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.