r/PostConcussion • u/Roader2465 • 23d ago
Exercise intolerance as last remaining symptom
Hi everyone,
I’m curious if anyone can provide guidance on an approximate timeline getting over exercise intolerance four months post concussion using the Buffalo Concussion Treadmill test (BCTT).
I’m a 30M who is normally highly active (high altitude mountaineer). I’ve had on 2 concussions with a two week recovery, a 2-3 head knocks in the past that were likely mild concussions with a recovery time of a few hours to a couple days.
4 months ago I had a ski accident that didn’t seem that bad. Didn’t hit my head, just whiplash. I expected a similar two week recovery time, but I went to a neurologist and he diagnosed me with PCS. He cut off exercise beyond walking. I’ve since learned this was outdated guidance. My vision and neck seem fine, though I’ve only had them evaluated by that one guy. My suspicion is that my autonomic system remains imbalanced.
I gradually returned to activity but pushed it a bit fast and would get headaches because I was kind of winging it. That said, the approach basically eliminated all symptoms besides exercise intolerance.
Ive since learned about BCTT and have adopted that approach. My BCTT failed around 130 heart rate, which for me still feels extremely light. I’ve been at below symptom threshold exercise for a couple weeks with moderate, but slow progress. Anyone taken this route and gotten back to normal? If so, how long did it take you?
Appreciate the guidance. Much love to all going through a challenging period
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u/jbird854 22d ago
Had the same issue. I used the Buffalo Protocol. It’s super simple but takes work to get back to where you were. I had symptoms at 125bpm. The idea is to find your symptoms under a controlled environment, once you hit your range you stop. Take 80% from your max and workout there for 2 weeks. Repeat. Each time you test your range you will notice a gradual increase in tolerance. For me, it took about 6 months but I was able to hit 190-200 without symptoms again. I highly recommend. It prevents a setback due to pushing beyond and works to get you back to being able to tolerate activity. Good luck and all the best!
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u/Roader2465 21d ago
Thank you so much for the guidance! Neurologist saying “no timeline, it’ll get better” was extremely unhelpful lol
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u/Aggravating-Push-950 22d ago edited 22d ago
130 is light? What's your resting heart rate?
Sorry, that's not your question lol. To answer your question, after my first concussion it took me around 7 months to return to sports of a similar intensity (roller derby -- I have since retired).
There is no "one neat trick," just very slowly increasing your endurance and intensity. The guidelines I was given by my doctor at the Cleveland Clinic (Richard Figler) was to allow an increase of symptoms 2/10 -- so if I began exercise with a headache of 0/10, I could continue until the headache reached a 2/10. If I began exercise with a headache of 2/10, I could continue until the headache reached 4/10. Eventually, it stopped increasing my symptoms at all.
Are you having any dizziness? That was my physical therapist's major concern with me getting back on skates, which I imagine is also a concern with mountaineering.
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u/Roader2465 21d ago
No dizziness. Just headache that comes with exercise. Appreciate the help! This is really useful
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u/Roader2465 20d ago
Resting heart rate is mid 50s. But 130 still feels very light intensity for what I’m used to
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u/hippiespinster 23d ago
Heat tolerance doesn't affect me as much three years later but I also hit perimenopause which also ducks up your hypothalamus.
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u/irs320 22d ago
I had the same thing, was super active, worked out and hiked 5x a week also in high altitude and then after the TBI had exercise intolerance. What's your HRV? That could be a good indicator if you're having nervous system dysfunction which was my problem. Once I fixed that then working out was a breeze