Concussion 101: More Than Rest
Every weekend, thousands of athletes sustain concussions. From soccer players heading balls to trail runners taking unexpected falls, it's estimated that one in five high school athletes will experience a concussion during their playing career.
What many don't realize is that a concussion is more than a bruise to your brain. Instead, the impact to the head triggers a complex energy crisis deep within the brain.
A concussion is a form of mild traumatic brain injury, and there's a whole energy crisis taking place that explains why either "toughing it out" or aiming for complete rest actually slows your return to the field.
Energy and the Brain
The brain is a very energy-hungry organ. It makes up only about two percent of our body weight, but consumes around twenty percent of the body's total energy at rest. In adults, this works out to approximately twenty watts of continuous power, which is comparable to a dim light bulb. Most of this energy isn't used for "thinking hard" but for basic maintenance and signalling, keeping the brain's circuits ready for use.
So what happens when we injure this energy-demanding organ? Let's look at what happens in your brain after that big hit against the boards or that fall during your long run.
The First 48 Hours: When Your Brain Goes into Crisis Mode
When a concussion occurs, the initial impact mechanically stretches neurons, which are the special cells in the brain responsible for transferring information through electrical and chemical signals. This stretch causes a chemical imbalance inside the cell and triggers an uncontrolled electrical surge in the area. That surge quickly sets off a domino effect in surrounding neurons and other cells as excitatory neurotransmitters are released.
Think of it like an electrical circuit that suddenly sparks and overloads. Your brain then scrambles to restore balance, but doing so requires massive amounts of energy. The electrical surge consumes ATP (the body's main energy source) at an incredible rate to return neurons to their resting state. In other words, there's a sudden increase in demand for fuel immediately after the concussion.
Here's where things get complicated: shortly after impact, blood flow to the brain actually decreases by 20 to 30%. This makes it harder to deliver the oxygen and glucose needed to fuel an already energy-deprived brain. The demand for energy skyrockets to restore balance and repair damage, while blood flow and fuel supply plummet. Experts call this an "energy crisis."
This mismatch explains why you might feel fine immediately after impact but develop symptoms hours later. It also explains why pushing through symptoms, something many athletes are tempted to do, actually makes things worse.
What This Feels Like for Athletes
This energy crisis causes the symptoms you're experiencing:
Headaches and dizziness - especially during or after physical activity
Brain fog - difficulty following plays, remembering instructions, or making quick decisions
Fatigue - feeling drained after activities that used to be easy
Mood changes - increased irritability or feeling overwhelmed
Focus problems - trouble concentrating during film review or strategy sessions
These symptoms often worsen with mental or physical effort because energy requirements increase. The cellular changes also make communication between brain cells less efficient, which is why athletes often struggle with reaction time and decision-making skills crucial for their sport.
Tiny structures that carry signals between cells can swell or break down, and inflammation may spread as the brain responds to the injury. This is why people often experience difficulty focusing, memory problems, mood changes, and prolonged fatigue.
Why "Walking It Off" Doesn't Work (But Smart Movement Does)
For years, the standard advice was complete rest until all symptoms disappeared. We now know this approach actually slows recovery.
Current research indicates that carefully guided aerobic exercise, initiated within 48 hours and performed at an intensity that doesn't exacerbate symptoms, can actually help the brain heal more quickly.
This approach works by restoring blood flow, improving energy regulation, and shortening recovery time more effectively than strict rest. Since reduced blood flow can persist for a month or longer in some individuals, gentle aerobic activity helps your brain utilize energy more efficiently during the healing process.
Here's what "carefully guided" can mean in practice: If you're a runner, this might mean walking at a pace where you can easily hold a conversation. For team sport athletes, it could be light stationary cycling for 15-20 minutes. The key is finding your "sweet spot", or exercising at an intensity that doesn't trigger or worsen your symptoms.
The Competitive Advantage of Proper Treatment
The need to find that "sweet spot" is why physiotherapy and structured return to activity plans are so valuable after a concussion. Research shows that athletes who participate in structured aerobic programs recover quicker, experience less severe symptoms, and are significantly less likely to develop persistent symptoms that could sideline them for months.
In other words, they get back to peak performance faster and more safely. Most athletes see meaningful improvement within 1-2 weeks with proper guidance, compared to the weeks or months of prolonged symptoms that can result from ignoring the injury entirely.
Athletes who try to power through symptoms or return too early often find themselves dealing with prolonged recovery periods that keep them out far longer than necessary. Proper treatment gets you back to your sport stronger and with confidence in your brain's full recovery.
What This Means for You
If you're dealing with a recent head injury, here are the key takeaways:
Don't wait: The first 48-72 hours are crucial for setting up optimal recovery
Gentle movement beats complete rest: Light aerobic activity that doesn't worsen symptoms promotes healing
Every concussion is different: Your recovery plan should be tailored to your sport, symptoms, and goals
Professional guidance matters: Working with specialists experienced in sports concussion dramatically improves outcomes
Your Path Back to Peak Performance
The science is clear: concussions involve complex metabolic changes that require active, guided rehabilitation rather than passive rest.
At The Runner's Academy, we understand that getting back to your sport isn't just about managing symptoms - it's about ensuring your brain can handle the split-second decisions, spatial awareness, and reaction times that competitive athletics demand. Our therapists coach you through concussion recovery in a way that is specific to your symptoms, your lifestyle, and your goals, creating a plan that supports your brain's healing process while building back the physical and cognitive demands of your sport.
Ready to start your recovery? If you're experiencing symptoms after a head injury, don't wait. Let’s connect to discuss starting a guided recovery program. Early intervention significantly improves long-term outcomes, so let's work together to create a plan that addresses your specific needs.
Concussions are complex, but recovery doesn't have to derail you. With the right guidance, most athletes return safely and confidently to peak performance in their sport.
References
Art, K., et al. (2023). The effectiveness of physical therapy interventions for athletes post-concussion: A systematic review. International Journal of Sports Physical Therapy, 18(6).
Howell, D. R., & Southard, J. (2021). The molecular pathophysiology of concussion. Clinical Sports Medicine, 40(1).
Leddy, J. J., Haider, M. N., Ellis, M., & Willer, B. (2018). Exercise is medicine for concussion. Current Sports Medicine Reports, 17(8), 262-270. https://doi.org/10.1249/JSR.0000000000000505
McCrory, P., Meeuwisse, W., Dvořák, J., Aubry, M., Bailes, J., Broglio, S., Cantu, R. C., Cassidy, D., Echemendia, R. J., Castellani, R. J., Davis, G. A., Ellenbogen, R., Emery, C., Engebretsen, L., Feddermann-Demont, N., Giza, C. C., Guskiewicz, K. M., Herring, S., Iverson, G. L., ... Vos, P. E. (2017). Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838-847. https://doi.org/10.1136/bjsports-2017-097699