Exercise after brain injury

Many people may be nervous to try exercising after brain injury in case they make their symptoms worse. But when you start slowly, complete your exercises safely and listen to your body, it can have a lot of benefits for your brain health. This is the reason many health professionals make recommendations for physical activity as part of a brain injury recovery plan.

Please note: You should always consult with your doctor or primary care physician about what exercises are appropriate for you. Not all exercises or exercise programs will be safe or effective for you.

The benefits of exercise after brain injury

Improved mood

Regular exercise that increases the heart rate can cause the release of serotonin and dopamine, which help alleviate feelings of depression [1]. Endorphins from exercises are also associated with improved mood [2]. This means that exercise can actually help make you feel happier.

Support for brain healing & function

Studies into the effects of exercise on brain injury survivors have shown that individuals with traumatic brain injury (TBI) who exercised, had fewer cognitive, physical, and emotional symptoms [3]. Additional reviews of existing studies demonstrated that physical exercise also has a positive effect on cognitive functioning [4] [5]. This includes thought processing and memory. According to research [6], the physiological factors of exercise that contribute to improvements in cognition include:

• Increased blood flow to the brain
• Changes in the brain involved in cognitive behaviour

Support for bodily health & well-being

The main purpose of exercise for the majority of people is to improve their physical health. Different types of exercises can strengthen the heart, lungs, and muscles. It’s an essential building block for a healthy lifestyle.

Exercise comes in many forms – you don’t have to be at the gym to be healthy, and you don’t have to exercise for hours at a time. The health benefits come from being consistently active in your day to day life to the best of your ability. Walking or stretching can be as beneficial as strenuous activities: it’s all dependent on what your body is able to do and what it needs.

• Physical activities tracker

The challenges of exercising after a brain injury

After a brain injury, you may face some challenges when it comes to exercise:

• Changes in physical capacity and mobility
• A lack of motivation, interest or energy
• Symptoms such as fatigue and headaches that may impact your abilities
• A lack of access to appropriate physical rehabilitation, exercise space or appropriate equipment
• Not enough support

While these definitely are challenges, that does not mean it’s impossible for you to exercise and receive the benefits. It just means that you may have to get creative.

Physical rehabilitation

Physical rehabilitation (physiotherapy) is one of the most common therapies for people of all abilities. It can be helpful for people with brain injury who are experiencing challenges with mobility, strength, balance, and cardiovascular fitness. A physiotherapist will perform an assessment and work directly with you to develop a treatment plan based on your challenges and your goals. The treatment plan will largely consist of exercises or physical motions that will be modified to your needs so that you can replicate them at home. It may be recommended that you continue the exercises at home to the best of your ability either on your own or under someone else’s guidance.

There are both private and public physiotherapy practices, and you may be covered for some of the costs through your provincial/territorial insurance plan, a private insurance plan, or an auto insurance plan (depending on the cause of your injury and type of coverage).

Types of exercises

Aerobic exercise

Aerobic exercise can also be known as cardio: in other words, any type of exercise that strengthens the cardiovascular system (your heart and lungs) [7]. Types of aerobic exercises include walking, running, cycling, or swimming. Aerobic exercises are meant to increase your heart rate, and are done for longer periods of time on a consistent basis.

A 12-week study on the effects of aerobic exercise on depression symptoms in those with traumatic brain injury (TBI) found that participants had higher self-esteem, improved cardiovascular function, and fewer symptoms of depression [8].

Aerobic exercise is often connected to a healthier heart, but it has tremendous effects on body and brain health as well. Check with your doctor to make sure you understand what you are able to do safely for exercise. You may not be able to go for a run, but you could go for a walk.

If you need some extra support for your aerobic exercise, there are assistive mobility devices that may be helpful.

Strength & conditioning exercise

For individuals with muscle weakness, strength and conditioning exercises after brain injury can be incredibly beneficial. Types of exercises that can help with strength and conditioning include resistance training, which can include using body weight or using free weights.

The key to strength and endurance training is patience. You don’t want to push yourself too hard or too quickly. Working with a physiotherapist or occupational therapist on a recovery program can be beneficial and help you progress safely.

Range of motion exercise

Range of motion (ROM) exercises can also be called flexibility and mobility exercises. Depending on the physical effects of your injury, you may be experiencing problems with your muscles or joint tightness. The purpose of ROM exercises is to help increase muscle flexibility and joint mobility. With time and patience, these types of exercises can help you move more easily (such as lifting your arms or bending your legs).

Balance exercise

Many individuals struggle with balance after brain injury. Balance is the ability to keep yourself centered.  Specific exercises can help you work on your balance and make you feel steadier as you move through your day.

• More tips on coping with changes in balance

Remember – any exercise is a gradual process. You may be feeling good one day, and not as great the next. And that is totally normal – the important thing is to take it slow and not get discouraged.