Exercising is one of the best things you can do to heal your brain. Yet exercise tends to make concussion symptoms a million times worse. So how do we solve this paradox?
My Exercise Journey
I was extremely active prior to my concussion. I exercised 5 days a week. I would mostly run 5-6 miles, do vinyasa yoga, and take spinning classes, but would also change it up every once in a while with bootcamp, barre, and boxing classes. I loved being active and going on walks. I used to sail competitively in high school and college, and continued to do so when I was able to.
It was a shock from going from such an active lifestyle to a completely sedentary one. But the reality was at the beginning of my concussion, exercise rarely crossed my mind. My focus was on getting out of the bed, eating, and staying awake for longer than a 3 hours at a time. Accomplishing normal daily tasks were a challenge. I can assure you that getting back to spinning class was not on my mind. My roommate at the time would ask me,
“Don’t you miss exercise? You used to be so active!” I would respond, “I feel so dizzy, fatigued, and drowsy all the time that I can’t even remember what its like to feel energized and want to exercise. So right now, no I don’t miss it. I just miss not feeling dizzy all the time.”
Going for a walk around the block was a challenge.
Fast forward 2 years and I am still very much dealing with post concussive syndrome, but I have reached my seemingly impossible goal of starting Kayla Itsine’s BBG workouts. I had finished week 1 of the program right before my accident and thought it was so difficult. To me being able to get back to those workouts was a sign that I had made it – that I was back to normal. I dreamed with being able to start working out again. I can’t tell you how amazing it felt to reach that goal. I have never been so ecstatic.
But reaching this goal, made me realize I had to redefine what it meant to be fully recovered. I was exercising, but I was not symptom free. Migraines, screen sensitivity, noise sensitivity, and issues with reading are still part of my daily life. But having one piece of my life back to seemingly normal is a massive step forward in this long road of recovery. I couldn’t be happier. I have now completed week 6 of the program. I wasn’t able to complete the full exercise protocol for week 6. I realized I was pushing myself a little too much and was suffering from headaches. No matter how much I wanted to continue pushing, I knew that I had to let my body rest.
Every exercise goal you reach will present itself with a whole new set of challenges. Figuring out what your brain can handle can be a challenge. Knowing when it’s ok to push yourself and when you should take it easy is confusing. The most difficult thing is to have the patience and perseverance it takes to go from walking 5 minutes with dizziness to complete a 30 minute HIIT workout.
So how did I accomplish this? I didn’t just wake up one day asymptomatic and bust out a HIIT workout. NO. This was a 2 year process of showing up everyday and putting in the work to heal. Sometimes that meant pushing myself to walk for 10 minutes. Other times it meant sleeping 17+ hours and letting my brain rest and heal. Some days it was a challenge to make it through the day, but the days I felt ok, I MOVED my body.
Read below for everything I’ve learned in this two year journey:
1. Seek out Professional Help.
Now in the early months of my concussion, I sought out professional help. I did vestibular therapy which gave me the tools and confidence to start exercising again. I started out getting dizzy after a 10 minute walk at 2.0 mph on a treadmill. After 3 months, I was able to walk 20 minutes at 2.7 mph. Recovery is SLOW. Let me repeat. PATIENCE is key.
2. Redefine exercise to mean movement of any kind.
Learning to redefine what exercise meant was KEY. Before my concussion a walk was a leisurely activity or a way to get from A to B, it was NOT exercise. If I wasn’t sweating, it wasn’t exercise. If I didn’t feel sore the next day, I didn’t push myself hard enough. I learned to appreciate any movement as exercise. I was SO incredibly grateful for the gift of movement and walking when most of my days were filled bedridden. I started taking leisurely strolls around my neighborhood and city and appreciating things I had missed from running or power walking by in my busy life prior to my concussion. I was grateful for being given a chance to slow down and have a chance to smell the flowers.
In addition to walking, restorative yoga became extremely important in my recovery. Not only for the physical benefits of stretching, but for the mental benefits. I was lucky enough that my front door neighbor in NYC was a restorative yoga instructor. When she found out about my concussion, she gifted me a private restorative yoga session with her. I was hooked. When I moved back to Miami, I found a yoga studio across the street that offered restorative yoga every Thursday at 11 am. Sometimes I overslept and missed the class. But most of the time, I rolled out of bed, walked across the street, and always felt so incredibly rejuvenated after the class. The gentle stretches and movement – all done in a reclined position – still felt like exercise to me. I still felt dizzy at times with certain stretches. It was calming, rejuvenating, and a challenge all at the same time.
3. Be grateful for what you can do, instead of focusing on what you can’t.
Four months into my concussion, I had to move out of my NYC apartment and back to Miami to move in with my parents. My short term disability had ended and I couldn’t afford paying rent. In Miami, my days consisted of sleep, journaling, coloring, and walking on the beach. After several months of walking leisurely on the beach. I realized I could walk for 20 minutes on the treadmill at 3.5 mph with no dizziness or pressure on my head. I was ecstatic! There were people next to me on the treadmill running and others in the back of the gym weight training. And here I was with a HUGE smile on my face because I was so excited to be walking at a faster speed! Had I been focusing on the fact that I couldn’t run and that 3.5 mph was so slow in comparison, chances are I wouldn’t have had the motivation to keep going. Celebrating your wins no matter how small makes a world of a difference. Which leads me to…
4. Don’t compare yourself to your pre-injury self. Compare yourself to the first week of your injury.
Its easy to get discouraged when you remember how active or strong you were prior to your injury. I must admit I have been guilty of this. Sometimes I would try jogging for a minute at 4.5 mph and had to stop because it was too much. All I could think about was how I would run 5 miles at 7.0 mph no problem. But then I would remember how a few months prior, I couldn’t even walk for 20 minutes without become symptomatic. Here I was feeling strong enough to try jogging again. It was a HUGE accomplishment.
4. Control your environment.
Music used to make me really dizzy. Loud music still does. I won’t be attending any spinning or bootcamp classes anytime soon. When I first started walking on the treadmill, the sound of the pounding on the treadmill from people next to me made me dizzy. Wear earplugs. Eventually I began listening to podcasts on my walks, then some acoustic music. Now I am able to listen to high energy electronic music to pump me up for those HIIT workouts. And get this – I have the bass booster setting set on Spotify. Several months ago I would not have been able to handle that. Definitely huge progress. When I was living in NYC, I would wear earplugs for my walks outside.
When walking on the beach, I would only go in the evenings when the sun was setting or late in the afternoon when it was cloudy. If it was windy, I wouldn’t go. It was too much effort for my brain to walk against the wind and the howling of the wind hurt my ears. I wanted to have a restorative walk not come back with a migraine from the sun or from overexerting myself.
When I began experimenting with strength training and yoga, I started at home where I had full control of my environment. Silence, dim lights, and a safe space. I could do it at any time of the day. I started out trying to do just 1 push up. Another day I would try 1 squat. No weights. This would make me dizzy. But after continuing to try week after week, I was able to add more reps little by little. I would try doing just one yoga pose at a time. One stretch.
When you reach the point where you can start going to a gym, try going at a non peak hour so you don’t get overstimulated by the number of people. Bring earplugs. Don’t push yourself. And don’t feel embarrassed. I know at times I wanted to have a sign attached to my back that said “Please, don’t judge my workout, I have a concussion. Thank you.” But truth be told, everyone is minding their own business. Do what you need to do, don’t worry about anyone else. If you get on the treadmill and have to leave after 5 minutes because you got dizzy, leave. Don’t try to stay there longer for fear of being judged. Take care of yourself.
5. Find your baseline movement.
Find a form of movement that you can do everyday and won’t make you symptomatic. This will go changing as you brain continues to heal. At first my baseline movement was my vestibular exercises walking up and down the hallway in my apartment building. Eventually, my baseline was a walk on the beach or restorative yoga. It was a restorative movement both physically and mentally. Moving helped prevent migraines, clear brain fog, and improve my energy levels. On days I wasn’t feeling well, I would generally still try to walk to the beach and breathe in some fresh air. Sometimes that 10 minute walk to the beach made me dizzy, other times I could walk on the beach for 20 minutes. But I always tried to move and get outside. On days, I felt extra energized, I would try walking on the treadmill.
6. Don’t push yourself. Do not try working out on days you are symptomatic.
Of course, there were days were I was bedridden with a migraine. Or days when I was having a setback and slept for 17+ hours. I did NOT walk on these days. Sometimes my movement was getting out of bed to walk to the kitchen to eat and back to bed again.
7. If you aren’t making progress, address your diet.
A year into my concussion, I started pushing myself in my workouts. I was walking at 4.0 mph. I was walking 45 min to 1.5 hrs on the beach. I was feeling stronger. On the days I felt extra energized, I would push myself and try a little more strength training or to do incline intervals walking or jogging intervals. I would do it and feel strong and accomplished. Until the next day, when I had a massive setback. I would sleep 15+ hours and be in bed all day unable to do anything. It would take me a few days to recover.
After a ton of research, I decided to dive head first into the ketogenic diet. Within a month, I had 10x the energy I had before and felt amazing! However, the most incredible thing I noticed a month into the diet was that I was no longer getting setbacks from workouts. This was HUGE! I could now push myself a little more without the fear of not being able to get out of bed the next day. This was when I really started to get some strength back slowly. For the first time in a year, I felt like I was working out for real. Just for reference, it still took me a year after this to do the BBG workouts.
8. Pick one goal to focus on.
I found this very helpful. This goal shifted a bit, but ultimately it led me to my success at being able to do the BBG workouts. I started out with the goal of not feeling dizzy all the time, which led to me walking little by little. I originally wanted to go back to running again, but every time I tried jogging I would feel horrible and would get a very uncomfortable pressure in my head. After reading several health and fitness books and listening to many podcasts, I learnt that long distance running creates chronic stress in the body and wasn’t particularly beneficial for our health. With that in mine, I decided that maybe I shouldn’t be focusing my energy on running. However, if running is your ultimate goal. Then make that your focus. Try walking, then jogging down the hall of your home, then jogging for 30 seconds, then a minute, then 2 one minute intervals, and so forth. I have not tried jogging probably for a year because I decided to focus on strength training instead. I do plan on trying again in the future.
Yoga was also important to me, but all the up and down movement made me very dizzy, so I decided to put that on hold. I realized that strength training was an easy way to slowly build my brain and body up to be able to do yoga and run in the future. I could start with just one lunge, one pushup, one squat vs a whole yoga sequence. If your personal goal was yoga, you could start with focusing on just one pose at a time vs trying to do a yoga sequence.
Ultimately, the BBG workouts to me was a sign of making it in terms of exercise, so I focused on that one goal. I am now also able to do some yoga without getting dizzy. As I get stronger with BBG, I hope to attempt going to a full vinyasa class to see how I handle it. There is a big difference between doing a slow 30 minute yoga flow at home and a 1.5 hour vinyasa yoga class. But for now, I am not overdoing it with trying to run, strength train, and do yoga all at the same time. I am focusing on one thing at a time.
9. Listen to your body.
I cannot stress this enough. Listen to your body. You will know when it’s ok to push yourself a little and when it’s not. Your body will give you signs. If you are dizzy, stop. If you get nauseous, stop. If you start feeling pressure in your head, stop. If you can’t get out of bed the next day, you pushed yourself too hard. Don’t attempt a more challenging exercise until you are no longer symptomatic for a few weeks with your current exercise.
Monitoring your heart rate is a good way to check if you are overdoing it. My vestibular therapist told me to keep my heart rate less than 100. However, eventually I started feeling stronger. On some of my longer walks my heart rate would go up to 115/120, but I always felt ok and was asymptomatic. If your heart rate is less than 100, but you don’t feel well, STOP. Your heart rate is only a guide to help you. How you feel is more important.
10. Don’t get discouraged. Don’t give up.
This one is hard. Some days I couldn’t help but feel totally doomed. Setbacks destroyed me. I would go to a dark place sometimes, but I would always come out the other side ready to tackle the day.
I would see instagram accounts of TBI survivors doing yoga and I couldn’t understand how they were doing it. Yoga made me so dizzy. I read so many articles about the brain healing benefits of yoga and exercising, yet I was unable to do yoga or exercise.
Eventually, I learned to focus on myself. My walks on the beach became more than just workouts. They were moments of reflection, time spent in nature, receiving the healing benefits of grounding, receiving the healing benefits of the ocean, and breathing in fresh air. I needed those walks outside for my mental health. As I started regaining my energy and strength back, I focus on trying to improve each day. I made a vision board with my exercise goals. I visualized myself doing the BBG workouts and doing yoga. I knew that if I kept trying little by little, I could accomplish my goals.
I still experience setbacks, but I don’t let them discourage me. I will be stronger than my pre concussion self. I will not give up.