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Physical Health Considerations

For most physical conditions, TRE can be practised with appropriate modifications. The key is working intelligently with your body's current capabilities.

Not Medical Advice

The information in this section is for educational purposes. It does not constitute medical advice. If you have health conditions or concerns, consult with qualified healthcare professionals before beginning TRE.

Recent Surgery​

Situation: Particularly abdominal, pelvic, or spinal surgery.

Approach:

  • Wait until fully healed and cleared by your surgeon (typically 6–12 weeks minimum)
  • Start very gently when you do resume
  • Avoid the wall sit exercise initially
  • Work with a certified TRE provider to develop appropriate modifications
  • Listen carefully to your body: any pulling or pain at the surgical site means stop

Pregnancy​

Situation: You are pregnant and want to practise TRE.

TRE during pregnancy requires modifications but can be practised safely:

Modifications needed:

  • Avoid lying flat on your back after the first trimester: use semi-reclined positions with support
  • Reduce intensity of exercises, particularly the wall sit
  • The tremor position can be modified: lie on your side with a pillow between your knees
  • Focus on gentle, shorter sessions
  • Some providers recommend skipping the exercises and just using gentle positions to allow tremoring

Important:

  • Work with a certified TRE provider experienced in prenatal modifications
  • Inform your midwife or obstetrician that you are practising TRE
  • TRE can be beneficial during pregnancy for stress release and preparation for birth
  • Many women find TRE helpful postpartum as well (see Postpartum Considerations)

Postpartum Considerations​

The postpartum period is an excellent time for TRE, but requires modifications initially:

Timing:

  • Wait until cleared for exercise by your healthcare provider (typically 6 weeks, longer if caesarean)
  • Start gently: your body has been through significant transformation
  • Consider working with a TRE provider who understands postpartum bodies

Modifications:

  • Check for diastasis recti (abdominal separation): if present, modify exercises that engage the core
  • Be gentle with pelvic floor: it may be weakened from pregnancy and birth
  • Support your breasts if breastfeeding (sports bra)
  • Honour fatigue: postpartum nervous systems need gentleness
  • Shorter sessions are better initially

Benefits:

  • TRE can be very helpful for processing birth experiences
  • Supports nervous system regulation during the demanding newborn period
  • Helps release tension accumulated during pregnancy
  • Can support recovery from birth trauma if present

Acute Injury​

Situation: You have an acute injury to the back, pelvis, hips, legs, or other area.

Approach:

  • Allow initial healing (typically 2–4 weeks depending on severity)
  • Modify or skip exercises that stress the injured area
  • The tremor position itself may still be accessible even if some exercises are not
  • Use pillows and supports to accommodate the injury
  • Consider chair-based modifications with a provider's guidance
  • Resume full practice gradually as healing progresses

Chronic Pain Conditions​

Situation: You have fibromyalgia, chronic fatigue syndrome, or other chronic pain conditions.

Approach:

  • TRE may be very helpful but requires a gentle approach
  • Start with very short sessions (5 minutes of tremoring maximum)
  • Reduce intensity of all exercises
  • Watch for post-exertional malaise or pain flares
  • You may need to practise less frequently (once per week or less)
  • The nervous system sensitisation common in these conditions means less is more
  • Work with a provider who understands chronic pain and can help pace appropriately

Pacing is crucial:

  • If you feel worse the next day, you did too much
  • Adjust duration and intensity down until you find your sustainable level
  • Gradual tolerance building over months is better than pushing too hard

Joint and Bone Conditions​

Hernias​

Situation: You have an inguinal, abdominal, or other hernia.

Approach:

  • Consult your doctor about whether exercise is safe
  • If cleared, avoid the wall sit or do it very gently at a higher position
  • Avoid bearing down or straining
  • Support the hernia area during practice if needed
  • Work with a certified provider for appropriate modifications
  • If considering hernia surgery, TRE can be resumed 6–8 weeks post-surgery with clearance

Osteoporosis or Bone Fragility​

Situation: You have osteoporosis, osteopenia, or other conditions affecting bone strength.

Approach:

  • TRE can be practised with modifications
  • Reduce the intensity and duration of weight-bearing exercises
  • Avoid sudden or forceful movements
  • Use support (chair, wall) liberally
  • The tremoring itself is generally safe: it's gentle movement
  • Work with a provider to develop a safe, adapted sequence
  • Focus on what your body can do rather than standard exercises

Joint Replacements​

Situation: You have had hip, knee, or other joint replacements.

Approach:

  • Wait for full healing and clearance from your surgeon (typically 3–6 months)
  • Modify exercises to respect any movement restrictions from your prosthesis
  • For hip replacement: check with your surgeon about hip positions in the tremor posture
  • For knee replacement: modify depth of wall sit and other knee-bending exercises
  • The tremoring mechanism itself is generally compatible with joint replacements
  • Work with a provider to ensure safe modifications

Cardiovascular Conditions​

Situation: You have heart disease, hypertension, recent cardiac event, or are on cardiac medications.

Approach:

  • Get clearance from your cardiologist before beginning
  • If recently post-heart attack or cardiac event, wait until cleared (typically 8–12 weeks minimum)
  • Monitor how you feel during the exercises, particularly the wall sit
  • Reduce intensity if you feel strained
  • The tremoring itself is generally low-intensity and safe
  • Hypertension: TRE often helps reduce blood pressure over time, but monitor your response
  • Work with a certified provider initially to ensure safety

Epilepsy or Seizure Disorders​

Situation: You have epilepsy or a seizure disorder.

Approach:

  • Tremoring is not a seizure: it's voluntary muscle movement you can control
  • However, consult your neurologist before beginning
  • If cleared, practise with someone else present initially
  • Ensure you can easily stop tremoring if needed
  • Most people with well-controlled epilepsy can practise TRE safely
  • If TRE triggers seizure activity (very rare), discontinue and inform your neurologist
  • Work with a certified provider who understands your condition
When in Doubt, Work with a Provider

If you have any physical health condition and are unsure whether TRE is appropriate or how to modify it, work with a certified TRE provider. They are trained to adapt the practice for various conditions and can help you develop a safe, effective approach for your unique body. Find providers at traumaprevention.com.