muscle tension, changes in heart rate, and hormonal activity, including cortisol release. These responses are typically adaptive in the short term, but may have wider effects when stress is ongoing (Hannibal & Bishop; Menger et al.).
Muscle tension and discomfort
Some individuals may notice increased muscle tension during periods of stress, particularly in areas such as the neck, shoulders, and lower back. This may contribute to symptoms such as stiffness or headaches. However, these symptoms are usually multifactorial, and stress is only one possible contributing factor.
Recovery and healing
Persistent stress may influence sleep, inflammation regulation, and tissue healing processes. As a result, some individuals may experience slower recovery following injury or surgery, although recovery varies widely between individuals (Menger et al.; Trevino et al.).
Pain experience
Pain is influenced by a combination of physical, psychological, and social factors. Stress may influence how pain is processed by the nervous system, and in some cases may increase sensitivity to pain. This reflects how the nervous system modulates pain rather than pain being “imagined” (Paananen et al.; Timmers et al.).
Breathing and movement patterns
During periods of stress, breathing may become more rapid or shallow. This can contribute to increased muscle tension, particularly around the chest, neck, and shoulders, and may influence movement efficiency in some individuals.
Impact on activity and performance
Stress may affect concentration, energy levels, and fatigue. For those engaging in sport or regular physical activity, this may influence performance, recovery, and training consistency (YiSong et al.).
The role of the nervous system
Stress involves activation of the autonomic nervous system, often described as a “fight or flight” response. In some individuals, prolonged activation may be associated with increased sensitivity or protective movement behaviours. Physiotherapy may include strategies that support regulation of these responses through education, movement, and breathing approaches.
Sleep and recovery
Sleep plays an important role in physical recovery and overall health. Stress and sleep influence each other, and ongoing stress may contribute to disrupted sleep patterns. In turn, reduced sleep quality may affect recovery, pain perception, and daytime function (Agustini et al.).
Considering stress within rehabilitation
Modern physiotherapy practice uses a biopsychosocial approach, recognising that physical symptoms are influenced by multiple interacting factors, including stress. Where appropriate, management may include education, graded exercise, pacing strategies, and support for relaxation or stress management.
Taking a broader approach to recovery
At RehabLab, physiotherapy assessment and treatment consider a range of factors that may contribute to your condition, including physical, lifestyle, and psychological influences. If you have concerns about how stress may be affecting your recovery, this can be discussed with a physiotherapist as part of your assessment.
References
Hannibal, K.E. & Bishop, M.D.
Menger, M.M. et al.
Paananen, M. et al.
Trevino, C.M. et al.
Timmers, I. et al.
Agustini, N.N.M. et al. (2025)
YiSong, Y. et al.
