Exercise/Sport: Hi all, Does anyone have any... - Headway


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Hi all,

Does anyone have any knowledge of returning to intense physical activity post head injury. I am 4.5months post head injury.and I feel very fortunate to still have the ability to exercise - I am managing the fatigue. Cycling, running and swimming, long and hard is my background, and I would like it to continue that way, I believe it is my personal healing place if that makes sense. However I also want to be sensible about it. Does anybody know much about HR zones, sleep recovery, HR variability and larasympathetic nervous systems, specifically towards head injury?

Thanks in advance!

20 Replies

I’m now 6 years after, took me 3 months or so before I could ride again, and 7 months or so before I could ride hard. Though probably another year or so before I was back vaguely where I had been.

In the early days I could feel that my pedalling wasn’t quite right, though admittedly was better than my walking that was a bit of zombie shuffle at times!

My vestibular system is knackered though curiously copes better MTBing or even ice skating (I kid you not) than walking down a street in low light, or buses etc.

For myself I have found that physically being tired doesn’t effect cognitive fatigue or vis versa.

Nicely put, thanks. I am particularly intrigued by the last sentence too. I am also trying to find out a bit more about the recovery. I am up to about 80% of previous, but that has been a testing experience - and recovery is certainly way longer, nearly a week before I can attempt the same effort/distance again.

Again, reading some of the articles on the forum I feel blessed to be asking these questions. Thank you.

Interesting subject. I believe exercise has really helped me.

I had a neurologist and some other specialists comment that getting sweaty 3 times a week is great for your rehabilitation, but slowly and steadily build up the amount of activities you do.

I was getting very fatigued from cognitive computer activities and it left me with out the energy to exercise.

But of course I needed the balance of all activities.

Then when the exercise stopped, my mood really dropped!

Also when I was very low, a Neuropsychology informed me that some believe that physical exercise is just as good, if not better for cognitive rehabilitation.

But I’m sure it comes back to having the right balance of both.

Exercise and sport are good for anybody’s mental health.

It’s definitely helped me with sleep.

I use a watch that shows my HR.

I’m not sure about the larasympathetic nervous systems (or what that word means?)

Sounds like you’re into triathlon?

Plenty in reply to Plenty

Parasympathetic nervous system, possibly.

Plenty in reply to Plenty

Runner’s world article


Warmbeetroot in reply to Plenty

I forgot to add, yes triathlons currently. History was other Sports, but now it's tri and coaching in all sports and endurance events. So income kind of relies on physical activity too, which is an added 'pressure' as such

Warmbeetroot in reply to Plenty

Hi Plenty,

Thanks for the reply, some great points there. Yes a typo there. Parasympathetic. It's the bodies recovery/resting system (as opposed to the automic nervous system which is our fight or flight). I have tracked Heart Rate Variability since the bike accident and head injury - this shows your parasympathetic nervous systems capabilities and it has been all at sorts.

Definitely an interesting topic. Without doubt, the place I have healed the most, physically and certainly mentally is back on the bike. But without finding much guidance it has been a little explorative on effort, therefore bombed for a week if went too far. The difficulty is knowing because at the time of activity, everything feels ok. It's the body's response and the recovery - particularly fatigue. Would love some guidance on HR zones and durations but as with everything head related, perhaps it's individual.


hello, my injury was a result of an accident while I was on my road bike. I had multiple injuries including skull fractures and 48 hours of amnesia. My bike was a part of my recovery being able to aid rehab to my badly broken leg on the turbo. My accident was almost three years ago and I still suffer with mental / cognitive fatigue and difficulties with noise, memory and sustained conversation. My bike is still my happy place. However, i am not back to the level that I was (150 miles a week). Through trial and error I have found a level that suits me. I find group rides harder because of the concentration required following the wheel in front and the need to be sociable and talk. I do use the Wattbike in the gym but find sessions on consecutive days difficult. I am still to my surprise able to give blood and that has no bearing on my fatigue. My advice is the usual with exercise - check with your GP and then build up gradually and see what works for you. All head injuries are different. Listen to your body.

Warmbeetroot in reply to Binjour

Thanks Binjour, some similarities there but huge congrats on your recovery from that. Trial and error for sure, just hard to tell at the time of activity. As with my previous replies, the recovery is different. I am the same, a hard Watt bike won't happen again for a week or so. Recovery rides in the interim. What's the damage done when stretching too far? Or is it just a delayed exaggerated recovery? As for groups rides I understand what you mean. I've currently only been going out with one other (just in case something happened), who knows my riding.

Cheers again for the reply.

Binjour in reply to Warmbeetroot

I have found 30 -40 miles for a ride is my max. If I push it to 50 + it’s too much. My other rides I am either 30 mins wattbike or short rides / commutes. After a 30 miles ride I am usually invigorated and have more energy any more and it’s off to bed! I don’t expect that there is much knowledge or research in this area. I think it’s probably delayed recovery if your push it and maybe impaired ability to improve cv fitness, muscle and endurance. Your body is clever and will direct energy to the brain rather than other areas hence as others have commented the need for balance.

Warmbeetroot in reply to Binjour

Interesting last sentence - anywhere I can read up on this?

Thanks. Sounds like you're doing great. My issue is my income has always relied on physical activity and related coaching, so I have that angle to balance too 🙈

I've read the 11 replies below. No-one has mentioned adaptogens which facilitate faster recovery or can mitigate the dip response after excessive output (stress response/ adrenal scraping the bottom). Does what it says on the tin, adapt.

This article is useful


Also I have a bag of Pure liquorice with me always for this purpose. Henry Goode's Soft Eating Liquorice 200G sold in Waitrose and various other supermarkets is a great one I use as it has iron in it. I use it for when I'm feeling a dull head coming on. Like you notice, oh I've had a long day, I've done too much, or I've done something new which was challenging i.e. cognitive development. That might be doing a personal best in sports or testing new environments with excessive noise where you know noise is going to be a problem. For me, I take 2 every 3 hours until I start to 'normalise' and reach balance homeostasis (feel normal). This works for me. After sport of long distance cycles, you might decide to take one or two on arrival at home, then check after an hour, then space it out to every 3 hours.

I would be guessing when I say after excessive output, the brain chemistry tries to activate, blend and release as normal the chemical pathways to bring homeostasis to the whole system using the pituitary, (related helpers - pineal (light) and hypothalamus (heat)) , but when it reaches into the regular places to complete the task (blood clean, turn down the lights it bedtime, feels cold warm up, get ready to eat, more requirement for energy) the support mechanisms simply are spent, they aren't there. Your brain may talk to you and tell you by way of brain fog, body fatigue or headache.

(Just as a side - Amitriptyline, a commonly prescribed antidepressant, can induce CoQ10 deficiency in patients with depressive episodes) .

Co Q10 sometimes described as an ‘energy spark plug’ because of the vital role it plays in the body. It drives the conversion of glucose into energy, which we use to power our metabolism and muscles – the most important being our heart.

This is when the adaptogens are fantastic. Tinctures of Rhodiola Rosea, Astralagus, Liquorice Root, Ashwaganda, and others worked wonders for me about 5 years ago. PM me if you are interested in a medical formulation which provides the right kick. The shop bought Rhodiola Root by Natures Best at Planet Organic is good but not as strong as the medical formulation I've used. Every three hours I would sit at the kitchen table with my bottles of adaptogens and a pint of water and place 10 drops of each under my tongue, hold for 10 seconds to allow receptors under tongue to send messages to the brain. Some tasted very strong but not unpleasant so I would gulp water with them. It may be that using all of the bottles in an intense way for a period of about 3-4 weeks to finish the bottles, re-trained my homeostatic regulation response. I used to get a whole body shut down dip after doing a walk of over 12 miles.

Also worth reading about the role of the vagus nerve in recovery times. If you want to retrain the body's glucose release to perform properly, the last thing you should be doing after a long cycle or excessive sport output is piling in white sugar in tea or orange juice or sugary chocolate. The oats or pasta should have been eaten 2 hours before exercise. After exercise, eat only fresh fruit if you need a sugar hit, and adaptogens. The body will learn in absence, it needs to start functioning again. Should probably leave proper eating until at least 2 hours after overdoing exercise as digestion needs to be shut down in order to complete homeostasis rebalance. If you start to eat, you will create further fatigue and steal resources from rebalancing which will add a new tiredness, reduced digestion of the food you do eat and obstruct proper nutrition absorption. Your brain is in your digestive function!

Heart Rate Variability - I have one at home, I used it to monitor my stress response. I have a device that modulates HRV which increases resilience to stress. PM me for more details.

Have I answered some of your questions Warmbeetroot?

This is a fantastic reply, thank you. Wow.

I take COQ10 (Not on anti-depressants) and Ashwaganda but will look at Adaptogens link - thank you so much. And definitely getting liquorice. Strangely had a craving for that stuff, how crazy!!

I love the input about the homeostasis rebalance after - and not consuming food after. That's interesting. I usually ride fasted just to use fat for fuel, and diet is traditionally keto (although not strict currently) - I was reading about fasting and keto / high fat foods being great for brain health too, is this something you have knowledge of?

I have little knowledge of Tincturea, but very interested in learning more. Will PM.

Thanks again!

You are welcome! If you ride fasted, then perhaps experiment with building fat reserves for longer output or changing the time between last eat and ride. The BI will have an impact but it is my experience that it can be retrained using a gentle approach, recording activity, response, sleep length, diet etc. You can work out the new you. And this new you changes as time goes on so prepare for BI healing to create pockets of 2-3 weeks of intense healing then normalises and so it goes on! It is a game of adjustment to retrain the brain.

Yes I've used intermittent fasting for over 20 years. Before my BI it was sporadic, maybe once or twice per year. These days its every 2-3 months for 5-7 days.

To facilitate brain healing, reducing intake to just vegetable juices (80% veg, 20% fruit) for 21 days was my longest fast. It allowed the digestive action and liver to take a rest, thus allowing the brain to explore more healing pathways. It allows intestines a good clean (if you use psyllium husks during juice fast - this scratches the inner walls removing any dead attached meat and other unwanted debris) thus improving digestive performance once back on food. It was out of desperation as I found my recovery had slowed down and I used this as a way to reignite progress. Also take chlorella, spirulina and shilajit either in a ginger juice shot first thing in the morning or stirred into the juice during these fasts which boosts internal body to PH7 - alkaline and nutrition.

I've heard good things about the keto diet in relation to healing a BI. Did you try it for a week and keep a diary to see if it works for you?

Nowadays I generally stop eating meat/fish and go vegan about 3 days before a juice fast to ease the body into it gently. It's just the way they used to run juice fasts back in the day, so I keep to it. I remain vegan and mostly without fat / oil / salt during the juicing to give intestines and liver and gall bladder a break. Or what I also do as a half fast is - juicing morning, lunch and tea, and eating a soup or salad in the evening. Rarely meat and veg aka keto. I can fast for longer this way and still enter ketosis (body burns fat naturally) and digestion gets a break.

Your craving for liquorice doesn't surprise me. Glad you listened to what your body is asking for ! I've got used to listening to what my brain wants to heal rather than eating habitual diets. I look up the food after eating it, to see what benefits that particular food offers the body and it often correlates to combat existing ailments. Listen, Trust, Recover. That's my motto.

Ride the Mare steady as my grandmother would say.

Feebie8 in reply to RecoveringH

I used to be able to fast easily before I hit my head. I now find to avoid intense brain pain 🙄 I can only fast after eating breakfast and lunch...hey ho it's something! Had to also change from hemp protein to just a vegan one because I cannot stomach hemp protein any more 🤢

After having an intense sugar addiction for around six months after hitting my head and not being able to train 😑 (apparently even walking causes my brain problems due to my inability to now multitask using/coordinating my eyes and body at the same time - so CrossFit is a discombobulated and painful mess) I need all the fasting I can do 🤣😉

Warmbeetroot in reply to Feebie8

Interesting what you say about sugar. I have struggled at times for sure with this. What I am struggling to know is, is it a new addiction or just a new inability to control the already existant addiction, if you know what I mean.

Feebie8 in reply to RecoveringH

When my brain is more "here" I need to read your response a million times 🤣 great info that I need to learn and adapt! My brain has just went off for a rest, I'm looking out from an empty cave again!

RecoveringH in reply to Feebie8

If its any consolation, I can relate to your comment very well. :) Best wishes.

KETO Diet... boost brain health... sounds great.

How does it affect your energy for sport? Running or cycling?

As a lot of people do carb loading for endurance events.

Warmbeetroot in reply to Plenty

I am not qualified or knowledgable enough to go into depth on it, but it feels good for me, on many fronts. Experts listed below!

Historically I used it for to access body fat for fuel on long distance. Ketones instead of glucose. Anything longer than a couple hours, keeping the HR below 155. I just felt good for it, and it worked. I am high in veg (which have carbs) and I source good meat and also supplement with a good quality amino acid plant based protein - this supposedly helps (I am no expert, but very body aware and tend to go off that). If I ever was to ever carb load, it's late at night Quinoa/millet so by the time I wake it would be Ketosis again. I eat lots and lots of fatty foods, avos, nuts, fish etc

Since brain injury, I am unsure if I have felt good due to Keto or fasting. Perhaps both. Always keen to learn more.

I am sure there are many but the experts in the field that I follow are Ben Greenfield, Dr Axe, Wellness Mama, and Dr Mercola. Podcasts whilst on the Watt Bike haha

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