CrossFit After Concussion
CrossFit & Concussion
CrossFit is a high-intensity fitness regimen known for its diverse and challenging workouts. For athletes recovering from a concussion, returning to such an intense activity can be daunting. However, with the right mindset and modifications, CrossFit can be harnessed to promote positive physiologic adaptations, enhance your recovery and rewire your brain for high performance. Understanding the link between concussion and exercise, knowing how to scale workouts, setting appropriate parameters, and optimizing sleep & diet can make this transition smoother and safer.
The Link Between Concussion and Exercise
Exercise can be challenging after a concussion due to your recovering brain's difficulty in regulating your autonomic nervous system. This system controls physiologic responses such as heart rate, blood pressure, breathing rate, and blood flow to the brain. Normally, the autonomic system operates seamlessly in the background, matching these responses to your physical workload very accurately. This accuracy prevents feelings of dizziness, lightheadedness, or headaches (except at extreme intensities, like during the last reps of Grace or Fran).
When you challenge your body with heavier loads and higher intensities post-concussion, your brain struggles to keep up. The good news is that exercise can be incredibly beneficial for your brain. Research shows that controlled, moderate exercise can speed up concussion recovery. One of the ways it does this is by integrating your nervous system and circulatory system more intimately (a phenomenon called neurovascular coupling), which creates a more accurate response to exercise and stress. It also promotes neuroplasticity, which helps the brain repair itself more efficiently. Exercise helps to rewire your brain to function well under any stress or demand you place upon it.
After a concussion, the key is to find the "Goldilocks zone" of exercise—not too much, which can worsen symptoms and prolong recovery, but not too little, which won't encourage positive change.
How can you scale and modify your CrossFit workouts to hit that sweet spot?
Workout Scaling Options
Scaling workouts is key for athletes to nurture recovery while also promoting positive physiologic adaptations. Here are some effective scaling options:
Reduce Intensity: Lower the weight and intensity of the workouts. Focus on form and technique rather than speed or load.
Modify Movements: Substitute high-impact exercises with low-impact alternatives. For instance, swap box jumps with step-ups or running with biking.
Shorten Workouts: Cut down the duration of workouts. Aim for shorter sessions and build up duration as you recover.
Increase Rest Periods: Allow for longer rest periods between sets and exercises to give the body ample time to recover.
Setting Workout Parameters
When returning to CrossFit post-concussion, it’s valuable to set appropriate parameters:
Start Light: Begin with light aerobic exercises such as walking or stationary cycling. Gradually increase the duration first. Once you can handle 40 minutes of light aerobic exercise, work to vary your exercise selection and increase the intensity.
Monitor Symptoms: Keep a close eye on symptoms such as headaches, dizziness, lightheadedness or nausea. A “gentle” symptom response is okay - you’re challenging your threshold. If symptoms worsen by 3 points (on a 0-10 scale), take a break. If you’re not recovered within 5 minutes of taking a break, call it a day. This is where it’s valuable to…
Have a Backup Plan: Life immediately after a concussion is a lot like life in general: you’ll have days where you feel pretty good and other days where you feel not-so-good. For every workout, have a backup plan. My favorite backup plan? The bike. If you’re getting into a workout and you’re feeling “off” or your symptoms are flaring, transition to an easy pedal for the rest of the workout. Consistency is more important than winning every workout!
Follow a Progressive Plan: Increase the difficulty of workouts gradually. If you attend a box that has solid programming options, from RX to Scaled to Beginner, choose the Beginner level. A good rule is to complete five workouts before increasing the intensity. Be patient and make progress incrementally!
Seek Professional Guidance: Work with a physical therapist or healthcare professional specializing in concussion management to develop a personalized return-to-exercise plan and to evaluate for visual, vestibular or cervical issues that are contributing to your symptom profile.
Nailing The Basics: Sleep, Hydration & Nutrition for Concussion Recovery
As in life, sleep, hydration and nutrition are vital components of your health. These, plus exercise, are the foundations - and they’re especially important after a head injury.
Sleep: Sleep is your brain’s best friend! Your glymphatic system clears toxins and post-injury debris from your brain, and it only clocks in to work when you sleep. You know the rules: cool, dark and quiet. Get your 7-10 hours of sleep per night. Stick to a schedule, going to bed and waking at similar times. Take your naps.
Hydration: Kick off your day with a glass of water. Aim for consistent hydration throughout the day. Start with 0.5-1.0 ounces of water per pound of body weight and adjust as needed. Take an electrolyte supplement, especially on exercise days.
Nutrition: Eat clean. Fill your plate with antioxidant-rich foods. Consider magnesium (L-threonate is the form most commonly used in research) and creatine supplementation. Consider taking a fish oil supplement or increasing the dosage if it’s already part of your routine. Avoid alcohol and limit caffeine early in recovery.
Conclusion
Returning to CrossFit after a concussion requires planning and careful consideration. Exercise is one major piece of the puzzle, but often not the only piece - it’s valuable to see a concussion specialist to create a personalized and well-rounded recovery program. However, by understanding the link between concussion and exercise, scaling workouts appropriately, setting thoughtful workout parameters, and optimizing sleep, nutrition & hydration, athletes can resume their fitness journey in a way that nurtures, and even enhances, concussion recovery.
About the Author
Joe Burkeland is a Doctor of Physical Therapy and CrossFit Level 1 Trainer at CrossFit Evolve in Fort Collins, Colorado. He owns Complete Concussion Care, a therapy business that specializes in helping humans bounce back from concussions - from recovery to resiliency. For more information, visit www.concussion.care, send an email to joe@concussion.care or find him on the socials at @completeconcussioncare.
