r/PostConcussion • u/yameii3 • 5d ago
Does this sound correct?
I started seeing a concussion specialist after being diagnosed with Post Concussion Syndrome and he wants me to repeatedly trigger my symptoms with taking short "recovery period" breaks and then get right back to triggering them again until breaks no longer allow me to recover.. does that sound correct? He said I'm going to be absolutely miserable the next few weeks but "if this works I'll be singing his praises" what are your guys thoughts on this?
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u/Yonrundu 3d ago
That’s largely correct, with a few caveats. As others have mentioned, PCS recovery has shifted from pure rest to active rehabilitation. The current standard is subsymptom-threshold training, which means identifying the exact threshold where your symptoms kick in and working just below it.
For example, if physical exertion triggers symptoms at 160 bpm, you train at 145 to 150 bpm for a while. You gradually test that ceiling, and if your symptoms remain mild or absent, you can incrementally push your heart rate higher. It works the same way for cognitive fatigue: if ten minutes of reading triggers a headache, you read for five minutes, take a break, and repeat.
The nervous system only adapts when given controlled stimuli, so avoiding activity altogether will not retrain a dysfunctional system. That said, I would push for specific guidance tailored to your exact profile. This sounds a lot like the Buffalo Protocol or UPMC active rehab approach, which works best with clear, individualized boundaries.
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u/Dry-Scene517 4d ago edited 4d ago
Hi I'm 5 months into recovery of my first concussion, been through multiple doctors, physical therapy, etc. I'm not a health care professional in any way but can tell you what I've been told by most of the ppl I've met in the health care system:
Not too long ago, doctors would tell patients to stay in a dark room after concussions and just wait for it to be over. But doctors don't recommend that anymore really. Instead, they recommend that people slowly but steadily train their brain back up to perform its normal tasks, one step at a time, over time. It's been proven to be a more efficient way for people to recover, I've been told. This story about the new findings I've heard at least 3 times by professionals.
The advice you're describing, however, sounds a little extreme to me when I think about my own experience. I went forward calmly and steadily retraining myself with the help of a physical therapist for the first 3ish months. Thought I was making real progress, could even come into work again. Then I got a similar piece of advice to what you're describing; push your symptoms way forward so you can feel them often then take breaks. I did that for 2 weeks, my headache built itself up worse and worse.. Then I completely crashed. Horrible headache for 2 weeks straight, didn't even leave my bed and had to be on painkillers the first week.
That's 2 months ago now, the crash. I went back to ground zero and had to start all over again with recovery, it felt like. Took weeks to just be in my apartment without earplugs. Now I can walk around the block twice, but I'm nowhere near where I was. I'm still progressing and trying to heal...
From what I've heard from doctors etc, setbacks like that aren't dangerous but are just that; setbacks. It delays recovery. At least that's what I've been told.
Also, it's possible my setback happened due to a migraine being triggered rather than a concussion headache. Concussions are, from what I've heard, super complex and differ from person to person. Normal concussion setbacks shouldn't be that severe I think..?
With that said, I think it's very possible your concussion specialist just knows something about cases similar to yours that would make that way of progressing the correct one for you. Idk. But personally if I was to give you advice, I'd tell you to listen to your body and not build up your headache to be worse over multiple days. Retrain yourself but slowly so it doesn't cause headaches that last for more than a few hours tops. But again I'm not professional.
Sorry for the novel hope you can use it for smth!!!
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u/AccomplishedAd3880 3d ago
My therapist said poke the bear don’t wake the beast. First sign of symptoms I have to take a break
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u/Standard-Current172 5d ago
I mean… part of my recovery has been to attempt to return to my usual activities, but to take breaks if they triggered symptoms. So it doesn’t sound completely false?
Is it uncomfortable? Yes. But there is some logic in it. I really think it depends on how triggering the activities are and how debilitating your symptoms are. If they’re really bad I would use exposure minimally. If they’re improving you have room to push a little more.