Concussion Recovery

General Information

Managing vision symptoms after concussion

  • Wear a hat with a wide brim when going outside or in places with fluorescent or bright overhead lights.
  • Use a weighted lap pad or blanket for dizziness and to help feel “grounded”.
  • Use ginger for nausea. Most effective form is crystallized ginger or ginger capsules taken as a supplement.
  • Use earplugs or noise cancelling headphones for loud environments. Good quality, highly rated pairs are available at a variety of price points.
  • Ice Kap (www.icekap.ca). A cold therapy cap to relieve head and neck pain. Soft-gel ice packs are placed in the cap to deliver gentle, cooling pressure.
  • Deep breathing: close your eyes and place your hands on your hips or abdomen. Take slow, deep and rhythmic breaths using your diaphragm. You should feel your hands rise as the air fills your belly. Be sure the breaths are coming from your belly and not your chest.
  • Grounding:  If possible lie on the floor and think about all of the places where your body is touching the floor. If sitting in a chair, place your hand on your head and apply gentle pressure.

General health guidelines for concussion recovery

Rest and Limiting Activity: Concussions damage the brain which will require extra energy to repair the cellular damage. After a concussion, the brain is like a cell phone battery that has been drained down to a very low battery level. It may take days or weeks for the brain to ‘recharge’.  If the energy demands are so great that the brain cannot recharge, it can remain in a fatigued state for prolonged periods of time.

It will be necessary to limit your activity following a concussion and to avoid activities which trigger symptoms, for example going to the grocery store, using a computer or large gatherings of people. Do only what you can ‘afford’, and plan your day accordingly. Doing too much creates an energy deficit that can take days or weeks to recover from.

The following are some things that are shown to be helpful in healing and providing a healing environment for the brain.

DHA (Omega-3):  Did you know that 30% of the dry weight of the brain is composed of DHA? Recovery from concussion can be improved by flooding the brain with this essential building block.

Omega-3 provides benefits to the brain through anti-inflammatory propertieswhich reduce nerve swelling; and improved mitochondrial function which brings energy to help repair damaged brain cells and to  assist in nerve repair2,3.  DHA  also improves cognition, memory4 and sleep2,3.  Nordic Naturals Omega-3 and Nutrisea supplements are brands with a very good reputation.  The dosage is 3g/day for continued use; and upwards of 9g/day for an intense dosage for a duration of 2 – 4 weeks5 for some cases.

Additional Supplements:

  • Zinc
  • Magnesium
  • Vitamin D
  • Vitamin C (antioxidant and neuroprotective)
  • CBD Oil (limits cell damage)
  • Curcumin (turmeric) with black pepper (anti-inflammatory, antioxidant)

Always consult your primary care practitioner for guidance on supplements, especially if you are already taking supplements or medications. 

Light Exercise:  Light exercise increases blood flow to the brain which improves healing and may lessen concussion symptoms6.  Exercise after a concussion should be at a level where symptoms are not made worse while exercising or the following day.  Make sure your exercise is at a level at which you can hold a conversation without pausing (gasping) to finish a sentence. Going for a walk or other low-risk activities are ideal. It is VERY important that you do not participate in any activity that puts you at risk for another concussion.

Sleep:  Without sleep, the brain’s battery cannot recharge. Establish a bedtime routine.  Turn off all screens once the sun goes down or 1-2 hours before bedtime.  Listen to meditation or relaxation apps like “Headspace” or “Calm”.  Take 1-2 teaspoonfuls of Magnesium Calm before bed. Drink Sleepytime Tea, Kava Stress Relief Tea or combine the two for an extra sleepy effect. Try using all of these treatments if you have trouble falling asleep and staying asleep, as each may provide a slight benefit and they can be combined to for a nice additive effect. 

Digestion:  Address any digestion issues (IBS or recurrent indigestion) with a functional nutritionist or functional medicine doctor.  Chronic GI issues can cause deficiencies in nutrients that prevent adequate healing.

Hormone assessment:  If the hormones in your body are off, it will be even more difficult to recover. You might consider having a hormone panel through your PCP or a functional medicine doctor.

Talk Therapy:  Dealing with a brain injury and all of its effects can feel overwhelming. If you feel “stuck” or are finding it difficult to come to terms with your situation, consider a talk therapist. Neurofeedback paired with therapy can also be very effective in dealing with anxiety and depression.

Additional Concussions:  Studies show that individuals who have had one concussion are more likely to sustain further brain injuries. This is especially true for athletes. And with each concussion, symptoms tend to last longer.

References:

  1. Dyall SC, Michael-Titus AT. Neurological benefits of omega-3 fatty acids. Neuromolecular Med. 2008; 10(4):219:35
  1. Mills JD, Bailes JE, Sedney CL, Hutchins H, Sears B. Omega-e fatty acid supplementation and reduction of traumatic axonal injury in a rodent head injury model. J Neurosurg. 2011 Jan: 114(1):77-84.
  1. A. Ying A, Gomez-Pinilla F. Omega-3 fatty acids supplementation restores mechanisms that maintain brain homeostasis in traumatic brain injury. J Neurotrauma. 2007 Oct; 24(10):1587*95
  2. Barrett EC, McBurney MI, Ciappio ED. ω-3 fatty acid supplementation as a potential therapeutic aid for the recovery from mild traumatic brain injury/concussion. Adv Nutr. 2014;5(3):268–277. Published 2014 May 14. doi:10.3945/an.113.005280
  1. Leddy, JJJ, Kozlowski KK, Fung MM, Pendergast DRD, Willer BB. Regulatory and autoregulatory physiological dysfunction as a primary characteristic of post concussion syndrome: implications for treatment. NeuroRehabilitation. 2007 Jan 1;22(3):199-205.5
  1. Lewis M, Ghassemi P, Hibbeln J. Therapeutic use of omega-3 fatty acids in severe head trauma. The American Journal of Emergency Medicine. 2013;31(1). doi:10.1016/j.ajem.2012.05.014.
  1. Guskiewicz, Kevin M., McCrea, Michael, Marshall, Stephen W. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA concussion study. Journal of the American Medical Association. 2003;290 (19) :2549-2555

Resources

Studies that describe the use of Omega-3 to help with brain injury/recovery

  • Barrett EC, McBurney MI, Ciappio ED. ω-3 fatty acid supplementation as a potential therapeutic aid for the recovery from mild traumatic brain injury/concussion. Adv Nutr. 2014;5(3):268–277. Published 2014 May 14. doi:10.3945/an.113.005280
  • Carbone BE, Abouleish M, Watters KE, et al. Synaptic Connectivity and Cortical Maturation Are Promoted by the ω-3 Fatty Acid Docosahexaenoic Acid. Cerebral Cortex. 2019. doi:10.1093/cercor/bhz083.
  • Desale SE, Chinnathambi S. Role of dietary fatty acids in microglial polarization in Alzheimer’s disease. J Neuroinflammation. 2020;17(1):93. Published 2020 Mar 24. doi:10.1186/s12974-020-01742-3
  • Donat CK, Scott G, Gentleman SM, Sastre M. Microglial Activation in Traumatic Brain Injury. Frontiers in Aging Neuroscience. 2017;9. doi:10.3389/fnagi.2017.00208.
  • Giza CC, Hovda DA. The Neurometabolic Cascade of Concussion. J Athl Train. 2001;36(3):228–235.
  • Hrkal P. Traumatic Brain Injury: Natural Therapeutics and New Perspectives for Clinical Practice . Canadian Association of Naturopathic Doctors. Vital Link. Summer 2013:21-29
  • Lewis M, Ghassemi P, Hibbeln J. Therapeutic use of omega-3 fatty acids in severe head trauma. The American Journal of Emergency Medicine. 2013;31(1). doi:10.1016/j.ajem.2012.05.014.
  • Lewis MD. Concussions, Traumatic Brain Injury, and the Innovative Use of Omega-3s. Journal of the American College of Nutrition. 2016;35(5):469-475. doi:10.1080/07315724.2016.1150796.
  • Miller SM, Zynda AJ, Sabatino MJ, Ellis HB, Dimeff R. Docosahexaenoic Acid (Dha) For The Treatment Of Pediatric Sport-Related Concussion: Results Of A Feasibility Trial. Orthopaedic Journal of Sports Medicine. 2019;7(3_suppl). doi:10.1177/2325967119s00004.

Studies that found no adverse effects with the use of Omega-3 supplements while taking warfarin