The normal, healthy brain uses about 20% of your calories to function before you get up and move!  So, you have to understand that the injured brain will take a LOT of your energy, leaving you feeling chronically fatigued.  However, you don’t need to suffer chronic fatigue or a brain injury to struggle with brain fog, memory issues, insomnia, low moods or any other host of symptoms.

The below sets out the stages in which someone with fatigue issues should return to physical activity, always respect your body’s limits.  Never perform above 80% of how you feel and always allow enough reserves for the rest of your day, plus the unexpected.  Start with maybe 5 minutes and very gradually build up the time and intensity. Even without a brain injury this is a great way to get back into shape and being considerate of your wellbeing.

  1. Mindfulness
  2. Balance and co-ordination issues
  3. Mobility
  4. Strength and flexibility
  5. Endurance
  6. High level training


Why train in this order?


The first step to physical activity is to deal with basic needs of your brain – it needs to learn to chill out before it will let any of your body demand lots of energy away from its busy brain repairing.  There is growing evidence of how mindfulness helps people and there are plenty of resources and courses available both online and face-to-face.  Mindfulness can help you learn to feel your body’s physical wellbeing – what energy you have & how you should move your body.  It can also aid pain relief with enough training, manage emotional instability (anxiety, stress & depression) and improve cognitive function (attention through presence).

Balance and Co-ordination

A common symptom of a mild TBI is balance problems.  I think I have more scars from walking into things than from actually falling down the stairs in the first place!  This is a MUST if you’re going to get back out on the world and try any physical exercise or not.  You need to not be falling over to prevent further injuries to yourself, including further head injury.  With simple balance exercises you can do in the home you can train yourself to begin to make bigger movements.


You’re probably super stiff from lots of ‘rest’ time & that leads to back problems, leg problems etc.  You need to move!  Human bodies are made to move & you sit still for too long then all the joints seize up and you feel stiff.  I will post some gentle mobility exercises that you can do in the safety of your own home to ease back pain.  This provides a controlled environment and enough movement in your joints to then add-on more physical exercise.

Strength & Flexibility

You need to be strong and flexible enough to move about whilst reducing the risk of further injury to yourself.  This doesn’t mean becoming a yogi or getting your legs around your ears, but your body will need some re-introduction to both after lots of rest time.


Once you’ve managed to do some balance, mobility, strength & flexibility training at home for 40 minutes, you can really start to build endurance.  This doesn’t mean a high energy aerobics class, but try to make sure that you can exercise for a solid 60-75 minutes at a low-moderate intensity before you try to really increase training.  At this stage you really have to deploy mindfulness skills to make sure you don’t become over-excited and exhaust yourself.  The endurance activities can vary to use all the skills your building and shouldn’t just be 60 minutes of cardio vascular workout.

High Intensity Workouts

You may never have trained like this anyway, but maybe you want to get back to 12 minute High Intensity Interval Training (HIIT) workouts like Jillian Michaels offers so you don’t have to make too much time for exercise.  HIIT is the most exhausting for the brain & should be delayed until you’re pretty high functioning.  This is due to the combination in muscle use of this type of exercise – both cardio and strength training – and happens for threefold reasons:

(a)  The phosphocreatine anaerobic system (cardio vascular training) takes energy stored in your muscles to pay for the energy spent on moving and creates an oxygen debt in the body.  The brain will feel this depletion as the lower oxygen levels fail to help your brain function and new oxygen is sent to your muscles to recover – so your symptoms will worsen during and after this activity.

(b) This training relies on large muscles working quickly which requires the brain to send faster messages to your muscles to work (frequency of nerve impulses), plus it has to recruit more motor units (trigger between brain & muscles) to make larger muscles work, requiring  more messages from the brain to fire more motor units.

(c) The fast muscle movement trains ‘fast twitch muscle fibres’ that need a higher brain nerve stimulation to activate the muscles into action, meaning more energy is taken from your brain.

If you think that the brain has more work from (b) and (c) but less oxygen due to (a), then you can see that HIIT is the worst form of exercise with a brain injury.


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