In Your Pants with Dr. Susie G - HRV for stress and recovery with pain

Episode Date: January 12, 2021

HRV is one marker that makes the intangible sensation of stress and recovery tangible through data. All systems are interconnected, and the balance of stress and recovery in the body is always at play. Learn to recognize what the body views as a stressor and how to bring the body back into balance to manage pain, recover efficiently from stressful events, and feel your best. Get started with a 6-week DIY Pelvic Pain Relief Program and learn the skills and guidance to do something about pelvic pain: https://drsusieg.com/pelvic-pain-in-men-online-program

you're listening to in your pants with dr suzy g the physiotherapist for your private helping you get in the know down below welcome everyone this is dr suzy g in the in your pants podcast and you can see i'm actually in a formal studio studio recorder here with jason moore who is the founder of Elite HRV. He's also a data geek, right? And a systems guy. And really they have, this is pretty amazing, 400,000 people who are signed up

in gathering data for HRV. I mean, that's pretty amazing. So tell us more about what you do, your company and all that fun stuff. Yeah, for sure. Thanks, Susie. Thanks for having me on the show. You know, I'm happy to hang out with you and also just geek out on all the fun things that

we like to talk about. You mentioned that I'm a data geek, and that is definitely true. Although usually I like data that's very practical and not just data for the sake of data. And so that's kind of the spin I like to take on my data geekiness. but with HRV heart rate variability as as one does I've become a nerd about heart rate variability specifically and my background is in designing data analysis systems that help people make better decisions using different types of data inputs and generating insights and charts and automated kind of algorithms and things like that and then but I have a deep passion for health for

fitness, for well-being, for cognition, for all of the things related to the human condition, basically. And so over the years, I've been really digging into that research personally and networking with smart people like yourself in the field. And so that has kind of helped me develop this toolkit that we call Elite HRV right now that helps people track important data about themselves and make better decisions for their health and their well-being in their life and like you said we've over the years uh accumulated a good uh community of about 400,000 people who signed up for that that's pretty amazing so that all that is fabulous and thank you so much for doing the work that you do because it is really important to have people feel you know on top of

their health especially these days when stress is pretty rampant so what it let's before we let's backtrack a little bit here. What is HRV for those who are listening who have no idea what that even stands for and what does that mean and how is that attributable to our health as one marker? Yeah, definitely. And that's a great little last two words that you use there is that HRV is one marker, but it's one that tells us quite a bit. And that's kind of what attracted me to it is it has a lot of practical application across a broad and deep spectrum. And so heart rate variability, what we're talking about here in the basics is tiny variations that happen in between each heartbeat. And what I mean by that is when your heart beats, let's say 60 beats per

minute, it's not beating just once every second like a metronome, right? In fact, it's having these tiny changes in when it beats based on inputs that your body is giving your heart through the nervous system and other systems. So it could be like 1.01 seconds between this beat and the next or 0.987 seconds between this beat and the next. And every beat is different than the one before it. And that's the variability that we're looking at. And you can get super deep and nerdy on all the statistics that go into calculating that variability and what those different statistics mean, and you can do root mean squares, or you can do Fourier transforms and, you know, translate the data into all different things. But ultimately, why we're interested in that is

because, especially because of the nervous system's influence on that beat-to-beat variation that we're looking at. Right, yeah, because the nervous system basically is like an electrical system that controls your heartbeat too you know there are certain nodes and electrical inputs that make that all happen the nervous system is a big deal and anyone that's listening to my show knows that i'm a big science uh neuroscience geek and i do all bring it back to the nervous system but it's not just the nervous system let's talk about the immune system and what from your data and all your research on the work that you do with hrv what can you tell us about the immune system and hrv or inflammation in hrv are there is there a correlation yeah yeah it's um so in general um

you know i i mentioned that the nervous system influences your hrv um and other systems are all of the systems in the body are interconnected and that's probably not a surprise i definitely not a surprise to you but probably not a surprise to anyone listening either um but the same things in the body that cause you to have like a stress response to exercise, for example, also activate during other activities, like if you have an immune response or you're digesting food or you're managing some sort of inflammatory response to something, right? And so you have this balance in the body of stress and recovery that are, that's kind of always at play. And HRV, certain patterns in HRV let us detect the balance of that stress and recovery in the body. And that stress

and recovery can come from things like the immune system or inflammatory systems that respond not only to inflammation itself, but help clear that inflammation and help repair damage and things like that. So when we're talking about the immune system, a lot of times what people see is that that typically is on the repair side of the body, right? So if you can think of the nervous system again into two categories, one being like the two main categories, the sympathetic side of the nervous system, which is that fight or flight type system, and the parasympathetic side of the nervous system, which is that rest and digest and repair side. And those two systems are the two that kind of have the primary interplay between stress response and recovery from stress. And

the immune system, in order for it to function well, you need to have a strong parasympathetic kind of rest and digest activity in order for your immune system to really function well. And a lot of times we end up in this kind of chronic state of stress or fight or flight, whether it's from psychological stress, which maybe we should take a step back and like just define stress a little bit more broadly, but, um, or it could be a stress from exercise or stress from digestion, uh, or trying to digest foods that don't agree with you or from structural stress or, uh, which, you know, that's totally your, uh, ball game. You could teach us all about that type of stress. And, um, but then when we're in that state of kind of overdrive all the time in our modern world,

with all these things pulling on us and not a lot of downtime to recover from it and not a, not a lot of natural activities that help our body naturally deal with stress, like natural movement and movement patterns and having time to just lay down in the middle of the day, for example, do nothing. Yeah. We don't get a lot of chance to do that. So our immune system is often suppressed because of all this other activity. And I know we're going really deep, really fast here. And I don't want to like oversimplify it because there's a lot of caveats and gray to the spectrum it's pretty complex and we're really breaking it down basically to simplify it but it's not so simple yeah i think that's what you're saying yes yeah yeah we're trying to make it simple

but it's not so black and white and there's so many variabilities that we need to consider for any human person because we're all very different and how we respond to certain stressors are going to be very different thanks jason sure so um one of the things though that i want to highlight though, is that what does this mean for HRV? Why are we even, you know, we've gone pretty deep here and we zoom out again for a second, is that when you suppress the immune system for an extended period of time, one type of story or analogy that people can relate to is, let's say you've been working really hard and you've scheduled a vacation at work, right? So before vacation, you're a little bit more stressed because you have to take care of all this stuff

before you go on vacation and then when you go on vacation you get sick and you're like what the heck this this is terrible yeah it happens to a lot of people and basically you know uh there is some evidence that leads us to believe that when you have that elevated kind of stress response for that period of time leading up to vacation it's suppressing your immune system and the things that, uh, potentially were making you sick, weren't getting, uh, taken care of efficiently and they started building up. And then finally, when you were able to relax, your immune system was able to come full force and be sick, which being sick is a necessary repair process. So you don't want to like skip the, uh, being sick part, uh, because that you need that to repair.

exactly well exactly gotta let your body do its thing and and it's interesting that you bring that up because even those that exercise a lot i don't know in your work and what you've seen but and maybe you guys listening that when you really push yourself hard physically or you're really like over exercising yes that is a thing uh and then not allowing that repair process to happen and there's an overall overall burden or allostatic load on the body that happens that after you exercise, push yourself or having a marathon or something like that, um, it's not uncommon for athletes to say like, I just, I, I got, I get really sick. Yeah. That's a great, that's a great example too. And, um, and then I'll expand upon that

and then we'll bring it all back to HRV. Right. And then, uh, so an interesting phenomenon that happens with exercisers, people who like to exercise a lot, um, especially people who get into endurance sports, where there's like a high volume of exercise, basically, there are a lot of hours per week that you're exercising, is that, so exercise is a very natural stressor, and the body's designed really well to handle exercise, but there is definitely a point where, especially repetitive exercise can be, can sort of overwhelm your body's ability to recover from that in the short, medium or long term, depending on how long you do it. But the interesting thing is, is that that in combination with all the other demands of modern life often doesn't leave enough time

for proper recovery. But when you're really depleted, one of the things that actually makes you feel good is elevating your cortisol and and also elevating like like, um, adrenaline and, uh, you know, epinephrine and, uh, your, all the other things that kind of turn on your body for performance that actually makes you feel good in the moment when you're doing that. It has, uh, like a dopamine effect and, and, and such. And so people actually start to, can start to get to the point where they only feel good when they're stressed and the best way for them to activate that is to exercise more. And so they get into this loop where they're depleted, but the only time they feel good is when they exercise. And so they start exercising

more because it actually is the only time they're able to feel really good because the rest of the time they're just fatigued, low energy, kind of like burned out essentially. And it can become a vicious loop that I've actually seen firsthand individuals go through. And we've heard lots of anecdotes through our network about this. But I just bring that up because like you said, those people often will push themselves to the point of collapse. And then when they collapse, they end up collapsing pretty hard. Or after the competition, when they're finally kind of in a psychological point of saying like, oh, now is off season. I'm going to take a break. They get sick. And then they're like, well, now I'm never going to take an off season because I always get

sick in the off season. Right. But bringing this all back around to HRV, how does HRV relate to all this? Well, HRV gives us a check engine light essentially for the body. And so since HRV is integrated so deeply with the nervous system and or it gives us a view deeply into the nervous system and the respiratory system the cardiovascular system all these systems it kind of gives you an idea of when you're pushing things too hard when you've had adequate recovery or not and it gives you a barometer or a check engine light or a speedometer depending on how you want to think about it, tachometer, right? Or a compass, you know, we can come up with all sorts of instruments that you could compare it to. Pick your favorite. Pick your favorite. A sextant. That is a navigation

instrument. Oh, that's a new one. My brain went somewhere else, but I'm sure everyone knows about that. Be careful on your spelling. Right, right. You know what I'm talking about. And so, but But it's so having this tool available that you can measure basically like what I like to call your body's reserves on a day to day basis allows you to make these calculated risks or take these calculated risks where you're like, OK, today my body is in pretty good condition. So I'm going to do all my work demands and then I'm also going to exercise hard after work. right? Or today I'm fairly depleted. So maybe I need to bring extra bottles of water with me to work so that I stay hydrated and avoid the donuts at the break room. And also instead of doing a beat down workout after work, maybe I'll go for a walk or do a lighter load exercise, right? I'm a really big fan of movement and exercise. So I often don't tell people to completely take off

from exercise. Yeah, me too. Because I think the routine of movement is more important than getting the exact movement right. Exactly. And, um, and so, uh, but I do recommend kind of trying to feel out and throttle the intensity or volume up and down. Um, and one of the other things that I think of HRV as is a self-awareness tool. And so you don't, it's ideal. Ideally, you don't have to rely upon any tools or anything you just naturally make all the right decisions but when we have all these demands on us from all different directions it becomes very difficult to make the right decision for everything all the time the good news is you don't have to make the right decision for everything all the time if you just pick out a few of the big movers and sort of

make those a little bit better then people can experience pretty big significant changes right Right. Well, and it sounds to me like this tool can, especially if someone has a lack of body awareness or they're just not aware of like trusting their body in essence, I think if I can say that. And if you have something that actually will give you some feedback that says, hey, this is what the data is showing. And does that correlate to how you're feeling? And you mentioned the phenomenon, which that might not may or may not be, I guess, equal, you know, because someone might feel good. but yet you know internally things might not be like you're feeling so this this whole concept of perception and yeah and and what's important to you and and is it important for you and you're making a choice but i think at that point as you're saying you're you have you have you have

a choice because you're aware right and without that awareness you can't make any choices um so so segueing into okay how do we interpret this data then because i'm i'm sure you know i'm the same way i'm guilty of this too you get a new gadget or someone tells you something you're like super vigilant about it like what is this saying i can't be doing this oh no i can't be doing this i need to rest i need you know and then we kind of structure our lives around you know data or some numbers that are very variable i'm sure yep um because we're all human and there's only so much that technology can do at this point and all sorts of things so how do you account like what do you say to people when when they're like okay here's the short-term data here's the long-term

data? How do I interpret this data? And should I really hold, you know, rigidly to this? Yeah, so that's a great question. And it's something that, like you said, the technology is evolving over time to where it's able to give more personalized and specific guidance over time. But in general, you know, one of the things that I like to tell people is to think critically about your own situation all the time. Right. Good advice. And so, um, data helps you make decisions, hopefully more accurately, but it shouldn't replace your own judgment. And, um, but that being said, some of the people that are the most incorrect about their own situation are also the most confident about their assessment of their situation. Right. And so some people are very

confident that they know everything about themselves. They know exactly what they need every day and that their condition, they're fully aware of it. Those people are often the most incorrect about their assessment of themselves. And so we've seen that in the data. We've seen that. I've seen that with clients that I used to work hands on with, and I've seen it in myself. And so basically it's really difficult because we're adaptive creatures that change slowly over time, it's really difficult to be aware of your exact condition. And a little bit of data can help you sort of calibrate your own, you know, instrument of choice for your own intellect or whatever, right? Or your own intuition rather of what's going on. But so when we're looking at the

data, basically what we recommend is measure HRV like once a day in the morning when you wake up for about 60 seconds is really all it takes. And you can miss days and that's okay. It's something that we try to say, you know, don't stress yourself out over taking the measurements. I have a nine month old baby and a lot of things going on like we talked about before. I still manage to measure my HRV almost every day. Granted, I am pretty invested in the process, but there are definitely days where I miss and it's occasional but I try not to get hung up about it and in general so that's kind of the routine that I recommend so what does that give you right so you get an HRV value back or you get some statistics or data back well in in our system

and some systems give you like a gauge or some type of visualization that gives you an indicator of how balanced your body is from between stress and recovery. So you kind of get like a morning check engine light or a morning, you know, like we said, a number of instruments. Yeah. Green, yellow, red is another way you can think of it. So we'll show you, okay, compared to yourself in recent history, today, it seems to be a pretty good day as far as your nervous system being in relative balance and strength. And the relativity of that is important because, um, I could try to compare my, by any biomarker, uh, to an Olympic athlete or something and just hate myself every day. Right. And, uh, and that wouldn't really be productive. Right. And so it's nice to

know where you start out on the spectrum. So when people take their first HRV reading on our platform, we show them some population data to say, here's where you kind of stack up what's normal for your age and your gender and your demographic information, right? Then you kind of just have a feel for where you're at on the spectrum. If you're really high on the spectrum, then that's generally a good thing. If you're really low on the spectrum, that's generally not a good thing. It's not a medical diagnosis or anything like that. It's just to sort of bring awareness to what's going on with you, right? And then where the real power is, is once you start measuring day to day, we start showing you a trend for yourself.

And that is where you can really start making practical decisions because if you're trending downward like hrv is getting less or worse is what some people say but it's not really i don't like to say better or worse agreed um because also there's specific scenarios when you want hrv to go down right not just for the sake of it going down but it just means that you're doing the right thing for your goal at that time oh well what scenarios would that be just as an example Yeah. So one example is if you're into fitness or exercise and you go from a period of not exercising at all to exercising, that's a new stress on your body. Sure. And so you could expect HRV to potentially go down a little bit temporarily.

Okay. And if you want to take that even further to like athletes who do this for a living or for competition, if they go from off season to in season or from off season to training camp or something like that, they could expect HRV to maybe go down depending on the type of training as well. Okay. But so if it goes down for, you know, especially for a day or even a week or even a few weeks, that's generally okay as long as you're aware of it and don't keep, you know, adding fuel to that fire. So that is telling you there's new stress in the system. Usually there's something that you're going to need to recover from at some point. It's not an emergency necessarily, but that performance and that extra stress should be expected in that scenario, right? um my hrv personally uh has gone down a lot this year with having a baby and juggling uh growing business and things like that and so i have personally experienced um a significant decline in my hrv but then again it's relative i'm still actually higher than a lot of the population. Um, but for me relatively, I've, uh, experienced less than ideal, uh, trend in my

health this year. Um, but it, but it's something that I would expect given all the things that I'm juggling and my awareness of it. Um, on the one hand, like you said, it could be something that stresses me out in and of itself. But on the other hand, I try to approach it as an opportunity and just to say, okay, I need to start saying no to some of my commitments, right? So that I can make sure that this doesn't go to a dark place that I can't come back from very easily. And I've spent years building up a reserve of my health. So I have that to kind of buffer it a little bit, but that's a unique situation, I think. That's such a great insight though. You know, you took that a piece of information that was basically based off of your own individual data, which I think

is an important message too. Like, yes, there are some population matched averages, but know that you are a unique individual, just like your thumbprint. And there is, you have to have flexibility for variability. Okay. So within your own self and with others, and you decided to use that piece of information for an opportunity to make a decision, to have a choice in, you know, hey, I want to say no to things more often so I can find space and balance in my life. If someone is too, again, I think that some people might be too grappling on to data so much. And, you know, in that case, again, it's a decision that you have to make. Like, is this adding more stress into your life and if it is it might not be useful for you as an individual totally or it's

an opportunity again to help with that mindset and like what can i do with this you know can i see this as an opportunity how can i flip it you know how can i flip the situation and there's something that you can do in the moment with hrv as well and so the neat thing about hrv is like when you're tracking day to day and you start to develop these trends you can do these things like i just did which was like look back at my year and say i had a baby in a growing business and we bought a house recently and all this stuff right so it's pretty clear to me why my trend is that right way it is we've had users submit screenshots of their year and say you can see this is where um i got a new boss at work and my hrv started trending downward to the point where i quit and then it jumped back

up wow and my health was like basically like three six or 180 yeah and i got a new job and my hrv went back up and then and then my new job like the new company uh had layoffs and so that came up and my hrv went back down and like they literally like pinned it to the date and saw the that's so cool i mean and i tell people like without even just looking at data but it'd be interesting to have this like we've all been you know we've all had this experience you're driving on the highway you're probably going a little too fast you see the lights behind you right here's a you know here's a police car what do you do you your heart rate goes a little bit faster you kind of hold your breath a little bit maybe a few cuss words come out and then the and then the guy you

know and then the car goes right past you and then what do you do oh my goodness you know repair recovery like and then and some people though take a long time to have that recovery and they and just noticing right like how long does it take you to go from to all right cool and you can feel physiologically for your own self right like how that resonates in your own body like what's my heart rate doing how's my body feeling what are my thoughts you know and i think having a tool like you know you know elite hrv to kind of show you have feedback so that you can start to put together the oh this is what you know in your example like this is what happened and i can actually physiologically see that this is how my body responded because you know when you talk to

someone about oh your body does these things when you have emotional psychological physical stressors in your life and environmental stressors but it's a bit abstract because you can't see these processes you don't know how they work you can't take them out and manipulate them like you can't take your brain out and see how it works and that'd be cool right wouldn't it be cool and i've dissected lots of brains and bodies and stuff and as one does as one does yes um but and it's quite amazing but they're still not living tissue at that point right and and it's it's taken outside of the whole context of the whole human being and having some sort of tool that kind of at least shows you like hey this isn't stuff that's being made up or tossed your way to make

you think that, you know, oh, it's stress or it's all in my head or whatever. I mean, these are actual physiological responses that occur in your own body in response to input, sensory input, and even information from within your own body as feedback. So now you're getting this like bi-directional constantly influencing one another to maintain a balance. So I just think this is fascinating that this technology is actually available for all of us and super easy. And you're explaining like, Hey, this is how it works. And you can track your own data. And, um, I just think that's really fascinating. I had to just comment on that. Sorry for going on a tangent. No, no, no. That's it is. It's like that same fascination is what drew me to it. And, and

originally I was reading, you know, uh, research that was done in labs with HRV that kind of drew me into interest, being interested in it. And what our goal was to just make the really fascinating research that was going on in these laboratory settings with really expensive equipment that costs tens of thousands of dollars and just putting it into a solution that you can get a heart rate monitor for as little as like $60, $70, and then our app is free. So you can start going with it and measure your data over time. What I didn't realize was going to happen, which has been a great side effect, is that once you make it so easy to measure, the labs were like well wait a second um we're not going to use this expensive equipment anymore because this

accurate tool will allow us to get more data more quickly and cheaply right so they can start doing more longitudinal studies they can start getting larger cohorts of participants across all everywhere around the world basically yeah and i think that is amazing that's pretty amazing yeah it's a crazy journey but it's uh but you know i want to come back to uh something that you highlighted with that police car story right and that whole moment of tension and the subsequent like uh period of like coming down from that uh stress response right and there's that actually relates to the more acute and real-time use of hrv that is something that we i hinted at but haven't touched on yet is that it actually, in that moment, if you were wearing a heart rate

monitor, you would be able to see your stress response in real time. And you could see what it's like when, you know, police car comes up behind you, or you're getting on stage for a presentation, or you're in a meeting that's really stressful, or, you know, whatever it is that kind of stresses you out. We've had reports from users about very interesting and creative things. But But as far as, I mean, exercise, definitely people have measured, but we've had people measure with children when they're in a confrontation with their parents. And there are moments where the child has learned to have a really stoic exterior, but physiologically on the inside, there's a lot of turmoil and you can still pick it up with HRV despite the calm appearance on the outside. That is interesting. And then the thing that people, like you said, have taken this a step further to say, well, OK, I can see the stress response.

That's great. Well, how long does it take me to come down from this? And using your example, actually, is that we've had people who have done experiments with different types of commuting. So they've commuted via bus or this was done in London. So or the subway system, the metro or driving themselves. and they actually found different participants have found different uh outcomes as to which method was the least stressful to them some people like the reliability of showing up to the metro at a specific time not having to deal with traffic and just getting on and zoning out right other people got really stressed out by the hustle and bustle of that metro system and then they preferred

being in the car and putting on a podcast and even though there might have been traffic or things they had to deal with it was an environment there were a bubble of control that they had and the neat thing that they found though is that when they took the method of commuting that gave them more stress it took them four to six hours to come down from it and that the people who found the method of transportation that was more agreeable to them would come down from it you know, within as little as 20 minutes. And, and so that has a pretty profound impact on your day. If you're working for, you know, for the first four to six hours of work, if you're having a residual stress response from your commute, then that's going to add to every interaction that you

have at work, all the decisions that you make in the break room, or whether or not to eat junk food at lunch or healthy food or all of these types of things, right? There's a cascading effect that just happens from your commute. And I don't want to add stress to people's commute. If you're listening to this on your commute right now, hopefully, uh, take a deep breath and laugh because, because the, the neat thing then is, okay, let's say you don't have a choice on how you commute, right? Like I'm from Houston, Texas, and I used to commute at one point, like 30 miles one way about, and, uh, there's really not too many options besides driving in you're driving with 5 million other people on the road.

And so there's not a lot of choices there, but there's some things that you can do. There's interventions that you can do to mitigate that, actually. So one is, you know, try to make the environment as enjoyable as possible. Listen to a podcast, listen to Susie. Favorite music or Jason's podcast,

which we'll talk about, you know, you'll give us all your resources at the end. There you go. Or at a minimum, when you get to work or when you get to where you're going or after any stressful event, you can do some really pretty easy and non-time consuming things like a few breathing exercises to reset the system. And we have seen data and evidence show that you can cancel out that whole residual stress response by just taking a moment to reset after a stressful activity. And you can see it in HRV and you can see it play out throughout the day. And like, for example, for me, drinking tea has a profound impact on my HRV and even tea with caffeine in it, which normally you would think is a stimulant. The ritual of drinking tea and like smelling it and, you know, sipping on warm liquid has a calming effect on me, even if it's caffeinated.

and so i still don't drink caffeine late in the day because you know sleep is important to me and all that stuff but but uh that's something that i know i can do if i have a stressful activity if i can just find like a cup of tea that really can help me or if i can take a moment to do a few breathing exercises which we can talk about um like mechanically and uh sort of what you could do with that. But that can cancel out that residual stress response, especially if you practice it. So the very first time you do it, as with anything, it can be difficult to really experience the full effects. But with a little bit of practice, you can get really good at activating that parasympathetic side of the nervous system to help calm down that fight or

flight response side and then come to a place of better balance before going about the rest of your day. Right. Right. I'm so glad that you brought the stress response, um, lasting, lingering on after the stressful event, whether it's emotional or physical, often both, you can't really separate mind. It's mind with body, body with mind. But they did this in pain, a lot of pain research as well. So, so they did this in animal studies and human studies and they assessed, um, biomarkers inflammatory biomarkers and such like cortisol and interleukins and all that fun stuff and they have found very similar results you know that even after a stressful event has long near passed the effects of that can depending on the intensity of the effect it can last even up to a few days

post but but they're not taking into account that hey we just don't deal with one stress response like it's not just oh one stressor and we're good for like the next week right the problem is is that this is an accumulated effect over time and in like you're saying if they're if you're not doing anything to be aware of how to mitigate that for your own self and your own body like you're saying tea works for you even though caffeine would naturally you would biologically think that that would ramp up the nervous system but for but perfect example of that doesn't happen for everyone because there's much more to that experience than the chemical makeup of what you're drinking it's your your how you're what it means for you to do that and how it makes you feel um

so i think that's important and this is a mindfulness bit or just a noticing what you're noticing yeah kind of thing yeah and being aware and having hrv tested in that way can really bring insight into the, the physiology, but also like how, how am I feeling and does it match up? And then what can I do to kind of tweak that and make my nervous system, my immune system, my overall health better so that I can be a better human, make better decisions, um, have greater patients, et cetera, et cetera. Um, so anyway, I wanted to comment on that cause I thought that was really cool that you brought that up and I'd be interested to do more or to look up. I haven't done the research on pain and hrv or or that but the anticipation or expectation of pain

wearing something like that to assess like when we're doing movements in the office and then you're taking that with you into your everyday life like noticing how your physiology changes when you know you're faced with um making a choice of if i do that oh i feel like it's going to hurt and then you have this precipitating stress response already happening you on a conscious level might not be even aware that you're having this physiologically this physiological stress response but having something show you like this is what's really happening because hey you are faced with a very like i don't know if i can do that if i bend over to pick something up that's terrible it hurts me and then we avoid or to that same extent like sexual activity you know a lot of

the people that i work with um have pain with with intimacy or sexual activity and and it'd be interesting to see like just what their thoughts and beliefs or context or environment around intimacy with or without a partner, how that would reflect in their physiology. I think that would pose for a really awesome research study. Who wants to do it? I'm not the researcher, I'm a clinician, but you know, who wants to do it? Who wants to be my guinea pig? You email us because So I think that would be fascinating to kind of just, just for people's own sake of seeing, like when I, even when I, when I know that there is no imminent or direct harm to me in that moment, like, is this really dangerous in terms of pain?

Even though that's not happening, the perception of a threat or a perceived threat or some sort of trigger for your salient detection system goes off, whatever trigger it is, most likely subconsciously driven. How does that reflect your physiology? yeah and you know we've seen uh interesting correlations that would maybe give us hints about what type of research or how to structure that type of research right um because we've seen that people with higher hrvs which uh actually at some point we should come back to what that means higher hrv but you can we want to talk about that yes quick quick sidebar what does

higher HRV mean? That actually means more variability in your heart rate. So that means that when you're at rest, you actually want more flexibility and more variability in your heart rate, which sounds counterintuitive. But when you kind of break it down like this is when something stressful happens, like if a tiger jumps out, your body's performance systems need to ramp up instantly. They need to deliver the right things to the right place at the right time, including messages throughout the body, energy systems, you know, delivering glucose and delivering, turning all of the adrenaline on and everything. So it takes very tight control of all those systems, including heart rate. It increases heart rate and makes it very consistent because you've

got to perform. Right. Right. And then when the system calms down, when that fire flight response is over, ideally the system can sort of chillax, right? Very scientific term. Of course, I use that all the time. Right. And so basically you can think about it like, okay, now we can sort of respond a little bit more subtly to what's going on with digestion. Oh, we just need to increase a little this beat, decrease a little that beat. What's going on with breathing? As we inhale, our heart rate typically increases very subtly. As we exhale, it decreases a bit. And so So ideally, when you're at rest is when we're measuring HRV most of the time, you want higher variability and lower variability is often an indicator of some type of residual stress or accumulated kind of elevation of that fight or flight response. So I just wanted to kind of sidebar there to say, yeah, sure.

That's why higher HRV is more desirable in general. But again, there's a whole gradient or spectrum to that. if your hrv all of a sudden jumps up you might have an early warning sign that you're getting sick and so we've had that report where people are like oh i got my highest score ever this morning and but your app said i was in the red i don't get it and uh and so you know on the one hand we explain it to them if they talk to us about that and we're doing better at automatically explaining that using our algorithms but oftentimes what happens is they'll be like oh and then at uh at lunchtime i had to go home because i was throwing up at work and so i got

like this little early warning sign that my immune system was like on full uh overdrive and that actually caused hrv to go up because it's a parasympathetic response right interesting and so coming back to if i can remember what before that sidebar what were you we were saying um oh pain you mentioned correlation right so people who have a higher baseline hrv which means like day-to-day you're averaging a little bit higher of an hrv which is good right which is good good variability good variability often have better resilience better uh ability to deal with stress and better ability to recover from stress and also better ability to digest pain as well and so pain is very much a perception experience right and so people may have heard like my dad is one

of these types of people who physical pain doesn't really phase him like I've seen him when I was a kid um working out in the yard and he accidentally screwed a screw into his hand very pleasant yeah and so he put the drill on reverse and just and then unscrewed it sounds like my husband and then just wrapped it up and kind of kept going about his day and so i was like i don't know what just happened there but you're an android where's my dad no and so he has a very high tolerance for physical pain and so um and but you know in general people who have higher hrv have better tolerance for pain and are able to cope with it better and are more resilient to it and and that's just correlations that we've seen there needs to be more research done on that it doesn't necessarily

mean that if you just artificially inflate your hrv that you're all of a sudden going to be right pain free for example right because it's a conscious experience and it's significantly based on context like for your dad it probably was you know who knows but his experiences with pain over his lifetime and how he was raised and what are his beliefs around it and you know then you get into masculinity and etc etc and who's there and who's watching like identity right exactly i just had this i'm gonna confess maybe you saw it i like banged my head i didn't see that did you oh my gosh so i was lifting something here in the office and i literally just whacked my head on one of the one of these things and jason's talking to me and i'm just i put i it hurt and i played it off like

it never even happened pretty cool i played it cool and it was like but it's still you know i had of course a sensory experience and you know maybe i have some red marks here but like i was like no i can't be like that's what that is oh yeah that's exactly what it is and and but it's funny because just the other day or actually just this morning you know my dog goes you know i we go hiking with our dogs and i have a ball that we play with and i had it in my hand and you know whenever you have it in your hand it's like watch out your fingers are going to be gone if you don't throw that thing and basically he just kind of like gently grabbed at it but my initial reaction and it didn't hurt whatsoever my initial reaction was to go ouch oh yeah interesting nothing hurt

though i was around my husband my dogs who i'm very comfortable with and i could totally be a baby around and that's kind of why you know but here it was like boom and i was like yeah okay interesting didn't even rub it didn't touch it didn't want to but yeah i mean that's just in my own experience and i'm sure many of you out there and you yourself maybe i can totally relate to that yeah it's just so fascinating and i would again would want to know what did my hrv like what was the physiological change in both those experiences i i don't know I just think that's so fascinating, but yeah, it is a perception. It's a sensory experience, but it's also a conscious, you know, conscious experience and very much so based on context

of the situation, whether or not what our behaviors will be or actions in relation to, you know, a consequence of whatever happens. So. And I think like those two scenarios are really interesting because, um, and definitely I can relate to, um, and my wife, Alyssa can, can let the world know that um i'm i have a pretty high tolerance for pain um but when i'm at home behind closed doors if i get like a tummy ache then i'll be like in the bedroom like i don't want to do life right like you know yeah like so like but then you know if i have to go on stage with the same tummy ache no one's gonna know 100 yeah and you you're gonna you're gonna do it because you know it's it's context it's all about how is it important for me to do x and if it is

i'm going to be more willing to experience discomfort right and that's actually and so the part that i want to highlight too is that it's it's important to not always mask pain and not always try to put on a facade of toughness right i mean i guess you could argue that but depending on your situation but um in general it's it's healthier we've seen to allow yourself to express your pain and to you know bring it out to the surface and let it be yeah but there are situations in life where you can't so like if i went on stage for a presentation and i just kind of sat in the corner of the stage and like held my tummy and like whimpered then people might not enjoy that presentation and by having built up a, um, not only sort of like a identity that

supports my ability to do that, but also just reserves of general resilience. I can push through it when I need to, to get something done, but I hopefully can not do that or not have to do that all the time. Right. Right. It's about balance. Yeah. Finding moments to be vulnerable is very important yes you're so right you're so right um jason last question because you talked about sleep what what are the studies around like hrv is there any relationship with hrv and poor quality sleep definitely yeah sleep is one of the biggest uh influencers of of daily change in your hrv and so sleep is just one of those things where almost everyone could improve their sleep like and you can see it very quickly when you do little sleep tweaks to try to

improve your sleep you can see it the next morning in your hrv right away usually wow and you can also see it very uh strongly in like a trend over the course of just two or three days and so it has a very strong impact on hrv both quality and quantity of sleep and also timing of when you sleep and so um this kind of relates to circadian rhythm in a way but um there's a lot of strong evidence you know people will say it's really important to sleep between like 10 p.m and 2 a.m uh and obviously more than that but like in that window it's good to be asleep for the maximal recovery and when people sleep from like midnight to 8 a.m for example that's eight hours but it's sort of pushed back out of that optimal window they actually see a benefit from shifting it to

10 p.m to 6 a.m the same eight hours and it's just uh aligning it more with the natural light cycles and of the day that totally makes sense because i am such i sleep that way like if i can help it it's like 9 30 10 o'clock you know it's getting dark i mean we're already in bed yeah for real we're in bed by like 9 9 30 that's awesome and then we'll wake up with the sun like as soon as it starts to the sun starts to daylight starts to peak we're we're up i mean that's it's a natural like my own body naturally does that i love that and like that and then when of course when the seasons will change then obviously that shifts a little bit because when it's too dark then i i don't feel rested enough even though i get the same amount of sleep yeah it's it's it you can

see it in the hrv and but i also want to say like for people who can't control exactly which hours they sleep there's a lot of other things you can do to improve the quality of the sleep you're getting even if you don't change the quantity or the timing of it so like sleeping in a cooler room versus a hot room can increase the quality of your sleep in a darker room instead of a room with light tv on yeah if you have bright electronics in the room then there's pretty solid evidence that supports that that impacts the quality of your sleep and uh and you can see that in your hrv and um and then also uh what was the other one oh um yeah i mean those are some big ones that people eating very late oh yeah that's what i was gonna say exercise alcohol too alcohol

yes so talk about that a little bit because like people say it relaxes me right that's one of the things like it relaxes me but it in essence it makes your bodily systems work harder yeah and so yeah exactly so alcohol is an interesting one in general stimulants and depressants are really interesting because they're not just black and white necessarily like stimulants don't always amp you up like i said caffeinated tea sometimes relaxes me um and alcohol it can calm you down but it doesn't actually help with the restoration of the body and so but that doesn't mean alcohol is necessarily evil all the time um depending on your relationship with it and how you use it or time it. Um, I find alcohol does relax me, but I sleep very poorly if I drink anything at all

in close proximity to bed. Likewise. Yeah. Yeah. And so, um, so that knowing that if I think like at the end of the week, like on a Friday, for example, um, there's a local brewery here that makes uh alcoholic ginger beer which is delicious and 95 organic naturally gluten-free and uh you know all those shameless plug not getting paid for that right yeah if you live in north carolina they're called ginger's revenge um but uh they're they're a great uh company and organization um i don't drink a ton of alcohol but sometimes on the weekend i like to have a ginger's revenge and so knowing that it relaxed me it's like a social decompression you know activity for me to have one of those i try to have it early in the evening and uh so that my body has plenty of time

to process it before bed and that seems to work really well for me it still allows me to relax in fact you get to spend more of the wake time relaxed you know like instead of doing it right before you go to bed right right um when you're going to be unconscious which this is the other thing that people use alcohol for not only just relaxing but actually trying to help with falling asleep and sedatives make you unconscious they don't make you sleep right and there's a difference and sleep is where restoration happens being unconscious just means your eyes are closed and you're not like thinking about stuff consciously right and so it's not restorative to be unconscious otherwise we could have like i'll just tell my spouse to hit me on the back of the head every

night before i go to sleep yeah that's why we keep it two by four in the right and so again not demonizing alcohol or sedatives or stimulants or any of that stuff it's just you can kind of tweak it a little bit to have a healthier relationship with it and get better quality sleep. And incidentally, if you get better quality sleep, you often need to rely upon substances less. And so kind of tying a bow around that subject for now is that making little tweaks to these big movers like sleep and doing little decompression like breathing exercises after a stressful event during the day can really have this like multiplying effect, this compounding effect where your overall stress load is much less and your restoration is much greater and then you

can start um having a ripple effect where you're like okay now i don't need as much coffee now i don't need as much alcohol now i don't um you know i don't make these snappy remarks at my colleagues or my significant other or my loved ones that cause more stressful events to happen right it's a it's a really interesting like freedom if you ask me yeah it is and it's a process though it takes time and uh you know when the walls are falling when the mountains are falling on you in the background if you're just listening the wall almost fell on me but um but it wasn't too stressful it seemed pretty light you bounced back i could totally see it that's right um before we wrap i just want to say that um the breathing exercise that i recommend for people to

do first of all don't start practicing it while you're driving um right because you don't want to like get lightheaded or something right while driving but um anytime you're uh have a moment to just breathe which hopefully people have plenty of moments for breathing of course yeah is to just emphasize that exhale. That's like the easiest way that you can sort of relax and activate the parasympathetic branch of the nervous system, which is that rest and digest and recovery system. Just focus on that exhale, play with how long you can make it or how much air you can totally move with it and just make a little game out of that. And as you get better at it, you can start incorporating different variations on the inhale you can try to do inhale through your nose

exhale through your mouth that type of thing but really um when people say take a deep breath people focus a lot on the inhale and so they're like and then yeah that was a deep breath right i'm so relaxed and uh and so you really it's the exhale that makes you relaxed right so if you think about like slowness not just yeah exactly exactly just like you're saying i didn't even inhale before i did that just there because when i'm recording i have a little bit of a sympathetic you know activity going yeah i've got to bring my a game we all do i know so i'm probably not exhaling completely during this and so i have reserved to just not even inhale extra just i excelled all of that at the end of a paragraph

it's pretty awesome it's pretty awesome so you're you know just come becoming aware of that exhale can be a nice reset yeah you can see it in real time in your hrv so hrv has an has a tool that can help you breathe this way is that a biofeedback tool if you fire up our app you can see different breathing patterns and how they impact your hrv in real time very cool in fact the next version of our app is going to have a bunch of different breathing exercises and so there's some that are for focus there's some that are for stress management there's some that are like kind of recovery triggering, um, and there are different, uh, breathing patterns that you can use and activate. And then once you get good at them, you can kind of integrate them into your life

in any activity, right? Absolutely. Well, that's really awesome. So on that note, where can our listeners and viewers learn more about Elite HRV? Yeah. Elite HRV. You can Google that. Um, or you can go to EliteHRV.com. Um, and we have a bunch of content out there on YouTube and podcasts and on our blog and things so plenty of free content out there our app is free all you need is a heart rate monitor that's accurate enough and accuracy is important so there's some list on our website of compatible devices but yeah basically elite hrv that's awesome and i'll make sure to link that in the podcast show notes jason thank you so much for being on the show today. I was so excited to have this with you. I think this is such an awesome topic and like

such wisdom and like information. Like I'm like, that's awesome. That's how I feel when I talk to you. So it's mutual. And thank you, Susie. Thank you. There's a lot of great information that we can share with each other. But I think the neat thing is, is that the kind of openness of us all learning together in this process is the part that really gets me excited and uh so happy to be here oh thank you jason we can totally see he's very passionate you're very passionate about your work so that's amazing big nerd is what you what you meant to say that's well of course and i'm nerd at heart nerds stick together that's right nerds stick together well all right well again all you viewers and listeners thank you so much for listening to the in your pants podcast

This is Dr. Suzy G, as always, in loving wellness for your pelvis. Until next time, my friends. Bye! Thanks for listening to today's episode. Be sure to head on over to drsuzyg.com where you can get more information, show notes, and related articles on today's topic. Also, if you like what you're hearing, head on over to iTunes, subscribe to the podcast, and leave us a rating and review.

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