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Do You Or Your Clients Have Bad Vagal Tone?


You are late getting home due to traffic. You go bursting through the front door and give a blustery, anger-filled response about why traffic made you late.

You are short with your spouse and lose your patience when your child asks you for help with their homework. 

Maybe something like this has happened to you (I know it's happened to me). 

Could such behaviour be indicative of a bad vagal tone? Can you improve it?

Ginger Garner, physiotherapist and founder of the Living Well Institute lets us know, as she talks about the importance of the vagus nerve, the polyvagal theory, how to find your sacred space, and nervous system hacks for a better life.  

Check out the following video from Dr. Garner on how to stimulate the vagus nerve.


How to Stimulate the Vagus Nerve with Ginger Garner:

If Ginger's video piqued your interest, check out the following great continuing education physiotherapy course: 

Click here to learn more with Ginger Garner


You can also read further below for some terrific content and hacks.


What is the Holy Grail of Being Well and Managing Stress Successfully?

Neuroscientists and researchers agree the vagus nerve has a lot to do with it. The vagus isn’t the only thing that drives your health, but it is a massive driver of it. 

Put it this way, if you don’t attend to vagal tone, then you have to make time for illness.

What is the Vagus Nerve?

Wikipedia Common License: Vagus Nerve
Wikipedia Common License


The Latin root behind the term “vagus,” means wandering. The wandering nerve.

It is true the vagus nerve wanders everywhere. It is the largest nerve in the autonomic (what we used to think of as involuntary) nervous system. Most of it functions in processing and receiving input, sending information from the body to the brain.

In fact, over 80% of the vagus consists of sending information from the body to the brain, which is called afferent activity. The other 20% is efferent, which is sending information from the brain to the body. That afferent input is important because it means the vagus affects everything from the brain and the mouth and vocal cords to the colon, gut, and pelvic floor.

Why is the Vagus Nerve Important?

Stress can wreak havoc on the vagus, and create patterns or ruts in the brain that cause the amygdala, the lower, more animalistic knee-jerk reaction area of the brain, to take over or hijack normal emotional behaviour and response.

Here’s an example:
Keep Calm & Vagus On: Dr. Ginger GarnerFostering mindfulness to avoid perpetual “amygdala highjack” takes awareness and compassion – toward others and yourself.
©2019. Ginger Garner. All rights reserved.

You are late getting home due to traffic. Instead of gathering yourself at the door when you arrive, taking a long exhale, and collecting your thoughts to create calm, something else happens. You go bursting through the front door and give a blustery, anger-filled response about why traffic made you late. You are short with your spouse, and lose your patience when your son or daughter asks you for help with their homework. You’re hungry, you still have work left to do, and you are overloaded.

What’s the Result?

Your family feels alienated and lashed out upon.

Here’s the key ingredient to knowing if you had what Daniel Goleman calls an “amygdala highjack”  - you regret it later. You realize you could’ve chosen a better response. You also realize that you probably owe someone an apology, especially when, whether that person did something right or wrong, you have to take responsibility for your actions and words.

Learn more with Ginger Garner


The Vagus is Listening

Keep Calm & Vagus On

The vagus is listening, and one of the big ways to influence it is through sound and music.

©2019. Ginger Garner. All rights reserved.


When the vagal tone is good, you have:

When the vagal tone is suffering, you:

 Good coping skills in stressful situations.  Can have high levels of inflammation in your body and  bloodstream
 Higher emotional intelligence.  Have higher rates of chronic disease.
 Empathy and understand and can respond to    
others' emotional states.
 Are more prone to heart disease.
 Resilience.  Are more prone to diabetes.
 Better sex.  Are more prone to get certain types of cancer.
 A better voice.  Are more likely to have weight management problems.
 An easier time communicating and connecting with others.  Are more likely to suffer from depression.
 Strong relationships and manage conflict within them  Are at higher risk for a traumatic event to lead to PTSD.
 The stamina to take on the stress and not let it beat you down.  For those with epilepsy, it can be worse.
 Good digestion.   For those with autism, outcomes are worse.
 A stable mood  The worst of poor vagal tone could mean you struggle with relationships, making genuine connections, understand people and other’s suffering and emotions, expressing yourself, communicating, and at worst, you could suffer from episodes of vasovagal syncope (fainting) because your body simply cannot handle the stress.
 Less of a propensity to get chronic diseases or depression.    The most severe result of poor vagal response can be dissociation (which can be lifesaving but is not sustainable) and shut down, or even death.


To Understand Vagus Functioning, Let’s Discuss Polyvagal Theory

There are three simple ways to look at vagal tone and response:

  1. If you have a happy vagus, it means the vagal brake is working and you have appropriate responses to every day and stressful events. That is called a ventral vagus circuit (VVC) response.
  2. If you have a stressful event happen, you may need the sympathetic nervous system (SNS) to kick in so you can fight or flee. This is called the sympathetic response. This isn’t bad, because sometimes you need this response to run or fight. However, we get into trouble if this response is the one the brain picks most of the time. No one can live in a perpetual fight or flight state, and yet the increasing reported stress levels of Americans reveals, as well as the amount of gun violence, sexual assault, and suicide reported, means we have a significant problem with stress management – aka vagal tone – in America.
  3. The last response, the one we may experience in life but that I wouldn’t wish on anyone, is that dissociative state I mentioned. The shutdown state. That is like the person with autism who doesn’t want to be touched and retreats in silence in a nonverbal state, eyes glazed over and inattentive; or the person that faints at the mere mention of blood; or the woman who is a sexual assault survivor or who has been abused or traumatized during childbirth and her eyes glaze over and she begins to dissociate from the present when she goes to get her annual gynecological exam. None of these are good situations and we want to do everything possible to help these good people recover. 

Click for the higher resolution image of the polyvagal chart 


What Happens When You Have a Healthy Stress Response?

Keep Calm and Vagus On: Dr. Ginger Garner
Fostering a healthy stress response.
©2019. Ginger Garner. All rights reserved.
Imagine going into a yoga class, church, mosque or anywhere you consider safe and comforting. You take the class or say the prayer or sit with a book and cup of tea. What happens? You begin to relax. You unwind. You begin to feel better, maybe even look more rested and at ease.

This response is called the relaxation response. This is the response we crave as human beings. As a parent I want my three sons to know how to achieve a relaxation response, especially when they are going through a stressful time. I share in this post how I overcame trauma and sexual assault, and certainly, I want to be able to access that relaxation response on demand. To be in control of my body and its response to stress.

But that doesn’t happen with a lot of people. Sometimes you go to that yoga class, you attend church, you go out with friends or stay home in front of a cozy fire with a book and some hot tea, and you don’t relax. You can’t. Then what?

That’s when the relaxation response switch just won’t flip. Ever been there?

Keep Calm and Vagus On: Dr. Ginger Garner
My son in ICU after his heart surgery in 2008. 
©2019. Ginger Garner. All rights reserved.

Coping with loss and trauma can be exponentially worse as a parent because the suffering your child is experiencing isn’t yours. You can’t take it away or stop it. It’s devastating. I would have gladly taken all his suffering on as my own if I could have.

I have when my oldest son, at 2 years old, had to have emergency heart surgery and there was a risk of him not surviving or having permanent brain damage. I couldn’t relax or sit the whole time he was in surgery – all 5 hours. I did not sit. I paced. I prayed, I meditated. I stayed present and mindful. I breathed deeply. I knew that as long as my child, who was nonverbal and hurting, could not rest, then neither would I. And so I paced. I knew I was deliberately not allowing the relaxation response to kick in. But at least I knew it and managed it.

For some, they don’t know they are stressed. In fact, living in a perpetual state of fleeing from or fighting their inner tiger maybe their status quo.

That is where these little tips I’m going to give you may just help. These tips are not a cure-all or psychotherapy or a substitute for medical care. These are tips that will help you, whether you are the person with stress and trauma or whether you are a teacher or therapist or loved one of a person suffering from stress and trauma.

The point is, if your relaxation response doesn’t kick in, your stress response will be poor. And if your stress response is poor, you could probably benefit from some trauma-sensitive help.

If you are a yoga teacher, healthcare professional or another therapist, you don’t have to be an expert at trauma management to teach trauma-informed yoga. But you do need to be sensitive and careful because not all yoga is therapy and not all yoga is trauma-informed.

Nervous System Hacks – Keep Calm & Vagus (Brake) On

Here are a few simple nervous system hacks you can use to be trauma-sensitive, to manage stress, and to most importantly, improve vagal tone.

  • Develop a safe space. This is a safe environment. It could be a room in your home, a yoga class or a certain teacher, or a church or class there. The point is to find your Sacred Space, a place where you feel safe and supported. The easiest way to imagine what this may look like is to practice this short exercise.

How to Find Your Sacred Space: A Short Exercise

Vagal Tone and Nervous System Balance: Finding Your Sacred Space
  • Consider using higher hertz (Hz) frequency pitches and sound. Listen to violin music, for example, which has 5000 Hz frequency. Or imagine the sound of a mother’s lullaby, which is more soothing and is more likely to nurture a relaxation response than lower frequencies of a male voice.

  • Cut out background noise. Your middle ear needs to be in tune with and toned in order to filter out the low tones which signal a predator “run from the tiger” response. Read more by checking out Dr. Stephen Porges’s “Polyvagal Theory Pocket Guide. When it isn’t toned, extra background noise doesn’t get filtered, and the person experiencing stress and trauma will not be able to hear or pay attention to what you are saying.

  • Be careful to turn down the lights and filter light sources. The hypervigilant individual will be light sensitive and need to have dimmers or filtered light at work and home. Even bright sunlight can be too much. Wearing high-quality sunglasses and putting on blue-light blocking glasses after sundown can improve sleep and the stress response.

  • Exhale through fear. Breathwork is really helpful in changing the stress response and “hacking” the nervous system. But several studies also stress the importance of controlling the breath by elongating the exhale, especially when you are stressed. One study showed that people perceive a fearful face more rapidly if they were inhaling through the nose. The pelvic floor is also more likely to be tightened and dysfunctional if fear is perceived and breathing is dysfunctional.

  • Finally, movement helps. It is anti-inflammatory, nourishing to the fascia, calming to the nerves and stamina-building for the musculoskeletal system. Specifically, sacral stimulation and rocking motions that are in a head to toe direction. This could mean “rolling like a ball,” the Pilates-like motion, or rolling out of boat pose to the floor and back up again.

Ginger Has Created an Online Continuing Education Physiotherapy Course in Collaboration with Embodia so that You Can Deepen Your Knowledge of the Vagus Nerve and: 

  • Describe an evolved definition of core strength & pelvic floor health.
  • List the biopsychosocial & neurophysiological implications for optimizing pelvic floor health.
  • Identify key breath work, postures, and mindfulness techniques that support vocal, diaphragmatic, and pelvic health.
  • Interpret how vagal tone impacts self-regulatory mechanisms in order to understand interventions that improve tone.
  • Differentiate between the motor systems that influence vagal tone.


Continue Learning with Ginger Garner


Dr. Ginger Garner PT, DPT, ATC, LAT, PYT

Dr. Garner is a physical therapist, published author, and educator. She received her master's and doctorate degrees from The University of North Carolina at Chapel Hill in 1998 and 2016, respectively. Prior to that Ginger was a practicing licensed athletic trainer. She has spent 20 years in education at the post-professional and graduate-level teaching a “whole person” biopsychosocial approach in interdisciplinary rehabilitation through the lens of Lifestyle Medicine, which includes the use of Yoga, Pilates, Mindfulness, Music, & Meditation as health promotion and intervention.

Dr. Garner is active in the American Physical Therapy Association and serves as the APTA – North Carolina Chapter Legislative Chair. She also serves on the US National Committee for UN Women as a member of the Board of Directors and as Secretary. Dr. Garner is also a former NC legislative candidate. Her dedication to public service & policy creation fuels her outspoken advocacy for social and healthcare justice and equity. Ginger believes equality is at the heart of resolving issues related to population and public health.

Dr. Garner’s has specialized in treating chronic pain & orthopedic issues in women’s health using an integrative approach since 1995. She founded one of the first integrative yoga-based physical therapy practices in the US in 1999. She is the founder of Professional Yoga Therapy Institute® and author of Medical Therapeutic Yoga, slated for translated in 4 foreign languages. Ginger teaches internationally and domestically; and is also an adjunct assistant professor at Elon University.

In her spare time, Ginger performs with choral groups around the world, including performances at Carnegie Hall, Lincoln Center, and in Europe, and also conducts vocal performance workshops. Ginger lives with her husband, three sons, and their rescue pup, Scout, in her home state of North Carolina. Visit Ginger at


Blog editor: Nataliya Zlotnikov

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