Post-concussion syndrome was difficult to explain so I drew a picture. I first posted this graph in the story in my signature but thought I'd give it more discussion.



Path A shows the typical recovery of a concussion. You're in bad shape at first then you make steady improvements until you're 100%.

Let's say that after a few days of resting you've improved up to 50% capacity so you decide to go to work. But going to work bumped your activity level up to 75% which exceeded your 50% capacity and aggravated your head. Because you aggravated your head your brain launches an increased neuroinflammation response which makes your condition worse and knocks your capacity down. Then it takes the brain a very long time to sort itself out. (Path B)

When your brain's capacity gets knocked down then it's easier to overdo it and make your concussion even more worse (Path C). In the beginning it took going to work to overdo it but towards the end just talking to a friend was detrimental.

The headaches and dizziness are a RESULT of the brain being overloaded. When the brain is overloaded, it is injured more and takes longer to heal. It's like if you run with a knee injury then it's going to hurt because the knee is being overexerted and you will injure it more.

The word pain comes from the Greek word poine which means "penalty or punishment." Pain is the body's way of alerting you that what you're doing is causing damage. So that pain should not be ignored. Hence, pushing through the pain will make your concussion worse.

The opposite is also true - if you stop the damaging activity then the pain goes away. Therefore, staying in the safe zone alleviates symptoms and gives the brain a chance to heal.

When doctors prescribe medications that makes the situation worse because medications blur that line so you don't know where your limits are.

If you go to work and your head starts hurting, you can either go home and rest or pop the pills that the doctor gave you. Most people would do the latter because we've been conditioned to think that if something hurts you pop a pill. Or you may think "just a couple more hours then I can rest." But it only takes a couple hours to trigger PCS. Teens and young adults are vulnerable because they think they're invincible and don't want to let a little headache to slow them down. Or they may be too embarrassed to admit that they might have hurt themselves.

So when recovering from a concussion you want to keep your activity level within capacity at all times. If you do so, then your brain will heal. As your brain heals, that capacity line will rise. As that line rises, you will be able to sustain more and more activity without aggravating your head. But if you exceed capacity, then that line will drop a whole lot faster than it will come back up. And no matter how low that line goes, you have to stay below it.

The reason why it is so easy to overdo it is because the aggravation(inflammation) accumulates and has a cumulative effect. For example, the morning I left for work I felt fine but the more I drove the worse my head hurt and next thing I know I have post-concussion syndrome. If I had turned around sooner I probably would have been ok.

Post-concussion syndrome is so devastating because that downward step can repeat itself over and over again. The first few times you overdo it you don't notice your capacity being knocked down because most of your activity is still within capacity. It's not until you've overdone it a few times that your capacity gets down to where your normal activity level is and then all of a sudden regular activities have devastating consequences.

As you can see from the graph, it's critical to rest properly from the beginning. So when you go to the doctor with a concussion and the doctor says "oh, you just have migraine" or "you just have vertigo" or "you're being overly dramatic," in reality they're setting you up for months or years of suffering! And the number of times I was told I did not have a concussion is alarming! I'm sure other readers can attest to that.

This study concludes that extensive cognitive activity level after concussion is associated with longer symptom duration which supports my theory: Effect of Cognitive Activity Level on Duration of Post-Concussion Symptoms | Articles | Pediatrics

By having a better understanding of what causes post-concussion syndrome it can be better treated and prevented.