Post-concussion self-care

I’m getting referrals for craniosacral therapy for people who have had concussions, and I want to help these folks heal. Not knowing what a doctor may have told them, and knowing how busy most doctors are, I’m providing information here that may help those with injured brains recover more quickly. If your doctor tells you something different, listen.

People who’ve had concussions report these symptoms: pain, dizziness or vertigo, balance issues, gait disturbance, vision changes, sensitivity to light and sound, language problems, confusion, lack of focus, forgetfulness, nausea, sleepiness, and/or emotional problems.

To clarify the language, concussions may also be called mild TBIs (traumatic brain injuries). People can get concussions from an impact, from being shaken (like shaken baby syndrome), or from being near an explosion (IEDs make this a tragic problem for many veterans).

To help you visualize what happens in a concussion, imagine your brain is like jello inside a closed hard container (the cranium) cushioned by a thin layer of water (cerebrospinal fluid), with substantial membranes (the meninges) separating the major parts (hemispheres, cerebrum and cerebellum). A major impact slams the brain around inside the cranium, damaging brain tissue. Research points to the corpus callosum, which connects and coordinate the left and right hemispheres, receiving the most damage from concussions.

After a concussion, most people recover most or all of their abilities — within few weeks for some, or after year or so for others. The healing period is likely related to the severity of the injury, the state of your health at the time, whether you’ve had previous concussions (perhaps from early childhood falls or undiagnosed), getting quick and appropriate treatment, and your self-care afterwards.

There is a statistical link between experiencing concussions and accelerating the mental decline of Alzheimer’s disease in those already at risk for Alzheimer’s (known through family history or genetic testing).

Here’s how to take care of yourself after concussion to encourage healing and possibly prevent serious health issues down the road.

Get support.

Let others help you, because you may be disoriented, less capable, ill, and more. You may need someone to drive you to appointments, sub for you at work, help with the kids, or frequently check in with you. Call on your friends, family, and whatever communities you belong to.

Stay hydrated.

Your brain is very sensitive to dehydration, and after a concussion, measuring how much you actually drink is important, just to make sure you’re getting enough fluid. Go for half your body weight in ounces of clean water each day. (If you weight 150 lbs., drink 75 ounces.) Start each day with a big glass of water. Here’s more about hydration.

Take an Epsom salt bath.

Soak every night to relax, relieve muscle pain, and absorb magnesium, the most vital mineral for brain health, through your skin. Magnesium levels (often deficient already) drop sharply after a concussion, so getting enough is important. Add two cups of Epsom salt to warm or hot water and soak for 12-15 minutes. Most grocery stores carry Epsom salt, and if you have the storage space, you can buy it in bulk from Amazon and save. Add essential oils to your bath water if you wish. You may wish to take magnesium threonate instead of or in addition to Epsom salt baths (link below).

Take supplements.

Concussions rapidly deplete your levels of vital nutrients in an attempt to recover brain health and function. To provide the building blocks for a better recovery, take these supplements in these amounts daily, starting as soon as possible after concussion until you feel recovered. These are high dosages to support production of BDNF (brain-derived neurotrophic factor) and glutathione, essential nutrients your body makes that recover brain function and reduce inflammation, and to help your neurotransmitters carry signals between brain cells.

  • creatine (10 g) is a protein that provides energy for the brain
  • N-Acetyl-Cysteine (1-5 g) helps your body produce glutathione, known as the master anti-oxidant, which protects cells from damage
  • fish oil (4,000 mg) greatly reduces inflammation
  • a Vitamin B complex supplement is easier than taking separate B2, B3, B6, B12, and folate, which reduce inflammation
  • Vitamin C (1,000 mg) helps your body produce glutathione
  • Vitamin D3 (5,000 IUs) improves cognitive function, helps with neurotransmitter production, and reduces inflammation
  • magnesium threonate (2 g) permeates the brain, increases BDNF, helps with memory, and does not tend to have a laxative effect
  • zinc (50 mg) improves memory, reduces inflammation, and helps with neurotransmitter production
  • curcumin raises BDNF production and is anti-inflammatory

If you are on a budget, I would focus on three: N-Acetyl-Cysteine (NAC), fish oil, and curcumin, and get the protein, vitamins, and minerals from nutrient-dense foods and Epsom salt baths.

Eat a ketogenic diet.

Going ketogenic (high in fats, moderate protein, low carbs) helps with recovering brain health. This diet was developed to help children with epilepsy and is considered to be very beneficial for brain health. Being low in carbs and high in healthy fats, the ketogenic diet is also an anti-inflammatory diet. Eat these beneficial foods: eggs from pastured chickens, wild salmon, sardines in olive oil, coconut oil, real olive oil, walnuts, tomatoes, broccoli, green leafy vegetables, avocados, and wild blueberries (all organic if possible). Avoid alcohol, caffeine, sugar, trans fats, seed oils, fried and processed foods, factory-farmed meats and fish, grains, legumes, and other fruits and juices. If nausea is a problem, try a protein shake (possibly adding some of the supplements and foods listed above).

Rest and resume activity as you are able.

In the first few days after a concussion, rest from strenuous mental or physical exertion and avoid additional stress.

  • Get someone else to drive you until you feel up to it.
  • Do one thing at a time. Do nothing, as well.
  • Move your body slowly and gently at first: walk or do qigong or gentle yoga. Start with what you can tolerate. Always stop if symptoms return.
  • As soon as you become able, work up to more intense exercise, which increases your body’s production of BDNF.
  • Cross-lateral movement (walking, marching in place, etc.) helps get your hemispheres working together.
  • Practice balancing on one foot as you are able.

Exercise your senses.

These will help you and your supporters monitor your recovery and can help relieve the anxiety and emotional volatility that often accompany concussions.

  • Look at soothing images.
  • Listen to nature sounds, soothing music, guided meditations.
  • Receive touch. Notice your body sensations.
  • Engage your sense of smell with essential oils, herbs, flowers, and food.
  • Really taste your food.

Monitor your memory.

As you go about your post-concussion life, you and your supporters will become aware of how well or poorly your memory is working. Memory can return slowly after a concussion, so be patient. Making lists and setting up reminders can help. Ask for help if you need it. If you want to track your daily post-concussion self-care activities on paper, here is a habit tracker you can print.

Do lymphatic drainage.

This simple self-care technique helps your lymphatic system remove metabolic waste products and toxins from the injured brain. The discovery of lymphatic vessels in the brain is recent. This video shows how to do the technique for the head and neck: https://www.youtube.com/watch?v=QA-wi0d7-Ro

Practice alternate nostril breathing.

This is an ancient technique from India taught in yoga and pranayama classes. It is said to help balance the left and right brain hemispheres. Nostril openness is connected to the opposite brain hemisphere, and it switches throughout the day. This daily practice may be a way to improve the functioning of the corpus callosum, which connects the hemispheres. In my experience and that of many others, alternate nostril breathing is calming and balancing. Here’s how to do it: https://www.youtube.com/watch?v=Xbbr6Udg1UA

Make an appointment for craniosacral therapy.

The more quickly you can come in for craniosacral therapy after a concussion, the more quickly you can recover. Craniosacral therapy works with the fluids in your central nervous system and your body. It can help your body and brain become more balanced and relax more deeply, which facilitates healing. Depending on your craniosacral therapist’s skills and your needs, they may add lymphatic drainage, massage, and energy work, as needed in your sessions.

If your doctor writes a letter of medical necessity for craniosacral therapy, your health insurance or your employer’s health savings account may reimburse you. The cost may also be partially or wholly reimbursed through worker’s comp for on-the-job injuries or personal injury protection for auto accidents.

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Note: I am not a doctor, just a geeky health-oriented craniosacral therapist who wants to be of excellent service to my clients in Austin, Texas, and to anyone anywhere seeking useful information for self-care after concussion. I used multiple reputable sources of information available online to compile this post.

If you have anything to add or enlighten me about, please comment!

Hydration: the first step to building health

The first step to preventing dementia is to stay hydrated. The brain is more sensitive to dehydration than any other tissue in your body. This issue is on my mind due to numerous friends’ parents having tragically developed Alzheimer’s and also learning of contemporaries with early-stage dementia. Craniosacral therapy can help, and I’ll write about that in the future. Today: hydration.

This is a topic that your doctor will probably never mention unless you have a severe issue like kidney disease, but your massage therapist certainly will!

You are at your most dehydrated when you wake up in the morning. Therefore, drink water soon after you wake! It’ll help get your brain and your whole system going.  Continue reading

Stay hydrated all the time, not just after a massage

I’ve written about this before. I tell my clients to stay hydrated, rather than asking them to drink “extra water” after a massage to “flush the toxins out.”

Water makes physiological processes, especially the brain, work better, so getting enough is important. Whatever measure you use – a gallon a day, half your body weight in ounces, until your pee is clear – most of us don’t drink enough, and we need extra to make up for sweating, diarrhea, etc.

Now New York Times health writer Gretchen Reynolds addresses the issue, interviewing an expertContinue reading

Massage and toxins: Laura Allen busts that myth

Aside from being hilarious, Laura Allen makes complete sense. This is why I like to tell recipients after a massage to stay hydrated, instead of telling them to drink extra water to flush out the toxins (that were supposedly loosened up by the massage and are floating around in your body just needing to be peed out by that extra water).

The body doesn’t work like that, as Laura points out.

However, your body thrives on getting enough water! Everything works better, including sweating, peeing, and pooping, which remove metabolic waste.

How much water? Divide your body weight in half and drink that many ounces. Weigh 150? Drink ~75 ounces per day. Add more on days when you sweat a lot.

Self-care for massage therapists, part 2 (what works for me)

In part 1, I listed various self-care methods that massage therapists use for their own aches and pains from giving massage. In part 2, I want to share what I’ve tried (so far) that works.

First, I want to say that my strength and endurance have increased with practice. I used to be in pain after giving 3 hour-long massages in a row several days in a row. Now I can do 4 hours 5 days a week with just a few twinges and aches afterwards. For several weeks, though, I was hurting and feeling some despair about having upended my life to get trained and start working in this new profession and the possibility of not being physically able to do it.

Key learnings from a newbie:

  • I no longer attempt deep tissue work, sticking to Swedish and reflexology. My Swedish massages are good and getting better. I incorporate some of David Lauterstein’s deep massage strokes into every Swedish massage, and I use pressure points, stretching, techniques from sports massage, body mobilization techniques, and reflexology, depending on the client’s issues and the amount of time I have. I cannot deliver the pressure that some clients (well-informed or not about what “deep tissue” means) seem to want. If I work within my limitations, it’s win-win for everyone.
  • I trained in Ashiatsu Oriental Bar Therapy so that I can deliver deeper pressure using my feet and body weight, controlled by holding onto overhead bars. It’s so much easier on my body and a lot of fun, too.
  • I rock with my feet and leverage my body weight strategically as I deliver Swedish massage so my arms and shoulders do less work.
  • Hydrotherapy totally rocks after a long shift. I fill my double kitchen sinks with hot water (my water heater is set to 130 degrees F. for sanitizing laundry) and cold water that I dump a quart or two of ice into. I immerse my aching forearms and hands in the water, alternating cold-hot-cold-hot-cold, for one minute each. I can barely stand it, and yet it makes a huge difference in just 5 minutes. Seems to flush toxins and swelling and pain right out.
  • I stretch my fingers and wrists, holding each stretch for 15 seconds. Good to do when driving, at red lights.
  • I press into the trigger points for the elbow and wrist (see part 1 for links).
  • I apply magnesium gel with seaweed extract topically. According to Wikipedia, symptoms of magnesium deficiency include muscle cramps, weakness, and fatigue, and fifty-seven percent of the US population does not get enough magnesium from food.
  • I love epsom salts in a bath. (Guess what? They contain magnesium!) When I was feeling a lot of pain all over, I would dump a cup or two of epsom salts into a fairly hot bath and add a few drops of lavender oil, then soak for 15-20 minutes. I felt like a new woman when I came out! I learned this years ago from dancers.
  • I use Young Living’s OrthoEase oil on clients’ painful muscles, and I use it on mine as well. Contains wintergreen, peppermint, eucalyptus, lemongrass, and more that are analgesic and anti-inflammatory.
  • I keep hydrated and have been avoiding nightshades lately. I’m already gluten-free and eat fairly healthily. I’m interested in following an anti-inflammatory diet but haven’t done the research yet.
  • I take at least a couple of days off per week, not always together, though. I’m still finding my ideal schedule.
  • I do 10-15 minutes of yoga every morning. Sun salutations stretch and strengthen my body. Plus, it’s a great check-in to do something that starts the same every day. I start slowly and really let my hamstrings lengthen in forward bend before I move on to the next pose. I add standing poses, balance poses, and pigeon as I feel the need and to keep it interesting.
  • I get at least a chair massage every week. I’m interested in setting up a weekly trade for a full-body massage with someone, too.
  • I use a foam roller on back when needed, and a tennis ball to my gluteus.
  • I have two tennis balls tied into a sock that I use when driving to massage my back. I’ve also learned to “pop” my own back while giving massage!

Here’s something that just doesn’t fit into any of the categories I’ve seen so far about self-care for MTs. It’s about how you use your attention. I’ve learned to keep some of my attention on my body most of the time.

When I focused exclusively on the client’s body, delivering what I thought they wanted, I hurt and fatigued myself. I listen more to my body now and check in verbally with the client if I am not noticing nonverbal feedback.

If I notice that I feel rigid anywhere in my body, I say to myself, “Soften,” and my body softens.

Sometimes I put my attention on the soles of my feet and their connection to the floor/earth (I massage with bare feet always for Ashiatsu and as much as possible for Swedish), making the movements of giving massage into a soft, fluid dance.

Sometimes I attend to my breath, letting it become easy and relaxing (and audible to the client, as a nonverbal suggestion that they relax too).

All of these techniques activate the inner body, subtle body, energy body, whatever you want to call it. It feels better to give massage with this “soft present alive expanded body” than not. There is definitely an aspect of being “in the flow” that seems somehow related to doing Reiki, but I don’t know how to put it into words (yet).

Another bonus: the sensations of pain and fatigue become distant as peace and love fill my awareness.

I don’t know if clients perceive the difference, but I don’t think it could hurt. I do it for me because I “in-joy” it!

It’s been four months since I got licensed and began working. I look forward to learning even more new things about self-care and sharing them here.