Fighting the Fatigue – Exercise and TBI

Before Christmas I had an interesting chat with a fellow patient after my hyperbaric oxygen session. We were discussing exercise and he was saying that since his injury he hasn’t had the energy to workout. He explained that he had horrible fatigue from the TBI, and that he didn’t think he would ever be able to ride his bike or run, or exercise the way he used to.  I told him that I know that crushing fatigue. I know what it is like to not even have the energy to get out my pajamas. Even though I ran 100 miles, there are still days when I feel like it would be easier to just stay in bed, or do nothing but nap on the couch. On bad days, finding the motivation to get moving can be hard, and to be honest, I don’t always win that battle. However, the majority of the time if I drag my butt out of bed and exercise I finish with more energy, mental focus, and a much better mood.

This isn’t a new concept. A good deal of research exists on the subject of exercise after TBI.  Brainline posted one video about a research study showing TBI patients that exercised had few cognitive symptoms and less depression. Knowing this information, and convincing a population of patients with horrible fatigue to exercise, are two different things.

Snow running. Getting out is always easier with company.

For what it is worth, my personal experience strongly supports the research. The more fatigue I feel, the less likely I am to exercise, and then I feel even more fatigue, and then the depression moves in like an enormous wet blanket, and then I’m even less likely to exercise. It is a negative loop. It takes a lot of effort to push beyond the fatigue and depression, and get moving. At the time of my crash, we were riding our bikes from Vienna to Venice. I was the strongest I have ever been on the bike, and yet in the weeks after the crash, just walking around the block was exhausting. My return to running was painfully slow; beginning literally with a few steps of what could barely count as a “jog”. But every day that I got out, I felt better. If I had gone out the first time and tried to run a mile, it would have been awful. Gradual habituation is the key for returning to most activities after brain injury. Waiting around to feel better before returning to activity means waiting a long time. It will not get easier without training the brain to handle it again.

When I spoke with this fellow patient, I tried my best to be motivational, but I’m not sure it had much impact, except for maybe on myself. Over the last month I have found myself in this negative loop of inactivity, lethargy, and depression. I’m not really sure if the hyperbaric oxygen therapy is wearing me out, or the holidays, or the weather, or getting sick, or if I was simply going to be at one of my low points. Regardless of the cause, here I am, and it is time to stop the negative loop.

Kili helping me with my yoga.

The conversation with my fellow patient made me think about all the things I still avoid, and I decided I need to take my own advice. This week, I started yoga. I haven’t been to a class post-TBI. I’ve told myself all the excuses – I can’t drive to the studio, I can’t listen to music, it would be too hard, my balance isn’t good. Well, it is time for baby steps. I found a yoga for runners video on YouTube that had no background music. I set up my mat in the study. I fell. More than once. The point is that I did it, and I did it again the following day.

Today I did my strength and core work. Tonight I will find a race and I will register. Tomorrow I will run; if you can call slogging through the deep snow “running”.





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