In this instructional YouTube video, David Brimacombe shares his personal experience recovering from post‑concussion syndrome and presents a step‑by‑step protocol for safely re‑introducing exercise. He begins by redefining "exercise" as any movement that increases blood flow and supports autonomic regulation, emphasizing that even a short walk or a single flight of stairs counts. He explains that symptoms are not signs of damage but indicators that a personal threshold has been reached, and introduces "sub‑symptom threshold training"—tracking duration, heart rate, and perceived exertion, then exercising just below the point where symptoms spike. Brimacombe warns that symptom escalation can occur hours after activity, so monitoring delayed effects is crucial. Because concussion often impairs the switch between sympathetic (stress) and parasympathetic (rest) states, he recommends pairing movement with calming practices: five slow, elongated exhalation breaths and brief somatic relaxation to help the body transition to a parasympathetic state. Throughout, he encourages viewers to listen to their bodies, progressively raise their thresholds, and share tolerable movements in the comments, reinforcing a community‑based, science‑backed recovery approach.
Chapters
Have you ever tried to exercise after a concussion only to have your symptoms flare up shortly thereafter? And this is not only physically demanding, it's emotionally debilitating. I am choosing to record this in my home gym because this is a place I thought 6 months post-concussion I would never get to use again. I thought this was going to be a place would gather dust. I would have to constantly come look at, but never ever be able to use to the capacity I once did. In this video, I'll show you how you can move safely and build back your tolerance so you can eventually get back to those exercises and that movement that you once loved. If you are working through post-concussion syndrome and want science-backed recovery tools that you can implement right away, make sure you subscribe to my channel so you don't miss a video. First thing you need to do when you are going ahead and starting your exercise post-concussion is to redefine what that word means. Exercise is not simply lifting heavy weights or going hard on the elliptical. Exercise is any kind of way you can move your body. It could be something as a simple 5-minute walk. It could be climbing one set of stairs. But exercise is basically movement which increases blood flow within which allows for autonomic nervous system regulation, the one thing that is most commonly out of sorts after a concussion. The next thing we need to understand are that symptoms are a sign that we need to stop and take it easy. They are not a sign that we're causing greater harm to our body. For the longest time, I felt like anytime my symptoms arose, I was actually doing greater harm and I should stop and never do that activity again. That could be that could not be further from the truth. Symptoms are a sign that your body's hit hit a threshold, and now you need to work out just below that called sub threshold recovery. So what does this look like? Let's say I'm walking for ten minutes. My heart rate is at about 120, and I'm starting to feel my symptoms escalate. Okay, maybe they're going from a moderate or mild. From a 2 out of 10 to a 7 out of 10. Now, that is a pretty substantial jump. That is my body telling me you've hit that threshold. We need to stop for today. So what I would do is I would record how long had I just walked? What was my heart rate or distance? What was my exertion? So that next time I want to walk, maybe it's tomorrow, maybe it's later that week, but I'm going to go ahead and I'm going to walk below that threshold. Meaning I'm going to walk for less duration and/or at a less intense, less intensity. Okay, that is sub-symptom threshold training. If you are able to continually do this each week, your threshold will increase. Okay, therefore you'll be able to do more and more and more with the hope that eventually you'll get to a point where you no longer have a threshold. Exercise is the most amazing thing to rediscover in your recovery, but it does take time and it does take a protocol. Step 3 is all about: Are your symptoms escalating later in that day? Okay. So another thing I thought originally was that my symptoms were only directly tied into what I was doing in that moment. So if I didn't feel brain fog, fatigue. irritability set in the moment I was doing an activity, it was okay to continue. So what you need to consider is if I were to go for a 15-minute walk, 2, 3 hours later, I start to feel those symptoms escalate. They go from a 4 maybe to an 8. I know that that exercise is likely the culprit and therefore those symptoms— that my symptom threshold has been set by my symptoms. We got to talk about pairing movement with calm. One of the hallmarks of PCS is the inability to regulate between your sympathetic, your stress state, and your parasympathetic, your rest and digest state. When you're working out, you're active, you're either mentally, physically engaged in a task, you want to be in that sympathetic state. Okay. Now, the problem lies is that once you stop that activity, a normally regulated person will then slowly toggle over to the parasympathetic state as they're resting and allows their body to heal. Now, if your body struggles to regulate between the two, which mine did, what will happen is after your exercise, you'll stay elevated. You'll stay in that stress state. Now, what's the problem with that? Is that your body is not able to recover. You're constantly at stress. You're at odds with your body. Now, I found that I was highly irritable after working out. That was my biggest symptom. I would go ahead and get angry at the simplest things, get mad at my family for not putting their dishes away, whatever the case may be. But it was completely irrational. It was based on the fact that I could not get out of that stress state. So after movement, the most important thing you need to do is reintroduce calm in your life. Now, how can you do that? There's a few ways that I like to think about. Number one is breathwork. Really simply, After I do any kind of exercise, regardless of how intense it is, I always drop down and at least do five breaths where I've elongated that exhalation. Now, your heart rate actually slows down when you exhale, so the longer and more long exhale breaths you're going to do, the easier it is for your body to understand it's safe. It's time to downregulate and go into that parasympathetic state. So I will work out. Then I'll do 5 breaths where I'm going to do 4 counts on the inhale, sometimes a hold, and then 6 to 8 on the exhale. And again, that's just telling my body it's now safe to get into that parasympathetic state. The second way you can do it is pair it with some kind of somatic movement. Maybe it's something where you're going to lie down on the floor and relax for a few minutes, but you have to give— send your body those signals that it is now safe to get into the parasympathetic state. It is now— your time of stress is done. Toggle over. Time to— I want you to answer this in the comments below. What's one kind of movement that feels good for you right now? Now, maybe it's just something as simple as a light stretch or a gentle walk, but tell me in the comments below, what is one kind of movement or exercise that you can tolerate that you love to do? And lastly, remember that movement and exercise are only beneficial when you do it within Your symptom threshold. Okay, listen to your body. Your body knows best. But remember, symptoms are not a sign you're doing greater harm. It's a sign that you've met your threshold. Continually push that threshold and you will get to a point that you never thought possible, and maybe even back to a place where you're exercising the same way you were pre-concussion. Till next time, thank you. See you later.
