Supporting Emotional Regulation Through Physical Exercise in Teens with Special Needs
March 24, 2026
Written by Kit Chan, Physiotherapist and Mother of Jonathon who is Autistic and attends Activate twice per week for Exercise Physiology sessions.
Puberty is a period of profound change, especially for teens with special needs. During this time, the brain undergoes significant remodelling and pruning, while hormone levels such as testosterone and estrogen rise. These biological changes contribute to heightened emotional sensitivity, disrupted sleep, and challenges with focus, learning, and self-regulation.
One of the most effective ways to support teens through this transition is through regular\ physical exercise. Exercise is not just sport, it’s any movement that gets the heart pumping and the body “huffing and puffing.” This type of consistent movement triggers a cascade of beneficial hormonal and neurological responses that can support emotional regulation, physical health, and overall wellbeing.
How Exercise Supports the Brain and Emotions
During physical activity, the body releases important chemicals that can help regulate mood and stress:
Endorphins – Reduce anxiety and create a sense of calm and wellbeing.
Dopamine – Boosts motivation, pleasure, and attention.
Serotonin – Supports mood stability and emotional regulation.
Cortisol – Although known as the “stress hormone,” regular exercise helps the body become less reactive to stress, improves cortisol balance, reduces anxiety, and supports better sleep.
BDNF (Brain-Derived Neurotrophic Factor) – Enhances learning, memory, and emotional control by supporting healthy brain connections.
These natural changes can help teens experience fewer emotional meltdowns, improved coping with frustration or sensory overload, and better sleep quality.
Making Exercise Enjoyable and Accessible
Exercise can be any activity that raises the heart rate—walking, cycling, swimming, or structured gym-based exercise. For some teens, especially those with autism, the physical sensations of exertion may initially feel unfamiliar or uncomfortable. With professional support, such as guidance from an exercise physiologist, teens can gradually learn to enjoy the positive sensations and emotional benefits that come during and after exercise.
Why Gym-Based Exercise Works Well
Gym equipment provides stable, predictable physical support, making it easier for teens who require help with motor planning and coordination. This allows them to engage safely in meaningful movement while still gaining the full physical and emotional benefits of exercise.
Exercise, Medications, and Metabolism
Some medications commonly prescribed for teens with special needs can affect metabolism and body weight. Regular physical exercise helps:
• regulate insulin levels
• reduce excess glucose storage
• improve how muscles absorb glucose
These metabolic benefits support healthy weight, stable energy levels, and improved recovery after physical activity.
The Power of a Supportive Exercise Environment
In a supportive setting like Activate, teens receive more than just physical guidance; they experience encouragement, connection, and positive social interaction. The welcoming environment created by experienced exercise physiologists helps teens:
• build confidence
• engage with peers
• practise communication and teamwork
• feel safe, supported, and motivated
These shared experiences enhance emotional wellbeing, social confidence, and overall quality of life.
How We Can Help
If you or someone you know is experiencing similar challenges, support is available. Our team works closely with individuals to provide personalised, evidence-based care that focuses on building confidence, strength, and long-term outcomes.
If you’d like to learn more or think this approach might be helpful, feel free to get in touch with us or speak to one of our clinicians. We’re always happy to have a conversation and point you in the right direction.
About Kit:
Kit Chan is a physiotherapist with over 20 years of clinical experience. She holds a Bachelor of Physiotherapy and a Master of Physiotherapy specialising in Women’s Health and Continence, and is now returning to her specialist practice as a Women’s Health Physiotherapist.
Following her son’s diagnosis of Autism Spectrum Disorder, Kit volunteered and later worked as a physiotherapist at St Paul’s College, a specialist school. In this role, she supported students with diverse needs to access physical activity and exercise within school and community settings, with a focus on participation, confidence, and overall wellbeing.
Kit has a strong interest in the role of exercise for autistic adolescents. Her son has participated in regular, structured exercise with an exercise physiologist since Year 8, and Kit has observed significant improvements in his physical health, mental wellbeing, and emotional regulation. This lived experience, combined with her clinical background and engagement with current research, informs her perspective and the work she shares in this area.
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Understanding Tendinopathy Tendinopathy is a condition affecting tendons, often caused by overuse, repetitive strain, or age-related degeneration. It can present as either acute inflammation or chronic tendon degeneration. Common areas affected include the Achilles tendon, gluteal tendon, rotator cuff, patellar tendon, and the elbow, commonly known as tennis or golfer’s elbow. These conditions can lead to discomfort, pain, and movement limitations. What Causes Tendinopathy? Tendinopathy is primarily caused by overload, repetitive motions, or sudden increases in activity intensity, which can lead to changes in tendon tissue. There are several risk factors associated with tendinopathy that can be divided into modifiable and non-modifiable categories. Modifiable Risk Factors Strength Flexibility Biomechanics Metabolic disorders such as diabetes or arthritis Weight Hormonal influences Sleep and stress Non-Modifiable Risk Factors Age-related degeneration Gender Genetics Structural characteristics Previous injuries Drug exposure It is important to recognise the interplay between modifiable and non-modifiable risk factors. A holistic approach focused on managing modifiable factors can help reduce risk and support tendon health. How Is Tendinopathy Diagnosed? Tendinopathy is diagnosed through a combination of clinical assessment and physical examination. A clinical assessment may include: Understanding an individual’s history Reviewing individual signs and symptoms Exercise Physiologists will typically begin with a physical examination, including: Evaluating pain, tenderness, and movement restrictions Inquiring about activity levels, including recent increases in physical load Assessing the presence of other health conditions Typical clinical presentations include: Localised pain Discomfort following a sudden increase in activity Pain aggravated by continuous load, though it may temporarily improve during movement A proportional relationship between load and pain Pain and stiffness in the mornings While imaging may reveal structural changes such as degeneration, it cannot definitively differentiate between a tendon tear and severe tendinopathy. Imaging should not be used as the sole diagnostic tool and is primarily helpful for ruling out other conditions or identifying referred pain from different areas. How Does Exercise Influence Tendinopathy? Exercise is one of the most effective tools for treating and strengthening tendons affected by tendinopathy. Loading the tendon and surrounding muscles through exercise can help with immediate pain reduction and strengthen the muscle-tendon unit. Properly structured exercise programs help to: Stimulate tendon repair Enhance tendon quality and strength Restore overall function What Is the Best Way to Manage Tendinopathy? There are three essential interventions for managing tendinopathy: Implementing an individualised exercise plan to gradually progress exposure to load for better tolerance and function Managing load outside the rehabilitation program Understanding pain, managing risk factors, and learning how to manage exercise load When managing tendinopathy through an exercise rehabilitation program, it is important to consider an individual’s response to physical stress. This is measured through load tolerance. Load tolerance refers to the amount of pain-free force an individual can produce or absorb for a specific movement over a specified period of time while still maintaining control of the movement. Adequate load tolerance includes: Acceptable pain during activity Pain that settles within a day What Is Acceptable Pain? Training within a pain range of 0–4 out of 10 is considered acceptable. Pain rated 5 out of 10 or higher may be problematic. Exercise Recommendations For any exercise rehabilitation program, it is important to gradually and progressively load the tendon and muscle while remaining within acceptable load tolerance parameters. Load response should continue to be monitored throughout the program. Example Exercise Loading Progressions for Patellar Tendinopathy Knee extension Leg press (double then single) Split squat Step up Walking lunges Higher step for step up Jumping and hopping Split jumps Maximal forward hop References Goom, T.S., Malliaras, P., Reiman, M.P. and Purdam, C.R., 2016. Proximal hamstring tendinopathy: clinical aspects of assessment and management. Journal of Orthopaedic & Sports Physical Therapy, 46(6), pp.483–493. Malliaras, P. and O’Neill, S., 2017. Potential risk factors leading to tendinopathy. Apunts. Medicina de l’Esport, 52(194), pp.71–77. Malliaras, P., Cook, J., Purdam, C. and Rio, E., 2015. Patellar tendinopathy: clinical diagnosis, load management, and advice for challenging case presentations. Journal of Orthopaedic & Sports Physical Therapy, 45(11), pp.887–898. Malliaras, P., 2024. Mastering Lower Limb Tendinopathy 5th edition ONLINE.
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