Part I broke down what actually happens in your brain and body under pressure. Now for the part you can use. In Part II of the Performing Under Pressure series, Dr. Kelsy Vick walks through the real science behind the things we reach for to perform better under pressure: breathwork and meditation, prayer and rituals, exercise, visualization, and naps. You will learn the 30 second physiological sigh that beat mindfulness in a 2023 Stanford study, why a lucky ritual can genuinely boost your performance through self efficacy, how consistent exercise trains your body to handle stress, the visualization method elite athletes use to rehearse pressure in their heads, and the short nap length NASA research linked to big gains in alertness and performance. Smart, science backed, and fun, with a clear here is what to do with this for every single tool.

Wellness Big Sis: The Pod is expert led, science backed wellness girl chats for women in their 20s and 30s, hosted by Dr. Kelsy Vick, a board certified orthopedic Doctor of Physical Therapy and women's health PT.

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RESOURCES:

Cyclic sighing beat mindfulness meditation for mood and lower arousal, five minutes a day for a month. Supports the physiological sigh segment. Balban, M. Y., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine. https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(22)00474-8 Plain language write up from Stanford: https://med.stanford.edu/news/insights/2023/02/cyclic-sighing-can-help-breathe-away-anxiety.html

Lucky charms and rituals can improve performance through self efficacy, with the honest caveat that replications are mixed. Supports the ritual and superstition segment. Damisch, L., Stoberock, B., and Mussweiler, T. (2010). Keep your fingers crossed! How superstition improves performance. Psychological Science. https://journals.sagepub.com/doi/abs/10.1177/0956797610372631 Replication caveat worth reading before airing: https://replicationindex.com/2016/01/31/too-good-to-be-true-a-reanalysis-of-damisch-stoberock-and-mussweiler-2010-keep-your-fingers-crossed-how-superstition-improves-performance-psychological-science-217-p-1014-1020/

Visualization and mental rehearsal improve performance. Supports the visualization segment. Driskell, J. E., Copper, C., and Moran, A. (1994). Does mental practice enhance performance? Journal of Applied Psychology. 2020 replication and extension: https://www.sciencedirect.com/science/article/abs/pii/S1469029219301530 The PETTLEP model and functional equivalence framing comes from Holmes, P. S., and Collins, D. J. (2001), The PETTLEP approach to motor imagery, Journal of Applied Sport Psychology. Verify the exact PETTLEP citation before airing if you name it on mic.

A short planned nap improved performance and alertness in NASA pilot research. Supports the NASA nap segment. The 26 minute nap improving performance about 34 percent and alertness about 54 percent traces to NASA work led by Mark Rosekind. Rosekind, M. R., et al. (1995). Crew factors in flight operations 9: Effects of planned cockpit rest on crew performance and alertness in long haul operations. NASA Technical Reports. https://ntrs.nasa.gov/citations/19950006379

Welcome to Wellness Fixes the Pod, a

by Maven Media production, where we

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believe you deserve real education

from real experts, delivered

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in a way you can actually use.

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I'm Dr.

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Kelsey Vick, your board-certified

orthopedic doctor of physical therapy, and

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this podcast was built for the girl who

is done feeling overwhelmed and frustrated

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by conflicting health noise and is ready

for something she can actually trust.

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Every week, we have honest, science-backed

conversations about your health,

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your hormones, your brain, your

body, and everything in between.

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No fluff, no fear-mongering,

just the truth.

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Because understanding your

body is the most powerful

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thing you can do for yourself.

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A table full of experts built for

the curious girl who wants the truth.

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So welcome.

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Your seat is waiting for you.

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Last episode, we watched the

whole world hold its breath as

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grown men took penalty kicks

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with millions of people staring at them.

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Today I wanna talk about the

thing that no one puts on the

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highlight reel, the breathing

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The pregame ritual, the little nap The

quiet prayer, the boring looking stuff

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That is actually the reason some

people fall apart under pressure

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And some people kick it into another gear

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So welcome to our part two of

this Performing Under Pressure

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miniseries, where we start to build

your own pressure toolkit Welcome

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back to Wellness Big Sis The Pod.

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I'm your host, Dr.

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Kelsey Vick, a board-certified

orthopedic doctor of physical therapy

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and a pelvic floor physical therapist

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If you caught part one last week,

you already know what happens in your

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brain and body when the stakes go up

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Your amygdala hits the alarm, cortisol

and adrenaline flood your system

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Your heart rate climbs and your

prefrontal cortex, the area of the brain

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in charge of execution and planning

and working memory or muscle memory

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gets a little hijacked

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That is the what part of the equation,

and this week we cover what to do about it

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We're gonna go through the

real science on breathwork

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prayer, rituals and superstitions

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exercise, naps, and all the things

that a lot of people rely on when it

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comes to better preparing theirselves

for these high-stakes moments And I'm

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gonna tell you exactly which ones are

worth your time and how to use them

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The first thing in your

toolkit is the 30-second reset

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And breathwork, meditation, both of

those things can fall under this tool

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Last week we made the metaphor of what's

happening in our brain during a high

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pressure environment as a group chat

amongst friends where the amygdala is

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sending alarm signals and the friend

that usually helps to talk her off the

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ledge left their phone in another room

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So in this situation, our

nervous system is like a group

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chat that won't stop blowing up

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Breathwork is that one friend

that can walk in, read the room

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and tell everyone to calm down

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In five seconds flat.

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And it's not that annoying sort

of friend that says, "Calm down,"

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and you don't listen to them.

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This is one where all the girls

in the group chat actually listen

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As a physical therapist, I use

breathing a lot in my practice,

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especially as a woman's health and

pelvic floor physical therapist.

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Breathwork is one of the tools

that I feel like we should have

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in our existing toolbox, just

like being a functioning human.

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It helps with core work.

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It helps with regulating

our nervous system.

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It helps lengthen certain muscles.

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It acts as like an internal

mobility technique.

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There are so many ways I use

breathwork in my practice.

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So breathwork is a great, I call it

bang for our buck tool when it comes

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to mobility and movement, but it's also

a great bang for our buck tool when

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it comes to performing under pressure

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It is the only part of our stress

response that we can actually

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grab the wheel and take control of

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You can't just will your stress

hormones down or your cortisol down.

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You can't just think about

it and will it to come down.

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But breathing and breathwork,

you can actually choose to do.

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It's in your control

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You can change your breath,

And that breath communicates

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directly with your nervous system

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One of the standout techniques

for performing under pressure

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is called the physiological sigh

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or cyclic sine

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Two short and quick

inhales through the nose

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Followed by one long slow

exhale through the mouth

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The extended exhale is what

actually flips you towards that

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rest, digest, parasympathetic,

calming part of your nervous system.

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And you can combine meditation and

breathwork, but it's truly breathwork

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in that physiological sigh that has

been shown to help calm your physiology,

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especially in a high-stakes environment,

not necessarily the meditation alone.

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It's okay to combine both, but the

research is behind the breathwork

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and actually gripping the steering

wheel on that breathwork, not

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necessarily on the meditation.

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A 2023 study out of Stanford

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had 111 people do five minutes a day of

one of several practices for an entire

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month cyclic sign, so that double inhale

followed by that long exhale through

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the mouth beat mindfulness meditation

for lowering stress, reducing resting,

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breathing rate, and improving mood

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We can think of that long exhale

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that increases activity in our

parasympathetic nervous system

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as that sort of brake pedal,

the reins on our nervous system

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So your heart rate and arousal come

down on purpose instead of by accident

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So next time you feel the

pressure start to spike

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Do one round of the physiological sigh

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Two sniffs in through the nose,

one long exhale through the mouth

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Repeat for about a minute

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And if you want the

mood benefits long term

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Do five minutes a day,

not just in a crisis

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So the second thing a lot of

people have in their toolkit

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is what I call the lucky ball.

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This can be superstitions or certain

rituals that people have to do.

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It can also be prayer

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It's the Taylor Swift

wears the same bracelet

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On tour energy The athlete who

always has to put their left sock

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on first Your friend who will

not go on a first date without

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listening to that specific playlist

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Let's talk about if any of this

is real or it's all in their heads

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I feel like superstitions and

rituals oftentimes get mocked,

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especially the crazy ones.

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The crazier, the better.

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We all love to hear them

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But for performing under pressure,

they can actually help And it's

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not magic, it's actually psychology

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The lucky charm The pregame routine,

the prayer that someone has to say

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What they help do is to give the

person using them a sense of control

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And a little hit of confidence

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right when their brains feel most out of

control Prayer specifically overlaps with

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contemplative and meditative practice

for a lot of people It slows you down,

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focuses your attention and gives you a

moment of steadiness before the storm

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So the confidence boost

for some people is real

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But it's not necessarily a guarantee

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So this is a tool, not necessarily a

crutch that you can rely on for helping

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you perform better under pressure.

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There were a few experiments done in 2010

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that showed people who were told

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They were using a lucky golf ball

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sank noticeably more putts

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Then people told it was just

a regular golf ball 65% versus

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48% in one of the studies

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The mechanism behind it wasn't

luck it was self-efficacy

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Your belief that you can

actually pull this off

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Activating a little bit of that

superstition by calling it a lucky ball

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raised confidence, and that increase

in confidence improved performance

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Rituals seem to work by giving your brain

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a predictable sequence to hold onto

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which can lower anxiety when

everything else feels uncertain

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So consider rituals a confidence primer

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rather than something that is guaranteed

to give you results under pressure

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So if you wanna use this tool, try

building yourself one pre-pressure ritual

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and use the same one every

time, a specific song, a mantra

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A prayer, a quick hand gesture

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It doesn't need to make

sense to anyone else

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What matters is that it's consistent

and makes you feel a little bit

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more in con- and it makes you feel

into that room or high-pressure

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environment with more confidence

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The third tool is exercise or movement

we can think of exercise like the friend

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who's already seen you cry, so nothing

you throw at her will be a surprise

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Regular training is basically allowing

your body to be in this stressed

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environment in a safe way So that

when you experience real pressure,

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it feels a little bit more familiar

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So there's two different

benefits with exercise

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There is the in-the-moment mood lift

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from a single workout

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And there's the long-term

game where exercise

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And exercising consistently changes

how your whole stress system responds.

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I always think of that Legally Blonde

quote "Endorphins make people happy, and

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happy people just don't kill people."

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It's like she's exercising, she's

releasing endorphins, and endorphins

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make people happy, and happy

people just don't kill anyone.

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So I always think of that quote

when something like this pops up

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So zooming into acute exercise or

that one session of exercise and

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the benefits that come with it

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A single exercise session can burn

off some of that jittery energy

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and create mood benefits

for hours afterwards

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However, the bigger prize

is stress inoculation

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Exercise is a controlled dose of

physical stress Your heart rate

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spikes, stress hormones increase

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and then your body recovers

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Do that regularly and your

system gets more efficient

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at turning the stress response both on

and crucially better at turning it off

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This is how you play

the exercise long game

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Yes, you can cram in exercise or

movement to burn off some of that

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jittery energy, but it's really that

investment in the long game that is better

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gonna help you perform under pressure

in a lot of high-stress environments

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When you exercise, your

body runs a smaller scale

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controlled version of the stress

cascade that we talked about in part one

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Over time, regular aerobic exercise

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is associated with a more regulated

cortisol response and better recovery

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back to baseline So that the same stressor

produces a smaller, shorter spike.

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Exercise also supports that

prefrontal cortex the planning

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and decision part of your brain

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that pressure tends to hijack

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Which is part of why people who train

regularly and exercise regularly

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Often stay in control a little bit

better when the stakes start to climb

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You can think of every

workout as a rehearsal

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that teaches your body

pressure is survivable

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So keep a consistent movement

routine, exercise routine

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as your baseline pressure insurance

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Aiming for regular aerobic

sessions throughout the week

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And on a specifically stressful day

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Do not skip movement.

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A brisk 10, 20-minute walk

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before the big moment

can genuinely settle you

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The next tool is what I'm calling the NASA

NAP, and it consists of naps and recovery

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A nap is the underrated it

girl of the pressure world

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Not glamorous, but quietly

running the whole operation

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And if it works for astronauts and

pilots It's good enough for your Monday

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A short nap is one of the

fastest ways to buy back

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The alertness

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and clear thinking that pressure

and poor sleep drain out of you

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The key word here is

short, the power nap per se

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not a two-hour nap that leaves you groggy

and worse off than before Timing matters.

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10 to 20 minutes is that sweet spot

and earlier in the day so that it

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doesn't wreck your night's sleep

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This can help in a variety of ways,

but when you feel sleep-deprived and

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when you haven't gotten very much sleep

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Your prefrontal cortex is

already running on fumes

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So pressure hits harder and judgment slips

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A nap tops the tank back up

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So why the NASA nap?

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There was a famous NASA-

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research on pilots that

was done in the '90s

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that found a planned rest

averaging about twenty six minutes

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improved performance by about 34%

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and alertness by about fifty four percent.

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Short naps clear out some of the adenosine

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the sleepy pressure chemical that

builds up the longer you're awake

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which restores alertness and reaction

time, which is very important for pilots

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Keeping it under about 20 minutes usually

means you wake up before a deep sleep

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So you skip the groggy fog and get

the sharpness without the hangover.

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So if you have a high-pressure event

and the option and capability of doing

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so, Take a 10 to 20-minute nap earlier

in the day to help fill up that tank

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If you don't have time

or a place to lie down

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Even resting with your eyes closed for

a few minutes gives your overworked

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brain a small recovery The last tool

is one that I feel like a lot of

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you guys have probably heard about.

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I used to use it as a gymnast,

but that is visualization

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This shows the manifestation

girlies were onto something

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They just needed a little bit of

a sports scientist in the group

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chat Visualization is not woo-woo.

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Maybe a more appropriate

term is mental rehearsal

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When you vividly imagine doing something,

your brain lights up some of the same

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circuits that are required to do that task

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So you're quietly practicing

without actually moving a muscle

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So the reason it works in these

high-pressure situations is

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that you get to run the model

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and run possibly a scary moment

in easy mode first by the

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time the real thing happens

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your brain has a version of it

that ended well So it feels more

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familiar and less threatening

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The key with mental rehearsal is to

make it very detailed and first person

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Do not watch yourself from the stands.

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Sit inside it

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What do you see, hear,

and feel walking in?

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And then visualize

yourself handling it calmly

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not just the end result of perfection.

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Walk through the process.

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Visualize through the process

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The other thing with mental

rehearsal and visualization is to

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add the imperfections on purpose

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Add the wobble on purpose.

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The pros don't only picture perfection

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They picture something

going a little wrong

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and then themselves recovering So

Pressure Day is not the first time

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they have seen a little hiccup.

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I believe I heard that Michael Phelps used

to visualize a lot of different things

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going wrong whenever he got in the pool.

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He'd visualize his goggles falling off

as one example, and I believe there

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was a very important race, and I can't

remember if he ended up crushing a

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world record during that race, But his

goggles fell off in the pool, and I

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don't think his time was affected too

much, and he might have even gotten

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the world record during that race.

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And I believe a reporter had

asked him "What happened?

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How did you do so well?"

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He was like, "I visualized it.

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I visualize a lot of things going wrong.

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That way, when I'm in the moment,

it doesn't shock me or scare me.

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I just know how to move through it

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So this is called motor imagery

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Imagined action and real action

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share overlapping brain activity

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Reviews of mental practice

consistently found that imagery

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Improves performance

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strongest when you already have some skill

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in the task and when the

imagery is vivid and specific

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It is a staple of Olympic and elite

sport prep for exactly this reason

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But to be completely honest

with you, imagery sharpens and

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refines a skill you already have

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It does not install one that

you haven't built yet So pair

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it with actual preparation.

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this comes back to our episode on

lucky girl syndrome that I'll link

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below for you guys if you missed

it, but it talks about visualization

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and what some call manifestation

with actual action and preparation.

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You have to visualize with action

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So the night before or the hour

before a high-pressure event

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Spend two or three minutes running

your mental movie First person,

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full sensory detail See yourself

walk in, feel steady handle one

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small hiccup and then finish well

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You're giving your brain a dress rehearsal

so the real deal feels like a rerun.

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So there's your pressure toolkit,

and none of it requires you to

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be a completely different person

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Here's what to actually do.

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One, when the pressure spikes, name it

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Reach out to your pressure people to

bring them in with you on the journey.

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We covered both of those two

things last week on our part

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one episode if you missed it

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But the first action in your

toolkit is a physiological sigh

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Two inhales through the nose,

one long exhale through the

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mouth, repeated for one minute

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Two, build one pre-pressure ritual or

prayer that you say consistently before

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every high-pressure circumstance or event

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It helps to prime your confidence

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Number three, keep a steady exercise

habit So your body can treat stress

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like something that has been rehearsed

and something that you have also

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shown your brain and body that

you can recover from Number

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four, protect a short nap.

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10 to 20 minutes, that's it

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And number five, run your

mental movie beforehand.

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First person, super detailed, include

a little hiccup that you successfully

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handle In part one, we talked about what

pressure does to your brain and body, and

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in part two, we learned how to handle it

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I hope you guys enjoyed this

episode, this little series.

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I need to dive into each of

these components a little more.

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I love the research on

visualization, on motor imagery.

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I'd also love to research how it pertains

to skill-based, so like a penalty kick

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versus public speaking, something that's

maybe a little bit less motor planning

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going on and just in a crowd speaking.

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So I might have to dive into

that for another episode.

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If you enjoyed this episode and

got something from it, send it to

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a friend, share it with a friend.

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As women, we definitely move

more towards that connection,

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especially in times of stress.

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So maybe that friend that you send it

to can be part of your pre-pressure

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group chat that hypes you up

right before you're about to go do

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something that's a little bit scary.

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I'd also be forever grateful if you

wouldn't mind rating and reviewing

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Wellness Fixes the Pod on whatever

podcast platform you're listening on.

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00:18:01,778 --> 00:18:03,708

That way, this can get out to more people.

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I hope you guys enjoyed this episode,

and I'll see you guys again on the

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next episode of Wellness Fixes the Pod.