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.