Gently Healing Your Brain: Yoga for Concussions
If I was to rename this category of head injury I would call it Unreliable Brain Syndrome because after a concussion, your brain needs to be tested over and over again in many different kinds of scenarios to see how you respond to different types of stress. But I want to emphasize: it is not your fault your brain is unreliable. This is simply the new reality of living with Post Concussion Syndrome.
In the first years after injury, you must self-monitor continually to manage flare ups. You may find you need a new skillset: how to self-assess, how to interpret our findings, and how to reduce your symptoms. This is the basis for my Yoga for Concussions approach, which centres accessibility, authenticity, and inquiry. I provide opportunities and options so you can practice body autonomy and personal choice via self-assessment and curiosity. I apply best practices of yoga for concussions along with my neurorehabilitation training from Brock University and the Ontario Brain Injury Association. If you are a Type A person who craves challenges and leans into chaos, your brain likely needs gentle healing. In my experience with three concussions, the harder I tried to get better, the worse I got. When I found ways to calm my nervous system, I was able to begin truly healing.
What is Yoga for Concussions and how does it specifically support brain health?
Why is yoga – which includes mindfulness, movement & breathing – an effective healing tool? Yoga is an ancient wellness system which has been brought to the West by a golden thread of teachers over thousands of years. Originating in India as a holistic approach to wellbeing, many of the aspects of yoga - mindfulness, gentle movement, and attention to the breath - lend themselves particularly well to support the healing of an injured brain. This is backed by new evidence and scientific research documenting the positive effects of yoga for brain injury conducted both within the neuroscience and yoga communities.
What is a Concussion?
A concussion is a jolt to the brain. First used around 1400, the word concussion originates from the Latin concussio, which means “to strike together” or "to shake violently." You don’t need to hit your head to experience a concussion.
When the brain is shaken, it bashes against the sides of the skull. This often bruises the brain and causes diffuse axonal shearing, a fancy way of saying widespread torn brain tissue at a cellular level.
Your brain is jelly-like and fatty, like soft butter, which makes it vulnerable. And the skeletal structure that it sits on at the base of the skull is like a bed of nails. There are pits and valleys and holes at the bottom of the interior of your skull that the brain rests on. So when your head is shaken, your brain gets raked across this bed of nails, tearing your brain tissue at a cellular level.
This very area at the base of the brain that so often gets damaged is the area responsible for our “personhood” or our own sense of self. Bewilderment, loss of identity, and related depression and anxiety is actually typical when the site of damage includes this vulnerable, soft area.
How does yoga help concussion symptoms?
To explain this, we have to first appreciate how your brain functions as a networked system. After a concussion, sheared neurons never entirely reconnect. This sounds terrifying but only if we don’t consider that your brain is plastic, meaning it is always changing in response to novel input, the same input, or a lack of input. Your brain finds ways to make new connections through detours in the brain. In particular, positive neuroplasticity is built into the practices of yoga. Yoga helps with concussion syndrome because it is:
a vast, potentially lifelong practice with endless learning opportunities.
a simple way to access the breath, the only autonomic function of our bodies we have control over. Breath control is our always available tool to calm our fight or flight response and settle into the calmer state of rest, digest, play. It helps us move from an activated sympathetic nervous system to a parasympathetic nervous system.
a mindful state. Meditation (a form of mindfulness) is scientifically proven to thicken the prefrontal cortex which is our centre of attention, impulse inhibition, memory, and cognitive flexibility.
a gentle physical activity that has all the other brain benefits of exercise. It boosts neurochemicals that promote brain cell repair and increases blood flow to the brain which prompts growth of new blood vessels. Some gradual increase in blood flow is good. Too much can increase symptoms.
incredibly accessible to all kinds of people and bodies.
What style of yoga is best for someone suffering from concussion?
Depending on a number of factors, you may have symptoms that appear days, weeks, months, or even years after the initial jolt. Your symptoms may fluctuate over time, even from minute to minute. So here are some questions to consider as you decide what style of yoga that you want to try:
Are you symptomatic right now? If so, less is more. Sitting quietly and breathing slowly through your nose might be the best yoga for you.
Do you get dizzy easily? If so, you will probably feel worse practicing traditional vinyasa which involves quickly taking your head to extremes like going from a forward fold to standing straight up. Vinyasa is a popular form of yoga where you flow from one pose to the next including transitions where the head is well below the heart, then immediately brought back up above the heart. For people with brain injuries, rapidly shifting the direction of blood flow to the brain can be incredibly disorienting and cause vertigo or fainting.
Are you having trouble leaving the house (for any reason)? If so, finding a gentle class you can do virtually or a pre-recorded video will help you to practice without having to drive somewhere, face a group of people, or navigate a new environment while you are recovering. Pro Tip: A good yoga instructor’s cues will be so clear you don’t need to look at the screen and instead rest your eyes and simply listen.
No Symptoms to Mild Symptoms (pain is 0 - 3 on pain scale of 0 - 10)
Perhaps you want to try one or two poses to see how it feels and your body responds. But traditional up/down yoga flow is too fast for TBI folks and the postures cause blood pressure changes in your head that can exacerbate symptoms like dizziness and headache.
In this situation, you can use physical support, pauses, and your gaze to manage blood flow with intention and check ins to see how your system responds. Here is a free 24 minute video you can experiment with. You will need a wall close by and a chair or yoga blocks for support. A cushion and blanket is also good to have on hand so you can get cozy. Give yourself time after practicing these movements to calm your nervous system.
Symptomatic (pain is 4 - 7 on pain scale of 0 - 10)
If you are experiencing moderate symptoms, you can try some closed monitoring meditation where you direct your focus to one thing, rather than open monitoring meditation, where you notice everything without reacting. Closed monitoring is less likely to increase symptoms like anxiety. Finding a comfortable seated shape first will be key to this practice. If you feel dizzy, you can keep your eyes open and cast your gaze downward so your eyes are relaxed.
Highly Symptomatic (pain is 8 - 10 on pain scale of 0 - 10)
Is it safe to practice Yoga for Concussions when highly symptomatic or experiencing a flare up? Yes! A good bet for anyone who is experiencing symptoms is my free video on Youtube, Legs on the Chair (10 minutes). This practice involves only the resting pose found at the end of the longer video linked above, for when you need to manage your symptoms.
Legs on the Chair is a special restorative pose that positions your femur bones so they can relax back into your hip joints. If you need to find space in your chest and shoulders, relax your spine, reset your pelvis after sitting too long, or soothe achy legs or swollen feet, this pose is also for you because it acts as a full body reset.
And if legs on the chair is too much, you can take Constructive Rest Pose: lie on your back with the soles of your feet on the floor, knees pointing up to the sky. Loop a strap above your knees so your legs can fully relax and use cushions and blankets to get comfortable. If I was to rename this category of head injury I would call it Unreliable Brain Syndrome because our brains need to be tested over and over again in many different kinds of scenarios to see how you respond to different types of stress. In the first years after injury, we must self-monitor continually to manage flare ups. We need a new skillset: how to self-assess, how to interpret our findings, and how to reduce our symptoms. This is the basis for my Yoga for Concussions approach.