Concussions and Post Concussion Syndrome are complex conditions that require a multi-pronged approach. Treatment should focus on 7 goals: Rest, Reduce inflammation, Gradual Exposure, Exercise, Neurogenesis, Nutrition, and Gut health.
The brain needs rest from intense high-level cognitive activity to heal, just like any other injury such as a knee injury. Rest for the first 1-2 days, then gradually build yourself back up. Moderate rest is best.
First, Relax because anxiety can cause the brain to produce inflammatory compounds which can be a roadblock. You can't change the past, you can only change the future, so rest and relax.
The amount of rest you give the brain depends on the severity of your symptoms. Stop high-level intense cognitive activities such as computer work or driving. Lower your activity to a level that you can tolerate comfortably with minimal pain. For most people that's just quiet time around the house. Once your condition stabilizes and begins to improve, then gradually increase your activity level while being careful to not overdo-it. Use the pain as a gauge of how much you can do so as to not induce excessive inflammation.
Ditch your smartphone and switch to a basic phone. Limit computer, TV, video game and tablet time to 2 hour per day. Electronic devices stream so much information at you so fast that it's a big chore for your brain to process it all.
Focus on getting more deep restorative sleep. Turn off electronic devices an hour before bedtime. Install incandescent lighting or use low color temperature light bulbs at night. Dim your computer screen with a blue light filter.
Take naps or mini-breaks during the day and Avoid noisy environments.
Avoid driving. It takes a lot more mental cognition to scan the road and manipulate the controls than to sit in the passenger seat and watch.
Space out activities and appointments so you have a couple rest days in between to recover.
Activities you can do: Walk around the neighborhood, read what you can, watch some TV, go on your phone if you can handle it and it doesn't worsen symptoms.
Inflammation is the cause of concussion symptoms. The inflammation after a head injury cascades and can spread and cause more inflammation. This inflammation has a damaging effect and can cause more symptoms than the initial force of impact so steps should be taken to minimize this secondary injury.
Take a maintenance dose of anti-inflammatory supplements such as fish oil Omega 3 and Curcumin. Look for an Omega 3 supplement that has a high proportion of DHA because that is the component that is beneficial for brain injuries.
Adopt an anti-inflammatory / ketogenic / sugar free / gluten free / organic diet to help keep the inflammation down. (See below)
If your head hurts, then stop what you're doing and rest. A little bit of aggravation is okay, but a lot of aggravation is bad.
Take a double dose of curcumin and fish oil when you experience intense symptoms or after a bump to the head. They have a neuroprotective effect and will slow the cascade of inflammation.
Protect the head with a helmet or protective hat or bump cap if head bumps become a problem. Many people complain that minor head bumps bring back their symptoms or wipe out their progress. Keep in mind that each successive head bump is harder to recover from and the symptoms get worse, and if you get another concussion before the first one heals, that's very bad. If you've already had one or two setbacks from head bumps then you should consider head protection because the longer your PCS drags on, the higher the risk of another head bump. And if that happens then you will sink deeper into the pit that is PCS and then it will be harder to climb out than it ever was at the beginning, before the first head bump.
Avoid high risk activities. Do not participate in activities that put you at risk of another head injury such as sports or heavy drinking.
Then gradually increase activity level while being careful to not overdo it. Do just enough activity to cause mild discomfort but not so much to cause a setback. As your condition improves you'll be able to do more and more activity without aggravating your head. It requires patience and discipline, but if you follow the logic, it works.
For example, dine out at quiet cafes before going to busy restaurants or shop at small stores before going to big box stores. Then do a little more each week.
The strategies above will not cure PCS overnight, but it will give the brain the conditions it needs to heal. As long as you keep making small gains while minimizing setbacks, then you will get better.
Sustained aerobic exercise promotes neurogenesis so incorporate brisk walking, cycling, or cardio exercise into your routine.
Aerobic exercise stimulates blood circulation to the brain and reduces inflammation
Start moderate aerobic exercise 2 days after the injury.
Patients who start exercising early are less likely to develop PCS or prolonged symptoms.
The brain is capable of generating new brain cells. (Neurogenesis.) But the brain needs optimal conditions and optimal nutrition for Neurogenesis to occur.
Diet and Nutrition: (See list below).
Low-carb High-fat diet: In the absence of sugar, the body burns fat for energy and when doing so, it generates Ketones which fuel the brain. So eat lots of healthy fats and stop eating starchy foods like bread, pasta, and pastries.
Rest: The brain needs rest to heal, just like any other injury. The brain needs extra downtime to recuperate and repair itself and rest is essential for neurogenesis and neuroplasticity to occur.
Sleep is important because the brain flushes out excess gunk while you sleep. If you are not getting enough sleep at night, then nap during the day. Also take mini-breaks throughout the day to allow the brain to recuperate.
Dark Chocolate: Flavonoids in cocoa promote neurogenesis because they contain antioxidant and anti-inflammatory agents. But regular chocolate is highly processed such that most of the beneficial flavonoids are stripped out and lots of sugar is added which makes it bad. Dark chocolate is less processed, so it's best to use pure cacao in recipes.
Time Restricted Eating: Consume food in a 8-10 hour window during the day. The long period of time between meals at night triggers a healing crisis which promotes neurogenesis and synaptic plasticity.
Stress: stress reduces neurogenesis, so learn to manage stressful situations in a calm manner. Meditation also helps calm the mind.
A lot of the foods we eat cause inflammation, which inhibits neurogenesis and contributes to symptoms, so it's important to stop eating inflammatory foods.
Fats and oils are important because they provide the building blocks for new brain cells. So add lots of healthy saturated fats to your food, especially Coconut oil. Fats also improve the absorption of nutrients in other foods so always use full-fat dressing on salads.
Don’t eat sugar or wheat because they cause inflammation, lack nutrition, and are acidic. Replace wheat with whole grains such as Quinoa flour, Almond flour, or Chickpea flour. Avoid processed unsaturated fats such as Canola oil or Safflower oil as they cause oxidation which can be destructive. Cook with healthy saturated fats such as Coconut oil, Olive oil, or butter instead.
Stop eating these inflammatory foods-
soda
sugar/fructose/corn syrup
wheat/gluten
fast foods
processed foods
fried foods
refined carbohydrates
processed vegetable and seed oils (polyunsaturated fats)
(safflower oil, canola oil, sunflower oil, corn oil, soybean oil, cottonseed oil)
Trans fats (shortening, hydrogenated vegetable oils, margarine)
Eat this instead:
Cook with lots of healthy saturated fats (Animal fats, Coconut oil, Butter, Olive oil, Avocado oil).
Replace wheat with whole grains. (Paleo flour, quinoa flour, almond flour, coconut flour, chickpea flour, etc)
Eat lots of protein, vegetables, leguems, nuts and seeds, and some fruit
bone broth
Eat cold water fatty fish for the Omega 3 DHA
Eat organic foods because pesticides contribute to neurodegeneration
Gut Microbiome and Gut health affects mental health and brain health. An overgrowth of bad bacteria causes inflammation in other parts of the body, including the brain. That inflammation contributes to concussion symptoms and inhibits neurogenesis, and is also linked to anxiety and depression. Sugar, refined carbohydrates, medications, and artificial sweeteners feed the bad bacteria. So address your gut health as part of the treatment plan. Probiotics and fiber help, but a proper diet is the best way to cultivate a healthy microbiome.
Eat whole foods - a variety of vegetables, healthy fats, whole grains, legumes, fruit, meat, but not deli meats, and no refined carbs such as white bread. Those foods rich in fiber will feed the good bacteria.
Also try colon cleansing and detoxification because poor gut health causes inflammation in the brain, so you want to do everything you can to stop fueling the fire.
Take 800 mg of Magnesium and drink Smooth Move tea before bed. The magnesium will soften the waste and the tea will make it come out.
Drink a large cup of green vegetable juice once a week, such as celery and cucumber, as a meal replacement. The alkalinity of the juice will release toxins from cells in the body.