In this video, concussion survivor and coach David Brimacombe explains that while brief rest (24‑48 hours) after a concussion is beneficial, extending rest beyond that period can worsen symptoms. Drawing on his experience with seven concussions over two decades, he argues that excessive rest conditions the nervous system to label normal sensory input—light, sound, movement—as dangerous, leading to a feedback loop of heightened symptoms. He critiques the outdated “cocoon therapy” model promoted by many physicians and advocates for a patient‑led, incremental re‑engagement strategy. Brimacombe outlines a step‑by‑step, kaizen‑style approach: start with minimal, sub‑symptom exposure to light or movement, gradually increase intensity while staying below the symptom threshold, thereby retraining the brain’s threat association. He emphasizes self‑advocacy, educating oneself, and becoming the leader of one’s own recovery, while warning against taking rest as the sole protocol. The video concludes with a call to adopt small, continuous improvements for safe reintegration into daily life.
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Rest is important right after a concussion, but after 24 to 48 hours, rest is actually doing you more harm than good. Hi, and welcome to the PCS Resilience Collective. My name is David Brimacombe, and after 7 concussions over 20 years, I learned a lot about how resting too much actually tricks your nervous system to believe that the world is dangerous and how movement allows you to break that cycle. Let's begin. I want to talk a little bit about my story, my recovery journey here. I was told after every concussion I had— so that was 7 times— I was told that rest is going to be your best tool for recovery. The brain will heal on its own. It just needs time. It just needs you to be in a dark room with your eyes closed with no other forms of stimulation. That is what I was told. And I truly believe that the people who told me that, the physicians, the specialists, weren't trying to do me harm, but they were talking from an outdated lens, from an archaic perspective. And for me, I adhered to anything the doctors would tell me. I didn't know any different. So this was at a time I wasn't really advocating for myself. I wasn't really doing my own research. I'd go see my doctor, he'd tell me sleep Sleep as much as you can. Avoid the bright lights, the loud noises, and you will recover. You'll be fine. And for some of my concussions, it did work. It did help. But for many of them, it made the symptoms worse. And I'm going to talk about why today. Understand that rest is not inherently bad. Rest is important. If you feel like you're overdoing it, you need to rest. The first 24 to 48 hours after the concussion, rest is fine. But rest as your only protocol, as the only system you're going to use in your recovery, is not going to get you anywhere. The brain learns through stimulation. It learns through relearning that association. If you never leave your room, if you never turn on the lights, if you never listen to anything or watch anything, it thinks that those things are dangerous. It has that association: danger, danger. When you do come outside to see your family, to, I don't know, go to the bathroom, it perceives that as danger because it has now made that association that I need to be in a dark place. Not only are you telling yourself subconsciously, your physician is telling you, you're reminding yourself, maybe now your spouse or your family members are saying, the doctor said don't leave the room. The doctor said stay in bed. The doctor said don't have any lights. Well, guess what? The doctor is using archaic forms of recovery. That is not going to get you anywhere except for an extended PCS bout. Much like if you don't use your muscles, they diminish. If you don't stimulate your body to different environments, you become deconditioned. Your body perceives that as a threat. What it doesn't get accustomed to It associates as something that I'm trying to avoid. I'm avoiding going outside. I'm avoiding opening that door because what out— what's out there is uncertain. With uncertainty becomes danger. And as a nervous system that's already dysregulated, that's already out of whack, when you add that danger element into it, you're now going to throw your symptoms for a loop. Everything's going to go haywire. And guess what? That's just going to reinforce to you that when I go outside, it's going to make me worse. The doctor was right. The doctor wasn't right. The doctor has now placed that into your mind that the outside world is dangerous and a threat. And that when you go out there and you have those symptoms, you're now confirming that bias, that bias that is completely incorrect. I lived this life. I lived like a hermit. They call this cocoon therapy. Basically, you throw the covers over your head, And you don't move. It's a terrible existence. I lied there like a sack of potatoes, nothing going, because that's what I thought I was supposed to do. I opened the doors, I opened the windows. Guess what? Whoa, that's bright. Symptoms flaring. Danger. That's what I was reinforcing in my system. But it doesn't have to be that way. But you can't start by just running outside Or running up and down the stairs, because that is going to flare your symptoms. That is going to reinforce that negative association. What you can do to— for starters is watch videos like this. Just kidding. But what you can do is educate yourself and understand that you can be a change agent in your recovery. You have power. It is the greatest thing I learned in my recovery. It is the greatest thing that I can teach you. You can be the person You want to be, and you can actually be the leader of your recovery. It's completely possible, but you need to start very, very small, especially right after a concussion. Your tolerance is very low. So maybe I struggle with light. I open that door a crack and I can see the light coming through. Whoa. I start to get that headache. I start to feel dizzy and I start to feel nauseous. I want to sit down. So I need to figure out a way to slowly add light into my day. And it's not by looking at the sun, I'll tell you that much. So maybe this week I'm going to throw on a very dim lamp just in the far corner. It's going to provide a little bit of light. But if I can go a day without that lamp causing me my symptoms to flare, what is that doing? It's changing that association. It's changing how I view light. Light is not inherently dangerous. Well, I know that as a person, but my nervous system has now tricked itself to think all light is bad, all sound is bad. So what about after that small lamp? Maybe I'm going to have a slightly brighter lamp, or I'm going to move the lamp closer to me, and maybe next I'm going to open the blinds just a touch, just to get a bit of natural light coming in. You see how I'm making small incremental changes? I'm making sure I stay below my symptom threshold. I'm making sure my body feels safe. I'm not becoming symptomatic. I'm not making myself worse. But what I'm doing is I'm convincing my body the world is not inherently dangerous. I can get out there. I can be productive. I don't have to be stuck in this bed for the rest of my life. Okay. So you need to start small. And anytime someone tells you the only recovery for a concussion is to rest, you need to tell them they're outdated. Please. Here's what I want you to understand about rest. Rest begins your recovery, but reintegration completes it. We need to start small, but we need to scale up eventually. Your brain needs safety. But it also needs re-engagement. It needs to be part of society. It needs to know that things are safe. But it starts small. So start small and you will be okay. If you want to learn more about starting small, you can watch my video on kaizen. It's a Japanese philosophy about small continuous improvements. Thank you very much for your time, even though I'm losing my voice. I'm gonna go drink some water. And have yourself a great day. ありがとうございました。
