Concussion Recovery: Why Exercise (Not Rest) Speeds Healing

If you've ever been told to "just rest" after a concussion and wait for symptoms to fade — you're not alone, and you're also not getting the full picture.

Concussions don't just affect athletes. Thousands of people every year — from weekend cyclists to office workers who hit their head getting out of a car — are left with headaches, dizziness, brain fog, and fatigue that linger far longer than expected. For years, the advice was simple: rest until it goes away. But we now know that approach can actually slow recovery down.

What's really going on after a concussion

A concussion doesn't just affect the brain in isolation — it disrupts the autonomic nervous system, the part of you that quietly regulates heart rate, blood pressure, and your body's stress response. That's part of why concussion symptoms can feel so much bigger than "just a headache" — dizziness, brain fog, and exercise intolerance often trace back to this system being thrown off balance.

Sitting still doesn't fix that. In fact, prolonged rest can lead to deconditioning, which makes the autonomic system even more reactive — a frustrating cycle for anyone desperate to feel normal again.

The shift: exercise as medicine, not the enemy

This is where the research has genuinely changed the game. Carefully dosed exercise — not random, not pushing through pain — has been shown to:

• Restore normal brain and body function

• Improve regulation of the autonomic nervous system

• Reduce deconditioning

• Rebuild tolerance to physical and mental stress

  
  

The key word is carefully. This isn't "push through it" advice — it's the opposite. It's about finding the exact point where your body starts to react, and training just below it.

How clinicians find that point: the Buffalo Concussion Treadmill Test

One of the most useful tools for this is the Buffalo Concussion Treadmill Test. It's exactly what it sounds like — a treadmill test where intensity increases gradually while your symptoms and heart rate are tracked in real time.

The goal isn't to push you until symptoms appear — it's to find your threshold, the point just before symptoms start. That threshold becomes the starting point for a personalised exercise program, set just below where things get uncomfortable.

Why heart rate tells us so much

After a concussion, your heart rate response to exercise often isn't quite "normal" anymore — it might spike faster than expected, or your resting heart rate might sit higher than usual. Monitoring this during activity gives us a window into how your nervous system is recovering, and helps guide how hard — and how often — you should be training.

It's not just about cardio

A proper concussion recovery plan often goes well beyond aerobic exercise. It can include:

• Balance and coordination retraining

• Vestibular (inner ear) and visual rehabilitation

• Eye tracking, convergence, and visual motion testing

• Pacing strategies for daily life — not just sport

Many people don't realise their lingering dizziness or "fog" is connected to their visual or vestibular system until it's specifically assessed.

Getting back to sport (or just back to yourself)

For athletes, return to play should be gradual and guided — starting with threshold testing, then progressing step by step toward sport-specific and higher-intensity work, with full contact only once cleared. Going back too soon is one of the biggest risk factors for setbacks and re-injury.

But this isn't just for athletes. Whether your goal is getting back to the gym, your commute, or simply not feeling exhausted by a grocery run, the same principles apply: test, don't guess — and build back up with the right support.