The connection between physical activity and mental health

I became a neurologist because I’m fascinated with the human brain, and after 11 years in practice, it still never fails to blow my mind (pun definitely intended).

There are more connections in the brain than there are stars in the universe, making the brain, not space, the real final frontier (sorry, Star Trek fans!).

We neurologists have spent hundreds of years studying the brain and discovering its secrets, and there’s still so much we don’t know. Some experts even suggest that our entire reality is a construction of our brain, which might explain how my wife can remember traffic routes instantly, while I keep looking at the GPS. Maybe she lives in a map and I don’t. One thing we can all agree on, though, is that both the brain and the body play an important role in everything we do and how healthy we feel.

Physical health and mental health are connected

The World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Physical and mental health are related and interdependent.

One can’t exist without the other.

In reality, they affect each other in many ways. If you’re physically healthy, the chances you’ll be mentally healthy are higher, and the reverse is also unfortunately true. Anxiety disorders are five times more common in people suffering from MSK conditions, and depression is three times more common.

But it’s not all bad news. Studies show that 40% of members who reported depression or anxiety at the beginning of a physical therapy treatment report reduced symptoms at the end of it. In order to understand why this is the case, it’s important to understand how pain and depression/anxiety work together in the brain.

How does physical activity improve mental health?

If you’ve ever felt your mind clear after a walk, a jog, or a good stretch, you already know the basics. But the science behind why movement helps your mental health is powerful, and well worth understanding.

When you move, your body releases chemicals like endorphins and endocannabinoids. These chemicals boost your mood and reduce your perception of pain. They also help regulate stress hormones like cortisol. This means that regular physical activity acts like a natural antidepressant and anti-anxiety tool, without the side effects of medication.

Clinical research shows that exercise is about 1.5 times more effective than medication or talk therapy alone for mild-to-moderate depression and anxiety. Movement also improves sleep quality and focus, which are directly linked to emotional well-being.

The brain loves movement

This connection isn’t just about feeling good for a few hours. Regular activity can actually change how your brain functions. Physical activity boosts blood flow to the brain and encourages the growth of new neural pathways. Research shows this helps protect memory, focus, and even reduces the risk of cognitive decline as we age.

For people living with chronic pain, this is a game changer. Movement helps quiet the “broken record” of pain signals in the brain. It teaches your nervous system that motion is safe. It also restores a sense of control, which is often missing when pain, anxiety, or depression take over.

Pain and mental illness: a self-sustaining loop

When you’re in pain, you feel it in your body, but all the action is happening in your brain.

Pain is your brain’s defense mechanism: we evolved it to deal with acute injuries, like breaking a bone. When we feel pain, our brain is telling us to stop what we’re doing so we don’t do more damage. This works really well when you’ve got a broken leg, but not as well when you’re dealing with a chronic condition.

When you suffer from chronic pain, your brain is like a broken record, stuck on the same pain signals, repeating them over and over again.

Because pain happens in the brain, it also means that our perception of pain is influenced by all of the other things that affect the way we think and feel. This impacts our mood, how much we’re sleeping, and even external stimuli. When you stub your toe in the middle of a quiet day, chances are you’ll feel a rush of pain. When you stub your toe on the way to the bathroom in the middle of the night having just been woken by an ambulance, you might feel it less, because all that other stimulation is crowding it out in your brain. This all means that if you’re depressed or anxious, you’ll feel pain more intensely, which in turn can worsen your depression or anxiety.

Pain and injury can trigger mental health issues

When you add loss of function to that pain, things get even more complicated.

When an MSK condition makes it difficult to walk, bend over or lift your arm, all of a sudden, things that you usually do without thinking, like getting into the shower or loading your groceries into the car become debilitatingly painful and sometimes impossible, and this can trigger anxiety and depression, too… and those bad feelings can stop us from wanting to to the things we love, which makes us feel more depressed. If you’ve ever been confined to the couch with an injury, you know exactly what I’m talking about.

Over longer periods of time, this lack of movement will weaken our muscles and tendons, and at the same time decrease our threshold for pain, causing even more pain. These loops can go on for years or even decades, leading to conditions both physical and mental that get progressively worse.

Breaking the mental health cycle with regular physical activity

Thankfully, there’s a way to get out of this loop and improve both your physical and mental health at the same time, no matter how far down the rabbit hole you’ve gone.

The first step is movement. Our bodies didn’t evolve to spend all day on video calls and all night binge-watching: they evolved to be in constant motion. Adding exercise into your day can improve your mood (not to mention your stress levels, energy levels and sex life!). If your movement program is a PT-designed therapeutic exercise program, then your chances of feeling better in body and mind increase even more.

What are the mental benefits of regular physical activity?

The benefits don’t stop at lifting your mood for a few hours. A consistent habit of physical activity actually changes your brain over time. Here are just a few proven mental health benefits:

• Reduces anxiety and depression: Moving your body helps your brain form new pathways and release feel-good neurotransmitters. People who exercise regularly have lower rates of mood disorders
• Improves memory and cognitive function: Physical activity boosts blood flow to the brain and stimulates growth factors that help keep brain cells healthy. Research shows it can even help prevent cognitive decline as you age.
• Builds stress resilience: People who exercise regularly tend to handle stressful events better. Activity acts like “stress inoculation,” strengthening your mind against life’s daily pressures.
• Supports better sleep: Good sleep and mental health go hand-in-hand. Regular activity helps you fall asleep faster and reach deeper, more restorative sleep stages.
• Boosts self-esteem and confidence: Movement helps you feel stronger, especially mobility work, strength training, and PT-designed therapeutic exercises.

What kind of exercise works best to boost mental health?

It doesn’t take a marathon to see results. Any kind of movement can help. The CDC recommends at least 150 minutes of moderate-intensity activity each week, plus muscle-strengthening exercises on two days. But even a daily 10–15 minute walk can lift your mood and cut the risk of depression and anxiety significantly. Small, doable steps really add up.

Try walking, swimming, yoga, or PT-guided therapeutic exercise. The best activity is the one you’ll actually enjoy and stick with. Add a reminder on your phone, invite a friend, or tie it to something you already do.

I sometimes combine movement with my favorite podcast. It works as an encouragement to get up and moving, and I always feel better after even a few minutes out of the office or the house.

Movement and mindset go hand in hand

Breaking the pain loop isn’t only about moving your body. It’s about training your mind, too.

This starts with accepting pain as a normal part of life, and not judging it or yourself, and using tools like cognitive behavioral therapy and mindfulness techniques to smooth over the grooves in that broken record and get your brain back on track.

At Sword, our digital MSK programs address both body and mind. At Sword, we use therapeutic exercise alongside mindfulness and CBT-based tools. This combination helps people accept pain as part of life, instead of letting it define them.

Our PTs are trained to get to the root of our members’ issues and prescribe a tailored exercise plan and give members behavioral coaching along the way to help them think differently about their pain. When members build a habit of regular activity and learn mental strategies to manage stress, the results are clear. Our data shows that 40% of members who reported depression or anxiety at the start of their physical therapy treatment feel better by the end.