Exercise for Post-concussion Syndrome

Across Australia, over 20,000 individuals are hospitalised with a traumatic brain injury (TBI) each year. The data suggests as many as 85 percent of these individuals will be diagnosed with a “mild” TBI, and will make a full recovery within 3 to 6 months. Following the initial trauma, developments and further changes can lead to conditions such as Second Impact Syndrome and Post-concussion Syndrome.

Post-concussion Syndrome (PCS) is the persistence of concussion symptoms following the initial period of recovery. Generally, concussion symptoms resolve within two to four weeks following the trauma; however, symptoms of PCS can persist for months and potentially become permanent. There are several complex theories that underpin the neurological changes within the brain which cause PCS symptoms, but in summary, these changes reduce the brains’ ability to complete their normal processes. Consequently, some parts of the brain become hyperactive while others hypoactive.

Some common symptoms of PCS are: persistent fatigue, low mood and poor mental health, changes in sleep, and changes in cognitive functioning such as reduced concentration and memory. These symptoms can be extremely debilitating and often result in withdrawing from normal daily life.

How can exercise help with PCS?

It may seem counterintuitive to be exercising for PCS when the most common advice is to reduce stress and rest as much as possible. However, there is building evidence to support the benefits of physical activity for the symptoms and underlying pathological changes that occur with PCS.

The integration of a structured exercise program is a useful tool to assist in managing fatigue and the negative psychological symptoms of PCS, through not only the release of ‘happy hormones’ in the brain such as Serotonin and Dopamine but more importantly, the reintroduction of meaningful activities and social engagement to the individual’s routine. Additionally, we see that exercise promotes the release of peptides and proteins in the brain such as Brain Derived Neurotrophic Factor, which protects from degeneration and supports neurogenesis within the central nervous system. Over time, regular and purposeful exercise can improve the brain’s capacity for learning and memory retention functions.

Top 3 Tips for Exercising with PCS

  • Start small and build up:
    1. Our bodies don’t always enjoy big and sudden changes in lifestyle, especially when already managing PCS symptoms. Set small, achievable exercise goals and slowly progress them each week. A little bit every day, goes a long way.
  • Initially start with low impact:
    2. To ensure you are reducing your risk of a fall, or impact to your head while recovering, initially opt for a more controlled environment for exercise. Higher intensity team sports, or exercise that involves high amounts of jumping and running may be too much during recovery. Practicing movements and skills to progress back to these in the future can be a more effective option initially.
  • Utilise Mindfulness and relaxation:
    3. Regularly using mindfulness and relaxation techniques such as guided breathing can be a really beneficial strategy to manage and reduce stress. Implementing mindfulness or relaxation techniques following exercise as a cool down can assist in bringing your body and brain back to its resting state.

PCS is still a relatively new diagnosis, and there is no gold standard treatment for it; however, the benefits of exercise for the brain and symptoms of PCS are clear. Exercise can be a powerful tool to not only manage PCS symptoms, but additionally assist in transitioning back into meaningful activities and normal life.

References:

Bathina, S., & Das, U. N. (2015). Brain-derived neurotrophic factor and its clinical implications. Archives of Medical Science.

John G et al. (2012) Return to Full Functioning after Graded Exercise Assessment and Progressive Exercise Treatment of Postconcussion Syndrome. Rehabilitation Research and Practice. https://www.braininjuryaustralia.org.au/brain-injury-australia-completes-study-on-post-concussion-syndrome-mild-traumatic-brain-injury/

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