Trauma lives through the body.
It can show up as tension, fatigue, flares of chronic pain, bracing patterns, or an inability to feel safe in stillness or movement. It shapes the way someone responds to stress, engages with their environment, and even perceives their own body. And while trauma is often addressed through counselling or psychological therapies, movement plays an equally important role.
This is where exercise physiology becomes a critical, and often missing, piece of the puzzle.
Exercise is not just about fitness or strength. It’s a regulator of the nervous system, a builder of capacity, and a reconnection tool for people who feel disconnected from their body. For individuals affected by trauma, particularly in the context of women’s health, movement, when done safely and intentionally, becomes a way to rebuild agency, stability, and trust in the body.
But here’s the catch: if we don’t understand how trauma manifests physiologically, even well-meaning exercise can backfire.
A client with a history of trauma may present as inconsistent, disengaged, avoidant, hypervigilant, or emotionally reactive during sessions. They may experience overwhelming fatigue or flare-ups after doing what seems like “appropriate” exercise. Without the right lens, this can be frustrating for both the client and the clinician.
That’s why we need more than trauma awareness. We need trauma competence.
I recently sat down with Stuart McDonald, an experienced EP, educator, and trauma specialist, to discuss and unpack how trauma intersects with women’s health, and what our true scope of practice looks like when working with trauma-affected clients.
Trauma Is More Common Than You Think
Trauma can look like birth trauma, medical gaslighting, emotional neglect, or more subtle cumulative stress that builds up in the body over time. In women’s health, these patterns show up often; in pelvic dysfunction, chronic pain, fatigue, and even resistance to exercise or movement.
Yet, as EPs, many of us were never trained to see this complexity, let alone respond to it with confidence.
Trauma-Informed Isn’t Always Enough
There’s growing awareness around being “trauma-informed,” but as Stuart explained, that’s often where the learning ends. What’s missing is how to apply the principles of trauma care through movement, within our scope, and without taking over the role and responsibilities of psychologists or counsellors. That’s exactly the gap we’re trying to close.
“As EPs, we already understand physiology, the nervous system, behaviour change, we’re not therapists, but we’re uniquely placed to support trauma recovery from the body outward.”
– Stuart McDonald
Redefining Scope
So what is our role? As Stuart put it, we’re not replacing therapy, we’re making it work better.
Trauma affects the nervous system. It shows up as hypervigilance, dissociation, avoidance, and emotional dysregulation, often long before a client has words for what’s going on. When we help clients move safely, regain agency in their body, and modify the physiological state they’re stuck in, we create a foundation for healing.
And the best part? That’s completely within our scope as exercise physiologists.
We don’t need to process the story.
We don’t need to do therapy.
But we do need to know how to listen to the body, understand what it’s saying, and respond with skill and clarity.
A Practical Approach to a Complex Problem
Inside our Working with Trauma & Women’s Health Program, we teach clinicians how to work with these layers without stepping outside their role. The course covers:
- Defining Trauma and Scope of Practice
- Valence, Salience, Longings & Strivings: Tools to help you understand what’s important to your client
- Hypervigilance, Avoidance & Dissociation: How to spot them, and what to do
- Agency, Power of Action & Exercise Physiology: Rebuilding capacity and control through movement
This is a deep dive into trauma-informed application, not just awareness. It’s designed to empower you as a clinician and give your clients access to support they didn’t know they needed.
The Takeaway
You don’t need to be a psychologist to help someone work through trauma.
You need knowledge. You need boundaries.
And you need tools that translate into your day-to-day clinical practice.
This is what the future of women’s health looks like.
And EPs have a powerful part to play.
Want to Learn More?
The Working with Trauma & Women’s Health Program is the perfect place.
Click here to learn more and join us