Question about exercise.
 

I read before on here that you should exercise until you have symptoms.

What if you always have symptoms?

I've always been afraid to exercise because when I do, it increases my brain fog and makes it harder to express myself. I'm trying to find ways to decrease the fog and improve the quality of my life. I would like to exercise but don't want to cause any further problems.

Anyone who deals with severe brain fog find that exercising helps clear it up? What type of exercises do you do? For how long and how often?

Can I walk, do crunches, push-ups and jog in place?

K thx.

What I would do is walk until you feel a symptom, just a light walk. Stop immediately if you feel anything weird. I have been able to walk a bit, but not much. I recently pushed myself too hard at the mall, I did too much, and got my nausea back. Recovery is horrible, but baby steps are the way to go. I feel your pain though, I desperately want to get back to being the person I was, and sometimes I feel like some days I can do that, but then I go right back to being the sick, hurting me.

Thanks!

Unfortunately, I'm never symptom free and haven't been for awhile. I always have this horrible dark cloud floating in my head that blocks me from accessing my memory, ability to articulate myself quickly and properly and other stuff. I'm lookin for a way to decrease the fog, that's always there, so im not always depressed about not being able to think.

Hopefully we both find a formula for success so we could kick some grass on League of Legends. Bwahhahha.

Notorious Nick

I am just getting into a vitamin regimen, so hopefully that helps. Brain fog, I remember having during the first weeks of my injury. It was horrible, plus the extreme nausea and headaches. Over time, it got better. I still have nausea from time to time, and eating is somewhat hard. Do you ever feel your symptoms are worse in the morning?

My doctor, who is very good, and who is constantly scrutinizing the evidence re concussion treatment, advised the following:

1. Stay sub-threshold of symptoms as much as possible

2. Exertion (physical or mental) is an index of recovery -- there is insufficient evidence to show that it promotes recovery

3. That said, some light exercise like walking is good if you can tolerate it and it doesn't exacerbate symptoms. When I asked to what extent I can safely push through symptoms, he said "a little" (emphasis on "little")

4. Once you can tolerate walking, you can try gradually moving up the ladder (for example, by trying light stationary cycling for brief periods)

5. Add running and/or swimming later in your recovery, as both involve more exertion and/or head movement / jarring

The process of adding physical activity can be awfully slow, but in my view there is no magic bullet -- you can't force it.

My symptoms are much worse in the morning. I wake up feeling like I've been hit by a wrecking ball. It usually takes me an hour or so to gain my bearings. So, you're not alone on that.

My recovery has been rather....weird. Instead of getting better, I have gotten worse and worse over time. My PCP is helping me find an underlying cause for the decline.

Have you tried Zofran for nausea?

I haven't tried that yet. I am going to a neuro in a few days, so I am going to see what she says. Hopefully with this, I am not batting zero.

There is very good evidence that aerobic exercise improves cognition in other groups, with particularly good evidence in ageing people, and rodents(!), suggesting that it may be beneficial for brain health generally. There isn't strong evidence for it doing so following concussion, but then there isn't much evidence for any interventions following concussion because most researchers are only interested in finding out whether our symptoms are organic or psychological, rather than finding out how to get rid of them.

Interestingly, if our symptoms were to be found to be entirely psychological, there would likely be an even firmer basis for aerobic exercise which has been found to be at least as beneficial for people with depression as anti-depressants.

My advice (and my interpretation of exercise guidelines) is not that you shouldn't exercise unless you are symptom free, but that you shouldn't exercise if doing so makes your symptoms worse. So when I was recovering I would exercise even though I had permanent slight brain fog and headaches that never went away - as long as these didn't get worse, then I wasn't doing myself any harm by exercising. This seemed to me to be very beneficial, definitely for my mood, and possibly playing a part in the reduction of my symptoms (though I can't prove a causal relationship).

My own homespun theory (based mainly on my experience) is that there are basically two phases to recovery:

1. Physical and mental rest (no exercise) until symptoms subside sufficiently (not necessarily completely)

2. Gradual increase in physical and mental activity as tolerated (i.e., so long as it doesn't trigger or exacerbate symptoms)

How long each phase lasts will vary for each person / injury. I think people sometimes conflate the two, thinking that they should be exercising when they should be resting (first phase), and possibly being too inactive during the second phase.

In any event, only the concussed person really knows how much he or she can handle. It's an ongoing trial and error process that requires both adding and subtracting activity as necessary.

I would definitely agree with that. The only thing I would add is that I think I could have started light exercise a little earlier than I did - so I'd recommend giving it a go if you're not sure. You can always stop if it makes you feel worse.

There was as greenfrog says though definitely a pretty long period when I just needed to rest and not exercise at all.

Space cadet,

I never found exercising to help the brain fog. Just makes me not depressed.
I would only do walking and stretching. Actually I did some leg lifts from tracy anderson. Basically you stand in one place holding a chair and I would close my eyes due to headache. Squats around the house too. Building up time walking seems the best idea. I know you live in the city though and can be hard.

Every once in a while I get frustrated and run as fast as I can. I always pay for it the rest of the day. I wouldn't recc it but I know sometimes it feels good.

Greenfrog, Do you have a pounding headache after a flight of stairs? Like a 10/10. Even with time and getting stronger this never abates.

Also other frustrating points. Headache could be partially caused by neck injury. It does get better but not much over time. I know my brain is getting better but have all symptoms when I exercise show up (brain ones).

What exactly is still damaged then? The headache from damage in brain/ shearing? or just neck. Say 10 years later I still have symptoms when exercising? Does it mean my neck never got better or my head? Any opinions?

Thank you!

Hi postconcussion,

My symptoms have mostly abated at rest. Both my cognitive and physical thresholds have increased a lot, and I feel I am on the path to recovery (it has been 20 months and counting). However, I have taken things really slow throughout my recovery -- limited travelling, almost no stairs, no heavy lifting, no elevated heart rates. I have opted for daily walks (very slow and short to start, now doing 2 x 35-40 mins of pretty much normal pace every day, and gradually going faster), household chores, minor local excursions in quiet suburban surroundings. I believe this "slow and steady" approach has helped with my recovery.

Walking is one of the aerobic exercises that is shown to reduce the harmful neurotransmitter in the brain. I think it is called Factor P?

So light walking (go as slowly as you need to) can actually be healing for the brain.

Again, don't push it. When I first started, I was going slower than the slowest old guy at the community center who had to hold onto the railing to walk. I still did it. I only could do 15 minutes at a time before I'd start to feel really wonky. I still did it.

Over time, my speed increased and so did the amount of time I could tolerate. And walking became one of the major things I did to pass time, to keep myself sane, and to help with recovery. It's really a win-win-win in that way!

Here is the article I read that talked about substance P. http://www.wellnessresources.com/hea...tes_take_note/

Walking actually increases BDNF in the brain, which helps fight substance P.

Substance P is BAD, BDNF is GOOD!!

Thanks everyone.

One of my original questions was "What if I always have symptoms?".

Even with lots and lots of rest, I'm stuck in a nasty fog that is impossible to think through. I'm lookin for a way to break through the fog cuz rest, no TV and vitamins aren't workin for me.

I had symptoms when I started. I walked through headache and brain fog for probably six months. But I would stop when I started feeling REALLY wonky, or if the symptoms started getting WORSE. Don't know if that helps?

For me, a stationary bike was the answer. At first it was hard for me to go for regular walks. Just the jarring feeling of steps against the sidewalk and overload of sensations of being outside made me dizzy.

So I started with the stationary bike for 20 minutes. Didn't push it, and slowly built up to where I now do 45-60 minutes per day of hard cardio without any problems.

Give the bike a try, but try to have someone there to monitor you. It helped me when I was unsure if I would have problems.

As for supplements, you really need to find the right combo for your specific symptoms. I find fish/krill oil, turmeric, vit B, vit D all essentials. Then I alternate neuro supps of Aniracetam with a prescription of Provigil. Both help with the brain fog a lot.

Try to get as much vitamins from foods. I've mostly cut out beef and pork. I now eat fish, chicken, and lots of fruits and veggies. Concentrating on brain friendly ones like apples and blueberries. Like 2-3 apples per day with 1 pint of blueberries daily I find helps a lot.

No matter what your condition, starting with a base of healthy, fresh foods gives you a baseline to work from.

Feel free to PM me for specifics. I hope it helps.

Sandwalker,

Can you tell me a little more about "aniracetam"? Can I ask my doctor to prescribe it to me, or is this a drug that needs to be purchased online? How often does it need to be taken? How long before it kicks in?

Brain fog is my most debilitating symptom. I would love to get some relief from it.

Thanks,

Nick

Nick the effects of not exercising can be hard on the body. My initial early recovery I was chair bound most of the time, it was devastating to my body. It has taken two months of physical therapy to correct the effects of both my injury and the effects of all that sedate rest. IMO light and mild would be best if you are still struggling. I really feel for you as I have watched your many posts and struggles. On an upside your posts are more articulate and have excellent structure so your language skills are showing improvement.

Hope you feel better.

Hi Nick,

My biggest problem, as it sounds like yours is, has been brain fog. This is what's helped me the most with that:

I take an Aniracetam dose of 750mg in combination with 250mg CDP Choline 1-3x per day, as needed. The affects last 2-4 hours per dose. It has worked great for me and I haven't had any side effects. Both Aniracetam and Choline are considered supplements, so you don't need a prescription for them. You can find them on Amazon.

More details: Aniracetam is a nootropic. Basically, Aniracetam stimulates the functions of certain neuronal receptors by means of glutamic acid. Choline is a nutrient you can find naturally in egg yolks and some other foods. Usually when you see a mention of Aniracetam, they suggest stacking CDP Choline for better affect.

Provigil on the other hand is a prescription drug that is very expensive. It was prescribed and highly recommended by my neurologist for brain fog. I use the generic version, Modafinil which you can find much cheaper online. Modafinil feels like a much stronger version of Aniracetam. I take 100mg which lasts about 10 hours.

To prevent my brain from building up a tolerance to either, I alternate several days between each of them. This has been the best solution for me by far for brain fog.

If you have any more questions about either, don't hesitate to ask me.

:)