I want to talk about priming the brain for better plasticity in the rehabilitation of concussion. It’s a long, long, uh, intro, but it is a traumatic brain injury awareness month here in the United States. We have an entire course called Post Concussion Syndrome Rehabilitation. We filmed a couple of years ago because this is such a huge topic. It’s so multifactorial. There are so many things that go into it.
But what we are seeing in the research is a very, very clear indication that the old ways of dealing with concussion, go into a room, keep it nice and dark, just rest for a while, rest for a couple of weeks before you do anything, actually cause bigger problems and they solve for most people.
So here’s what I want you to know today. We’re going to talk about the use of aerobic exercise as an early stage intervention or tool for dealing with the results of a concussion. What we are now seeing is that one of the challenges is that after a head injury or brain injury, there is a big alteration in the amount of blood flowing to the brain, right?
It’s called decreased cerebral blood flow. And as opposed to, again, what we used to think, we now know that that reduction in blood flow can last for years. Not just a few weeks. Particularly we see this in adolescents. There’s some studies that show reduction in cerebral blood flow 2, 3, 4 years after a concussion.
And a reduction in blood flow is not good for the brain. It makes it very hard for the neurons to do their job, for the brain to actually heal. What we’re seeing now are combination rehabilitation approaches. But we’re using now a base of aerobic exercise. Now, the challenge in this is that some people, when they hear that, they’re like, okay, so if someone has a concussion, then we just need to have them get into a typical aerobic exercise routine. We’re going to elevate their heart rate. We’re going to do that 150 200 minutes per week.
No, that is not how this one needs to be approached. Because concussion hits people very differently. Maybe they have headaches. Maybe they have vertigo. Maybe they have visual issues. other balance issues. Maybe they are not sleeping.
Maybe they’re, experiencing uncontrolled anger. There’s a whole lot of different things that can be impacted in human functioning based off what part of the brain is involved in the injury. So what we need you to do is if you’re going to apply aerobic exercise as a part of an overall approach to rehabilitating concussion, is you must personalize it.
And here’s how you’re going to do that. Basically, we need to exercise at an intensity level and for a duration that does not massively increase their symptoms. So this is called sub symptom aerobic exercise. So let’s say their primary complaint is light sensitivity and headache. They come into train and you go, okay.
Or you’re having them do it at their house. You say, okay, how are you feeling right now? Okay, uh, I still have a headache because this is maybe, you know, four or five days after the initial mild head injury. Still have a little bit of a headache. All right, well, we’re going to have you do safe aerobic exercise. What does safe mean?
It means reduce the risk of falling. So don’t have them do crazy stuff. They’re going to walk. They can, you know, make sure that it’s in an area where they’re going to be able to see obstacles. If they’re going to be on an exercise bike and they’re having vertigo, well, someone needs to be there with them, or they need to have that, you know, near a wall or something.
You’ve got to think about these things to make sure that they don’t hurt themselves. Once they are now moving, what you’re going to tell them is, alright, if you’re currently experiencing a headache, even though it’s mild, let’s say it’s a 2 out of 10, you can push your intensity and your duration up to a point where the headache may go to a 4.
Anything beyond that, is hugely problematic. And in fact, in most cases, I would like for their headache to not get worse at all or their dizziness or their eye, you know, their visual complaints. It’s called sub symptom aerobic exercise. The maximum amount of increase in intensity It’s around a two on a zero to 10 scale.
Anything beyond that, they’re going to hard. So dependent upon them, you may have to start their aerobic exercise campaign with five minutes of work or three minutes of work. But week by week, we will increase the duration and intensity based off their symptoms. All right, this is a very individualized approach, which means there’s no perfect protocol, but eventually we should be working them up to 30 to 45 minutes of aerobic exercise per day.
That’s going to be huge. Now we couple this in Z-Health because we’re a brain based company with breathing, with isometrics, with a lot of other stuff to improve cerebral blood flow. The most important takeaway as well from all of this is you’re going to use aerobic exercise as a priming tool. When I say priming, I mean we’re setting the brain up to be more plastic, so that when we do other exercises after the aerobic exercise, they tend to have a bigger effect.
So if you’re going to be using vision exercises, vestibular exercises, movement exercises, sensory stimulation, I don’t care what you’re doing, have them do the aerobic exercise first and then do all the other stuff after. It will often have a much more profound and more long lasting impact. on their rehabilitation.
All right. So this is stage one and it’s something that we always try to hammer on because it’s so different than the old recommendations of just rest until you feel better and then go back to playing. Nope. Uh, bad idea. Uh, we want to avoid the 30 to 40 percent of people who have long term consequences from concussion and using aerobic exercise as a priming tool is really one of the best things that we’ve seen, in practice so far, all right?
If you are a movement professional, you’re a doctor, a coach, a therapist, you’re interested in blending brain-based training with what you already do, subscribe to the channel, check out the million and a half blogs we have here, join our free mini course, whatever it is. We love sharing cutting edge neuroscience and showing how that integrates with biomechanics and movement, as well as dealing with things that are more profound like post concussion, hypertension, all kinds of stuff.
The brain is in charge. and so there’s some amazingly cool practical neurology available to all of us to really help our clients succeed in ways that maybe we weren’t able to hit before. That’s what we love to teach. All right, so check us out. Uh, have a great week.
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