[CenterIce]

I was 8 months into my healing when I got caught up in a long mountain bike ride. I couldn't get out of it (cut it short and return to my car) and "bonked" and it took everything I had in me to finish. Since then my PCS symptoms have returned and are even worse than at the time of my initial injury.

Does anyone know what happens in the brain to cause the symptoms to return? I know there increased blood flow, blood pressure, body heat, etc...

One thing I heard is that the jostling of my head during the ride may have caused the return of the pain. However, I am quite certain the physical exertion has more to do with it.

Any thoughts would be greatly appreciated.

Thanks.

[Mark in Idaho]

If you had continuous strong vibrations, shaking or bumps over a reasonably long period, there can be cumulative injury similar to the sub-concussive impacts see by football players as they clash helmets off the line ever 45 second in a game or even more often during a practice.

The physical exertion also put a blood pressure and pulse strain on sensitive tissues.

And, the waste products of metabolism can flood the bloodstream. Any time a physical effort cause fatigue, a recovering concussed brain will be stressed.

The Buffalo Protocol suggests keeping pulse rate 10% below any symptomatic levels during recovery.

The important part of recovery is to minimize or moderate activities that cause an increase in symptoms. The brain recovers best when it is symptoms free or at a lower level of symptoms. Activities that raise the symptom level often cause a setback. Gains in recovery can be lost by pushing too hard.

But, once you have pushed too hard, the only thing you can do is get back on a moderated activity level so recovery can continue. Stressing over "I screwed up and wrecked my recovery" is counter to recovery. Anxiety kills recovery progress.

[CenterIce]

Thanks Mark. Hopefully I didn't do any long-term damage. I was taking it easy on my rides and started to get slight headaches but ended getting caught up in a group ride that went on much longer than planned.

In the brain I'm wondering how the neurons are affected by all this physical activity. One person I spoke to said that because there are tears in the brain (among the neurons?) that blood wasn't able to flow properly throughout the brain and the results after intense physical activity is a return of the PCS symptoms.

[Joannetb]

My answer is not nearly as educated as Marks but my specialist says I can only do mild exercised that do not increase blood flow to the brain. She says it would prolong the recovery. So probably something you should consider.


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[CenterIce]

Hi. Thanks, however I already got myself into trouble but getting caught up in the long bike ride. I learned the hard way, unfortunately. I did get into a concussion clinic for better care. Wish I had found out about them earlier.

But to get back to my question of, "What Does Extreme Physical Exertion do to a PCS Brain?" I'm trying to figure out what happens at a biological level. I guess my thinking is if I can understand that then I can figure out whether or not I did any long-term damage. I had PCS for 8 months, went on that MTB ride, then my symptoms worse than they were at the beginning.

p.s. Joannetb - It's great you found a specialist that gave you that helpful information. My neurologist didn't cover things like that, unfortunately.

[Mark in Idaho]

There is no way to know if the ride did long term damage. The fact that you are concerned suggests you may be prone to anxiety. Anxious thoughts can prolong your recovery.

If you ask this questions of most doctors, most will hold it against you and likely label you as an anxious patient.

The take away from this is simple. Don't do that again until you are completely symptoms free for a month or more.

Another thought for you. Mountain bike rides are a very risky activity, even with a helmet. Bike helmets are better at protecting from skull fractures than concussions. They reduce impact forces but do not prevent concussions.

[Bud]

Center ice,

When I wasn't getting better I started running just 3 months after almost having my head torn off. That's what I've always done when I didn't feel good, go run it off. I would go in the 100 degree heat and direct sunlight so I wasn't babying myself. I couldn't understand why I felt so sick after. By a week I was an absolute wreck...mentally and physically.

I was able to swim a year later and now 21 months later I go to a gym again. I am not able to go at the same pace or as hard not can I go 5 days a week like 2 years ago but I am there!

I don't know why I get increased anxiety and some other odd feelings in my body after exercise but it is worth the trade at this point.

I couldn't even walk for a half mile through April of 2015 without to much overwhelming symptology and by Nov I went on a 10 mile hike.

I will tell you I never ever would have guessed this recovery would be so unpredictable and scary.

Bud

[newbie787]

Originally Posted by Mark in Idaho

If you ask this questions of most doctors, most will hold it against you and likely label you as an anxious patient.

This seems a pretty common thing really, and quite counter intuitive to having a trusting relationship with them. If you express symptoms they don't feel you should be experiencing, its anxiety. I had to get into an actual conversation with my doctor that yes, while I was clearly concerned about my recovery that I didn't feel anxiety was responsible for my symptoms.

[CenterIce]

Mark, thanks again for your help. I wanted to come back and thank you again for your thoughts in previous posts.

You're right about what you said below. In his doctors notes he said I had anxiety disorder. Oh well.

"There is no way to know if the ride did long term damage. The fact that you are concerned suggests you may be prone to anxiety. Anxious thoughts can prolong your recovery.

If you ask this questions of most doctors, most will hold it against you and likely label you as an anxious patient."

Bud, I can related to what you have experienced. Hopefully I'll be able to get out and cover some hiking distance (walking) when the snow melts. I'll be trying to do all the right things in the meantime.

"I had to get into an actual conversation with my doctor that yes, while I was clearly concerned about my recovery that I didn't feel anxiety was responsible for my symptoms."

Great thing to do newbie787. I think I can carefully explain my situation in a similar way. I may try to do this if I feel I need to in the next few weeks.

I appreciate all your helpful comments guys. Sorry for the delay in my response. I need to keep checking the "instant email notification" box.

[Alpinelooper]

Hi all,

My first post to this board. I'm five and a half months post-injury (a deer ran into me while biking and I landed on my head, unconscious for 15 minutes). How can I know what level of exercise is OK? I'm deep in PCS, never sure what symptoms are caused by the concussion and what are part of the mood disorder that begun about four months post-injury.