Why does physical activity make your concussion symptoms worse?

In this video, Dr. Mark breaks down recent research that explains (at least in part) why symptoms flare with exercise and physical activity. He also discusses the Buffalo Concussion Treadmill Test, and how it helps to minimize symptoms during concussion recovery.
Read the original research here: n.neurology.org/content/97/22...
If you're in Arizona or Washington, schedule a consult: www.drheisig.com/schedule
If you're anywhere else in the world, join the Concussion Reset program and community: concussion-reset-program.teac...
#physicalactivities #concussion #concussionsymptoms #postconcussionsyndrome #exerciseismedicine

[@kaygibson1842]

This is good to know.. Thank you soo much.. 8 concussions later and I struggle. No memory of what happened to me. others were from a vagus faint. One strange thing is my brain now works in imperial. Not metrics.. I'm just going to go with that as I'm now able to sew again and my machine stitches are getting straighter.. Last concussion, few mths ago hasn't altered that and I'm growing more confident.. So i think I'm doing pretty damn good.. Just don't want to damage my head anymore.. Scarey stuff.. Own and work on our own farm and so accidents happen.. Not matter how careful we are.. Seems always to be my head..thank you for this. Will check out your other vids..

[@drmarkheisig]

Farm life definitely comes with its own obstacles. One thing I would be curious to chat with you about is if you were sustaining true concussions or if you were experiencing whiplash injuries. Symptomatically, these are identical. The only reason I bring that up is when patients aren't in contact with athletes (e.g., collegiate football /hockey/LAX or MMA), I usually find more cervical injuries than true concussions. We still progress through rehab, but there's comfort and ease in patients knowing that their brain was not being jostled as much as they thought.

[@Lemoncare]

Stress intolerance. It’s real.

[@2809thalia]

just THANK YOU

[@gloing]

This really helps thank you!

[@drmarkheisig]

I'm glad to hear that!

[@militarychase864]

​@@drmarkheisigCurantky i have a decent headache from footy yesterday and Ive had a few headknovks in my football career in 2022 wich was my 1st season i had no headknocks in 2023 my 2nd season i had a headknock at training it was suspected concussion and then I had hia but was cleared and I played rest if season that was mid season This year my 3rd seaon it's currantly round 11/18 in round 1 quater 1 at the end of the quater i got a headknovk had to have hia it was suspected concussion but was cleared then round 5 I got 2 little small hesdknocks nor really thouh just minor knocks thay fidnt need a hia then yesterday round 11 I hit my forehead on opisitions legs goung for the ball and herd neck crack then like had headache and stuff and I still jsve a headache I've had on off I had a prety bad headache during the next game the grade above that i watched like I've had on off frequent persistent headache since end of the game up until now i didnt mention to my coach or anything coz i didnt want another hia but i did have nausea in 3rd quater some 2nd quater aswell but i was on bench snd quater 3rd quater was i felt lkke i couldve thrown up i was on bench aswel feeling not best though i had a headcahe and rining and itvacn on 2nd quater after theknocj i didt mention coz it dint hurt that bad at the time plus i dont wanna miss out on 3 weeks lukiluwe have a bye then a break round so thats 2 wees of eest that i can have to recovor and I have been told to wear a helmet by a kid who wears a helmet by coach assistant and mu brothers all have said I should wear one I'm up against it I know what the helmets look like buy its not worth it would be uncomfortable and anoying instead of a free head during games no kne wears helmets only a few do om talking about aussie rules footy not nfl or soccer i have a decent headace and the budeos with the rinig makes it eorse and i already hae ear rining i might have a concussion but i didnt tell my coah coz i didnt want a hia (I always have typos and stuff it's not from thr knock I just type too fast)

[@smca7271]

Thats interesting,I've found interval training seems to help....had a tbi for 3 yrs,trying to improve.

[@drmarkheisig]

If you can tolerate intervals, you're doing well in the "autonomic bucket" of concussion.

[@kennethmoore3783]

Dr. Mark Heisig is a naturopathic doctor (ND) in Scottsdale, AZ. He completed his “medical education” at Bastyr University in Seattle, Washington.

[@drmarkheisig]

Nice to meet you 🤝 Where are you located and where did you receive your accredited, regulated, and licensable medical training?

[@kennethmoore3783]

@@drmarkheisig University of Chicago

[@angelatrudeau739]

Not disagreeing with you, I used a different model for understanding that impact of exercise induced symptoms, and regulating my exercise. Goal to get good blood flow, oxygen to the tissues, necessary for healing. But especially in early months, it Was very difficult to monitor myself. thinking of physical change, that brain inflammation resulted in narrowed blood vessels, as measured by spect scan. so with exercise, increased blood flow / heart rate, hit this lower throughput capacity (like having a section of 1/2 inch diameter hose in a 3/4 inch pipe) and resulted in physical stress on those tissues. I used Fitbit to get a visual indication of rate/duration that resulted in symptoms and to monitor heart rate to keep just below the rate which triggered symptoms. Allowed me to walk, do housework, etc. and stay just below the point of triggering symptoms. I could pull back, rest enough to let the heart rate settle back a bit, and then continue. It was such a delicate balance point to be aware of. When everything felt like too much.

[@drmarkheisig]

Hi Angela! That's awesome you found that on your own. It's actually not different from what I do at all (check out my video on exercise testing). It turns out that a SPECT scan does not actually change the treatment plan at all in 99% of cases. In all cases, we're looking to improve autonomic tolerance through sub-symptom aerobic exercise. Inflammation is also VERY important to address, though it's not the primary driver of blood flow dysregulation in concussion/PCS. 🙏❤️🧠

[@bruceelliot1503]

@@drmarkheisigis it possible to gradually increase your exercise tolerance?

[@2809thalia]

for a follow up video? Why some ppl (inc me) get symptoms the NEXT day after exercise?? thanks again!!

[@drmarkheisig]

I can try and make a video for this, for sure. But quick here, delayed symptoms often point us to a cervical or vestibular dysfunction leading to these symptoms.

[@2809thalia]

@@drmarkheisig thank you 🙏 A video would be so helpful and appreciated!!

[@andytitcombe8834]

@@drmarkheisig like Thalia I suffer post exercise. The best way that I can describe the symptoms is that of a hangover, headache, nausea, lethargy etc. Symptoms can last for maybe 48hours. I now also seem to have an intolerance to alcohol.

[@angelatrudeau739]

Yes, I would get knocked back the next day, or 2 or 3. Imo, when brain is jangled, nothing works according to rules. I found cumulative load mattered also, I.e. visual tasks, sound, stress, thinking hard, plus physical activity

[@angelatrudeau739]

And for me alcohol, caffeine gave me trouble. Remembering to drink water was challenge. I lined up glasses of water on kitchen counter in the morning because I’d forget.

[@RaneBane]

Have you experience with anyone who held their concussion off for a few weeks while continuing to work a very physically demanding job? I mean I was having driving issues and pressure right away. The more debilitating symptoms came when I finally cracked and stopped working. Its like it hit me all at once. Workers comp says its impossible.

[@drmarkheisig]

Yes, I have had folks push on and hit a "breaking point."

[@siobhanmulvey]

Yes yes yes

[@reginaldwilliams617]

Sex makes me feel like I have a fresh concussion every time... 6 months later, I still have sex problems... makes sense now, thanks

[@Asfgxff]

Same situation here brother.

[@reginaldwilliams617]

@mr.ibfsfviyhudvbueribviuebru the struggle is real...

[@drmarkheisig]

Sex is a miraculous symphony/interaction between sympathetic and parasympathetic activity. The altered autonomic function from a TBI can make this whole situation wonky. With rehab, we can make progress - but there usually isn't a cookie cutter solution here.

[@chickenwingsranch2995]

No sex drive ?

[@reginaldwilliams617]

@chickenwingsranch2995 it's not sex drive. The drive is there. It's the feeling afterward that makes you not want sex.... I don't know if you had a concussion before, but that's the feeling I get after sex.. it's like a hit, my head dizzy feeling that leads to a real bad headache for several days after sex..

[@scentsbda]

🙏🏾🙏🏾🙏🏾🙏🏾🙏🏾

[@danielsykes7558]

This is very helpful for me. I just went on a walk for about 20 minutes, but the treadmill was set to about 3.3 by the end and I do have a headache now. I have long had a rough relationship with cardio, usually opting for weights, but now I understand that my concussion from a couple months back has likely been making exercise more difficult

[@drmarkheisig]

I'm glad this was helpful! Aerobic exercise is still something that we'd eventually like to get you back to some sort of baseline with (e.g., passing a BCTT), but opting for any form of activity is great!

[@angieguss5556]

So I have this issue. I cannot weight lift even though i started back very slowly. I feel hopeless. The problem is that I experienced no symptoms on the buffalo test at all. I experience symptoms from weight lifting only and these symptims happen several hours afterward. I have tried si many tjingsvto no avail. Why is my blood vessels still so sensitive after a year out?

[@drmarkheisig]

While impossible to tell via a comment section, it's unlikely that you'll pass a Buffalo Concussion Treadmill Test and still have autonomic (blood flow) issues. When we see delayed symptoms, as you describe, we often have to look deeper into the neck and its relationship with our eyes and "ears."

[@angieguss5556]

I have looked into those things comprehensively but to no avail. I have no symptoms with cardio at all. Weight lifting causes more pressure built up in the head than walking does...for me at least.

[@angieguss5556]

I have gone to vision and vestibular therapy, atlas chiro and I hold very well, regular chirio, neck strength exercises, stretching. I'm not dizzy either.

[@angieguss5556]

I have debikitating headaches and eye pain from lifting light weight. Hiw do i fix this? They just want to thriw meds at it and ive tried everything. Im so depressed.

[@drmarkheisig]

If it's during your exercise/lifts, it could be autonomic and related to your ability to distribute blood during changing HR and BP demands. It could also be neck-related. Or it could be both. We'd need to do a proper physical exam to determine the cause.

[@jimkragelund7517]

You have no clue as to real and true tbi damage! I have lived with issues 44 yrs. And can honestly tell you that you are full of it!

[@drmarkheisig]

Hi there! I'm sorry that this video describing one particular study doesn't resonate with your experience. After a concussion (mild TBI-only one form of TBI. It sounds like you may have had moderate or severe), we see altered cerebrovascular reactivity, cerebral autoregulation, neurovascular coupling, and neuroautonomic regulation. This was a study looking at cerebrovascular reactivity aspect (e.g., CO2 tolerance).

[@user-mk8ei4tm2f]

I had a heavy concussion and I healed…this is all bull

[@drmarkheisig]

Glad you healed! To clarify - there's no such thing as grading in concussion. You have a concussion or not - there's no mild, Grade II, etc... Physical activity does not impair recovery, but in many patients can provoke symptoms. This video explained one mechanism about why we think that is. That said, physical activity (i.e., aerobic exercise) is a mainstay treatment modality following a Buffalo Concussion Treadmill Test (BCTT). So, while I'm glad you had a healthy recovery - this, my friend, is not bull.