Monday, December 14, 2015

5 tips for improving recovery from a concussion

Do you play sports professionally or as a weekend warrior?

Do your children play sports in school or in their free time with friends?

If you answered yes to either of these questions, then you are familiar with the concern over concussions in sports.  But what is a concussion?

While traumatic brain injuries can lead to concussions, not all do.  Light blows to the head are typically not a concern and are common.  But when these blows become strong enough to damage the brain and alter brain function, they're referred to as concussions.

Complete recovery from a concussion depends on many things including the severity of your injury, your current health, and if you have recovered from a previous brain injury.

Chances are the increased awareness brought about by concussions in the NFL and combat sports has you worried about the long term effects of repeated blows to the head.  While most people who suffer from a sports-related concussion recover within 7-10 days, around 10% can experience symptoms beyond 10 weeks.  Some can experience symptoms for years afterwards. 

An issue that makes this worse is that sometimes the symptoms of a concussion are not obvious.  This is a major problem because suffering another blow to the head before the brain has fully recovered can lead to long-term problems and even death as increased swelling can cut off blood supply to the brain.

As you can see, it's important to make sure you heal properly from a concussion.  While some of the factors are out of your control, there are things you can do to speed up the process and make sure the damage heals completely.

So let's go over some tips on how to improve recovery from a concussion.  We'll go over some of the basics in the tips in this blog.  For a more detailed description of why each tip is important, take a look at this blog on the science behind concussions.



Tip 1: Avoid alcohol

This tip may seem like a no-brainer, but the importance of avoiding alcohol can't be overstated.  Even if you're feeling fine symptom-wise, alcohol can delay recovery from a concussion and prevent full recovery.

Another issue with drinking alcohol during recovery from a concussion is that it increases your risk for a second concussion.  It can do this by delaying recovery or by negatively affecting balance and coordination, which are already a problem for people recovering from a concussion.   In fact, the effects of alcohol are often amplified in people recovering from a concussion.

The main way that alcohol affects recovery from a concussion is through inflammation.  Alcohol increases inflammation throughout the body, something you'll want to avoid while recovering from a concussion.  Chronic inflammation causes immune cells in the brain to kill healthy brain cells and prevent damaged ones from healing.

Chronic traumatic encephalopathy(CTE) is the disease affecting former NFL players that has brought all of these concussion issues to light.  Alcohol abuse appears to be a major player in this disease in two ways.

As mentioned before, alcohol abuse delays recovery from concussion.  This disease is thought to be the consequence of repeated blows to the head.  These repeated concussions may lead to an accumulation of damage over the years that never heals with chronic alcohol use. 

One of the hallmark symptoms of CTE is changes in mood and personality.  Since the disease also lowers your inhibitions, it increases the likelihood that you drink, a double-edged sword.

Bottom line, don't drink alcohol while recovering from a concussion.  If  you choose to drink alcohol and have a history of concussions, do so in moderation and take other steps to prevent further damage.


Tip 2: Eat fish and other foods high in Omega 3 fatty acids

Omega 3 fatty acids are found in fatty fish, nuts, eggs, and pasture-raised animals.  Omega 3 fatty acids are important for proper brain function, but they also have very specific benefits for people recovering from a concussion.

DHA, one of the omega 3 fatty acids, is necessary for proper brain development and to maintain function throughout adulthood.  It's a major component of brain cells because it's necessary for the production of myelin, a coating that covers nerve cells to speed nerve transmission.  In fact, the brain contains the most DHA in the body.

DHA also has other positive effects in the brain.  It promotes neurogenesis, the formation of new neurons throughout life.  Neurogenesis is important for forming new memories and healing damage to the brain.

This is interesting because many people who do not fully recover from traumatic brain injury have impaired neurogenesis.  This can lead to mood problems which are helped with DHA.

One final benefit of omega 3 fatty acids is that they lower inflammation throughout the body.  They not only lower inflammation directly, they help reduce levels of lipopolysaccharide(LPS)LPS causes more inflammation and prevents recovery from concussion by causing more damage.

The bottom line here is to eat fish regularly, but don't overdo it.  Larger fish contain high levels of mercury which is toxic.  Eating smaller fish such as sardines or anchovies regularly can give you some Omega 3 fatty acids while limiting your exposure to mercury.


Tip 3: Eat lots of colorful fruits and vegetables

Fruits and vegetables have many components that can help you recover from a concussion.  Many polyphenols such as the curcumin found in turmeric, the sulforaphane found in broccoli and brussel sprouts, and the pterostlibene found in blueberries reduce inflammation AND promote neurogenesis at the same time.

These are just a few of the many polyphenols that can improve recovery from a concussion.  And the best part is, polyphenols are what give fruits and vegetables their color.  It's easy to identify vegetables that are high in polyphenols, they're the most colorful.

Fruits and vegetables are also very nutrient dense.  This means that they are rich in vitamins and minerals.  These vitamins and minerals are essential to heal damage to the brain.

Another component of fruits and vegetables that improves recovery from a concussion is fiber.  Fiber helps calm inflammation by reducing the amount of LPS that enters the bloodstream from the gut.  It also helps seal off the blood-brain barrier so that any LPS that enters the bloodstream can't access the brain.

When it comes to fruits and vegetables you should eat at least 5 different colors of fruits and vegetables a day.  It's also important to eat at least 6 cups of vegetables every day.  Get your veggies from a variety of categories including cruciferous vegetables, leafy greens, and root vegetables.


Tip 4: Make sure you get enough thiamine

Thiamine, also called vitamin B1, is necessary for proper brain function.  Thiamine is required for neurons to generate energy.  Not enough thiamine can kill neurons and cause high levels of inflammation.

Since thiamine is so crucial for the brain, most of the signs of thiamine deficiency are related to brain function.  This includes depression, confusion, poor memory, and balance/coordination problems.  These symptoms are also common when a concussion isn't healing properly.

While foods that are high in thiamine are important, supplements can be more effective because you can absorb them better.  Fat-soluble forms of thiamine such as sulbutiamine have been shown to create much higher levels of thiamine in the brain than the water soluble kinds found in multi-vitamins.


Tip 5: Get out of bed and exercise...gradually

Over the years, strict bed rest has been the go-to therapy for a concussion.  However, recent scientific evidence is showing that prolonged bed rest may actually delay recovery from a concussion.

A recent study found that student athletes who remained on bed rest for 2-5 days after a concussion reported more post-concussion symptoms than athletes who restarted their normal routine within 1-2 days.  The athletes on longer bed rest also reported that it took longer for their symptoms to go away.

Another study followed concussed athletes for 12 weeks.  One group just stretched while the other performed 20 minutes of aerobic exercise for 20 minutes a day, 6 days a week.  What makes this study cool is that they looked at brain activity in each of the 2 groups and compared it to people who did not experience a concussion.

The results of this study were incredible.  Athletes who performed aerobic exercise saw better improvements in brain activity than those who just stretched.  In fact, their brain activity patterns were not different from people who hadn't experienced a concussion.

Why would aerobic exercise improve recovery from a concussion?  It's because aerobic exercise increases neurogenesisAerobic exercise also has the added benefit of reducing chronic inflammation.

Unlike the other 4 tips that can be implemented immediately, exercise must be added gradually.  A good rule of thumb is to let your symptoms dictate when you begin aerobic exercise.   Your symptoms should also dictate the intensity of your exercise.

Start with walking and only progress to more intense aerobic exercise if you don't experience symptoms.  Symptoms to look for include headache, dizziness, or confusion.  Once symptoms allow, increase exercise intensity so that your heart rate is in the 60-75% of maximum heart rate range.  Stop exercise if symptoms worsen.


As we learn more about the effects of concussions, treatment options will improve.  Currently, the only treatment option is rest, observation, and pain relievers as needed.  Very little attention is given to lifestyle factors other than rest.

Diet and exercise are 2 lifestyle factors that can improve recovery from concussion.  Both factors improve recovery by reducing inflammation and increasing neurogenesis.

On the diet side of things it's important to avoid alcohol, eat fish, eat your fruits and veggies, and get enough thiamine to support brain recovery.  These 4 diet tips can be implemented immediately following a concussion since there is no risk.

Exercise, on the other hand, must be approached with more caution.  Full bed rest for a day or two following a concussion may be necessary if low level activities worsen symptoms.  You can begin walking as symptoms get better and add in more intense aerobic exercise as symptoms allow.

These 5 tips will improve recovery from a concussion.  When paired with monitoring by your healthcare professional, the risk to implementing these tips is negligible.   But, you should discuss these tips with your doctor before beginning.

Looking for more information on what you can do to improve recovery from a concussion?  We will be expanding these tips in the future.  Like us on facebook for updates on this article and future articles on the topic.