One of the many things we measure during our initial examinations, but also during care, is heart rate variability (HRV).  It is one of the 3 scans that we do in the office, typically the last thing done, that helps us measure the overall functionality of someone’s nervous system.  HRV is trendy nowadays in the fitness world with things like the Oura ring or Whoop bracelet.  These devices are constantly measuring your HRV throughout the day/sleep/everything.  Our measurement is a snapshot of your HRV, which we liken to a habit of your system.  

Based on the name, it should be no surprise that HRV is dependent on your heart rate, and what your heart is doing.  Without getting into the weeds of HRV, it can simply be described as the variation in time between each heartbeat.  While resting, it could be a long interval.  While working out, it should be shorter due to the increase in heart rate.  HRV is controlled by our autonomic nervous system (ANS), which has 2 branches we have discussed before; sympathetic and parasympathetic. Your sympathetic nervous system, fight or flight, increases your heart rate.  The parasympathetic nervous system, rest and digest, decreases your heart rate.  Your ANS is influenced by everything you do/see/hear/eat/etc.  The ANS is a branch of your central nervous system(CNS).  Your CNS is responsible for taking in all of the information that is constantly bombarding us, organizing it, and then tells your body how to respond to the information.  


Your ANS can be influenced by a poor night’s sleep, a delicious meal, exciting news, a workout, or even a scary movie.  With the constant measuring the above mentioned devices do, they give you a “readiness” score every single morning based on the last few days.  For example, if you ran a marathon yesterday and then had a poor night’s sleep, you would most likely get a low score telling you to take it easy that day.  On the other hand, if you did not train the day before and got a full 9 hours of sleep that night, you’d likely get a high score telling you to go out and conquer the world.  

Our in-office system measures the same thing, but shows it via a cool graph.  After 3 minutes of measuring a patient’s heart rate, we have all that we need.  Our measurement shows us a few things, but we typically describe it in the office as the patient’s “adaptability score” and/or “healing reserve.”  It shows us what branch of their ANS they are favoring, parasympathetic or sympathetic.  It also gives us an activity score that translates to their body’s ability to handle stress.  This scan is easy to go over with our patients as they get a numerical value for each of these.  We can then add those two scores together, divide them by 2, and be able to give their CNS an overall score.  For example, if someone had a balance score of 83 and an activity score of 90, their system would functionally be operating at an 87%…or solid B/B+.

After going through this with a patient, the most common question we get is “how do I improve my score?”  The obvious answer here is to get adjusted more than you are 😀.  Dr Stan and I will usually respond with, “we improve our HRV scores by doing the things we know we should be doing, but don’t do.”  Things like…

  • Prioritizing good sleep
  • Anti inflammatory foods
  • Stretching/mobility/yoga
  • Prayer/gratitude
  • Meditation
  • Breath work
  • Cold exposure – for you overachievers 
  • Movement
  • Getting out in nature
  • Limiting screen time
  • Hydration

Reading this list reads like a bunch of things a healthy person would do.  Go figure.

For good measure, here’s a list of things that will absolutely destroy your HRV, so do your best to limit these

  • Not sleeping
  • Inflammatory foods
  • Lack of exercise/movement
  • Being sick
  • Alcohol
  • High stress levels (emotional and physical)
  • Overtraining 
  • Too much screen time (scrolling)
  • Anxiety

That said, if you or anybody you know is wondering how well their body is performing, please let us know.  We are happy to help in any way we can.