Is Systemic Inflammation Driving Your Concussion Symptoms?

Let’s talk about your body’s immune system and healing responses that occur with any injury, including concussion. When you sustain an injury, your body will heal itself more times than not. Healing is 4 step process: Homeostasis, Inflammatory, Proliferation, and Maturation. 

When discussing wounds sustained on the surface, Homeostasis is the forming of a blood clot to stop the bleeding. Next is the inflammatory stage where your body’s immune system cells will come in and clean out the old and start building new (where the scab forms). The initial inflammatory stage takes about 2-6 days to complete when undisrupted. Next stage is Proliferation. This is where your body starts to rebuild the damaged tissue and this lasts up to several weeks (4-24 days) depending on the severity of damage. Finally, is the maturation stage. Here the new rebuilt tissue starts to reorganize and strengthen (scar tissue develops) and this can last anywhere between 21 days to 2 years in some cases.  

These are generally the same stages that occur with mild traumatic brain injury, mTBI (concussion). However, there are some cases where you get stuck in the inflammatory phase. 

In acute mTBI, immune cells in the brain (microglia) are primed and trigger the inflammation process following mechanical injury (quick acceleration-deceleration of the brain in the skull resulting in stretching and shearing of neurons). Secondarily, the neurotrauma causes your gut’s (intestinal) permeability to be increased. This means ions and bacteria are more easily crossing the barrier of the gut lining. This alters your gut’s microbiota (good bacteria in GI tract). In response, your body’s immune system is further triggered to go into hyperdrive. As a result, pro-inflammatory markers influence your central nervous system to continue the inflammation process. Your brain’s blood brain barrier (BBB) also has increased permeability allowing cells and ions to more easily cross this barrier. This phenomenon is referred to as “leaky gut” and “leaky brain” syndrome and this is what drives chronic systemic inflammation to persist. 

This increased inflammation can contribute to increased symptoms following concussion or other injuries as well. So how do we combat this? Diet and exercise of course!!!

Muscles are like your body’s pumps to aide circulation of blood and oxygen. That’s why when you have swelling in your feet and legs, it is advised to perform ankle pumps and elevate your leg to help flush out the swelling quicker. Therefore, the best treatment to recover from injury is progressive exercise. Movement Cures!!!

Getting started can seem daunting and dangerous to some especially dealing with injuries most healthcare professionals don’t even understand. It has been long advised by doctors that you should rest until all your symptoms have subsided following concussion. That is WRONG! This can significantly delay your recovery, make you deconditioned causing more weakness, stiffness, and increased sensitivity to normal stimulus. It has even been declared that rest beyond 48 hours will delay recovery post-concussion. It is actually much more beneficial to slowly expose yourself to cognitive and physical activity as tolerated and progress over time as your body can tolerate. So how do I get started?

Seeing a trained healthcare professional well versed in treating people with concussion as soon as possible, even the same day as the injury occurred. Early intervention and education has been proven to significantly speed recovery. There is no medication proven to help reduce symptoms or improve function following concussion the way exercise and diet modifications has been proven to do. Developing a plan is key to navigating through these injuries that can seem scary and confusing. Keep it simple: start with light walking, light cognitive and work activities as tolerated, and diet modifications are key!

An anti-inflammatory and neuro-protective diet can significantly reduce lingering symptoms, improve cognitive and physical function, and mitigate the risk of developing a chronic condition. These diet modifications can also help reduce pain and inflammation following bodily injury as well. If you have suffered an injury that just seems to never go away or are experiencing aches and pain all over, feeling sluggish, trouble concentrating in general, or just feel your body isn’t quite functioning as optimally as possible, these diet suggestions can change the game!!

So, let’s start with what you should avoid. 

  • Processed foods
  • Dairy
  • High sugar content
  • Refined carbs
  • Heavy red meat and pork
  • Alcohol 

These can increase your body’s systemic inflammation, making you feel less than great. Avoiding these types of foods and beverage can help reduce your body’s inflammation. 

General recommendations of foods you want to include in your daily diet are as follows: 

  • Lean organic protein (fish, chicken)
  • Ancient grains (cous-cous, quinoa, chia)
  • Anti-oxidants (berries, glass of wine)
  • Dark green salads, avocados, and other vegetables 
  • Fish oil (Omega-3’s)
  • Supplements such as:
    • Turmeric
    • Creatine
    • Melatonin 

These are some general recommendations to get you started. For more information or an individualized program, well… you got to come in and see us for that! 

So, if you feel you are doing everything right with your rehab or training programs, but just can’t seem to get over the hump and fell 100%, give these things a try! 

“It is much more important to know what sort of person has a disease, than what sort of disease a person has” -Sir William Osler 

– Dr. Kirk Ramirez, PT, DPT

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