Concussion Recovery: Looking Beyond Rest

A concussion is a mild traumatic brain injury (TBI), but the effects can extend well beyond the brain itself.

Headaches, dizziness, brain fog, fatigue, nausea, sensitivity to light or sound, difficulty concentrating and neck pain are all common following concussion. And while most people recover well, symptoms can sometimes linger for weeks or even months.

The good news is that concussion management has moved beyond simply being told to “rest and wait.”

The neck matters too

The forces strong enough to cause a concussion can also affect the muscles, joints and soft tissues of the cervical spine.

This is important because dysfunction in the neck can contribute to symptoms that look remarkably similar to concussion itself, including headaches, dizziness, neck pain and balance problems.

For this reason, assessing the cervical spine can be an important part of concussion care.

Where appropriate, chiropractic care may help address the musculoskeletal component of the injury through individually tailored chiropractic adjustments, gentle cranial therapy and soft-tissue techniques.

Rest, but don't stop moving completely

Concussion advice has changed considerably over recent years.

Rather than prolonged complete rest, current recommendations favour relative rest for the first 24–48 hours, followed by a gradual return to normal cognitive and physical activity.

During those early days, reducing screen time can be particularly helpful. If reading, scrolling or watching television aggravates symptoms, listening to an audiobook, music or podcast may provide an alternative without the same visual load.

Gentle physical activity can also be introduced as tolerated. This may begin with something as simple as a short, slow walk, keeping the heart rate relatively low, and gradually increase as symptoms improve.

Current guidelines recommend starting with light aerobic exercise and progressing towards moderate exercise while remaining below the level that significantly aggravates symptoms.

The key is not to push through significant symptoms, but also not to remain completely inactive for longer than necessary.

Can nutrition support brain recovery?

A concussion creates a temporary metabolic and inflammatory cascade within the brain. This has led to increasing interest in whether certain nutrients may help support the brain during the recovery process.

Three nutrients I am particularly interested in are omega-3 fatty acids, CDP-choline (citicoline) and creatine.

Omega-3 fatty acids

DHA is an omega-3 fatty acid found in particularly high concentrations in the brain, where it forms an important part of neuronal cell membranes.

Following a brain injury, supporting adequate omega-3 status may help provide some of the raw materials needed for healthy neuronal membranes and normal inflammatory regulation.

Although omega-3s are very promising from a biological perspective, we still need more high-quality human trials to determine how much supplementation may improve concussion recovery.

CDP-Choline

Choline is another important nutrient for the brain.

CDP-choline, also known as citicoline, provides choline used in the production of phosphatidylcholine, an important component of brain cell membranes. Choline is also required to produce acetylcholine, a neurotransmitter involved in memory, attention and nervous-system function.

For these reasons, citicoline has been investigated in traumatic brain injury.

Research is mixed, and it shouldn't be considered a stand-alone treatment for concussion. However, its role in phospholipid synthesis and normal brain function makes choline status an interesting consideration when looking at nutrition following brain injury.

Creatine

Creatine is best known for its role in muscle performance, but it also plays an important role in brain energy production. Following a concussion, the brain can experience a temporary energy crisis, with increased energy demands at the same time as its ability to produce energy may be disrupted.

Creatine helps the brain rapidly regenerate ATP, the primary energy source used by our cells, which is why researchers are increasingly interested in its potential role following concussion and traumatic brain injury.

Early research is promising, but we still need more high-quality human studies before we can say that creatine speeds concussion recovery. For now, it is another interesting nutritional tool that may help support the brain's increased energy needs during healing.

A more complete approach to concussion

Concussion recovery isn't necessarily about finding one treatment.

It is about identifying the systems affected by the injury and supporting recovery appropriately.

That may include spine and nervous system care through tailored chiropractic care and gentle cranial therapy, alongside vestibular or balance rehabilitation, gradually increasing exercise, appropriate cognitive rest, good sleep and hydration, and targeted nutritional support where appropriate.

If concussion symptoms aren't resolving as expected, it may be worth looking beyond the brain alone.