Supporting Injury Rehabilitation with Somatic Therapy

As a somatic therapist and trauma specialist, I see firsthand how the body holds onto injury—not just in the muscles and bones, but deep within the nervous system. Whether you’re someone recovering from a car accident or a high-level athlete facing rehabilitation, physical injury isn’t just a mechanical problem; it’s also a nervous system event. This is where Somatic Experiencing (SE) comes in, offering a powerful lens for understanding and facilitating recovery.

Traditional rehabilitation approaches have long focused on structural repair—healing bones, tendons, and muscles. But there’s a growing recognition in sports medicine and physical therapy that injury recovery must also include the nervous system. Researchers and clinicians are beginning to integrate somatic and trauma-informed approaches into orthopedic and rehabilitative care, especially for patients with chronic pain, recurrent injuries, or movement disorders (Mehling et al., 2011; Van der Maas & De Jong, 2020). Somatic therapies like SE are increasingly being used alongside physical therapy to address the autonomic dysregulation and body-brain disconnects that often follow injury. This integrative model acknowledges that healing isn’t just about restoring physical range of motion—it’s about re-establishing a sense of safety and agency in the body.

Injury as Trauma

Injuries often involve more than torn ligaments or strained muscles. They can dysregulate the autonomic nervous system, locking a person into states of fight, flight, or freeze. This can interfere with healing, increase pain perception, and delay a return to physical function (Levine, 2010).

For athletes, this is particularly complex. Sports culture often celebrates pushing through pain and minimizing emotional responses to injury. But unresolved trauma responses—like hypervigilance, dissociation, or chronic tension—can persist long after the physical injury has healed (Scaer, 2005). These nervous system patterns increase the risk of reinjury and make performance recovery more difficult.

What Somatic Experiencing Looks Like in Practice

In SE sessions with injured clients, I don’t start by going into the pain. I start by helping the nervous system find safety. That might look like tracking sensations of support, like the ground beneath the feet, or locating areas of ease or neutrality in the body. Only then do we gently approach the site of the injury—not to “fix” it, but to listen.

We might notice heat, tingling, or a sudden memory flash of the moment of injury. Rather than diving into these sensations, we titrate—touching them lightly and then backing off—so that the body can metabolize what was overwhelming at the time of the injury (Payne, Levine, & Crane-Godreau, 2015). Often, clients describe a spontaneous softening, a deep breath, or a new mobility emerging without force.

In athletes, I’ve seen SE support not just physical healing but also improved focus, body awareness, and emotional resilience. It becomes a tool not only for injury recovery but for performance enhancement. After all, a regulated nervous system is a responsive one.

Why It Works

SE doesn’t treat injuries in the same way as physical therapy or orthopedic care. It works with those modalities by addressing what’s happening underneath the surface. It allows the body to complete defensive responses that were cut off during the moment of injury—responses like bracing, orienting, or crying out (Van der Kolk, 2014). Once these incomplete actions are discharged, the nervous system often regains a sense of agency and calm.

This can shift a client’s entire relationship with their injury. I’ve had clients say, “For the first time, I can feel my body,” or “I’m not scared to move anymore.” That psychological and somatic shift is life-changing.

A Gentle Power

The beauty of somatic therapies is their gentleness. Especially when working with people who’ve been injured, forced pushing often replicates the original trauma. SE offers a different path—one that honors the body’s wisdom, trusts its timing, and supports deep integration.

All injury treatment plans should include nervous system support, especially for athletes and people whose careers and identities are tied to their physicality. When we treat the injury and the trauma, we get something even better than recovery—we get transformation.

References
    •    Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books.
    •    Mehling, W. E., Hamel, K. A., Acree, M., Byl, N., & Hecht, F. M. (2011). Body awareness: A phenomenological inquiry into the common ground of mind-body therapies. Philosophy, Ethics, and Humanities in Medicine, 6(1), 6. https://doi.org/10.1186/1747-5341-6-6
    •    Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93. https://doi.org/10.3389/fpsyg.2015.00093
    •    Scaer, R. (2005). The Body Bears the Burden: Trauma, Dissociation, and Disease. Routledge.
    •    Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.
    •    Van der Maas, M., & De Jong, J. R. (2020). Trauma-informed physiotherapy: The importance of safety, choice, and collaboration in physical rehabilitation. Journal of Bodywork and Movement Therapies, 24(4), 273–278. https://doi.org/10.1016/j.jbmt.2020.03.008