In this instructional video, David Brimacombe explains why some individuals continue to experience persistent post‑concussion syndrome (PCS) beyond the typical recovery window and offers a multi‑dimensional approach to overcoming it. He begins by defining PCS (symptoms lasting > 1 month) and noting that 20 % of cases exceed a month while 2‑3 % persist beyond a year, sharing his own experience of two year‑long PCS episodes. Brimacombe critiques the traditional “rest in a dark room” advice, arguing that prolonged inactivity worsens cerebral blood‑flow dysregulation and hampers healing. He highlights three core physiological drivers of ongoing PCS: (1) autonomic nervous system (ANS) imbalance – a chronic sympathetic‑dominant state that feels like a constant threat; (2) reduced cellular energy (ATP) threshold – low stamina that triggers symptoms when activity exceeds a personal limit; and (3) whole‑body inflammation, often compounded by untreated neck, vestibular, or ocular dysfunctions. He stresses that fragmented specialist care often misses these interconnected systems. Psychological factors are also crucial: loss of belief and negative self‑talk can lock patients into a maladaptive cycle. To address these issues, Brimacombe outlines practical strategies: (a) regulation through breathwork with elongated exhalations; (b) the PACE acronym (Pause, Anchor, Close the cue, Elongate breath) for moment‑to‑moment stress management; (c) reframing with positive mantras (the “Maui Habit” from BJ Fogg); (d) graded exposure training just below the current energy threshold to gradually raise capacity; and (e) belief‑rewiring before sleep to reinforce that the brain is not broken, only dysregulated. He illustrates the turning point in his own recovery with a personal anecdote about losing control, punching a stool, and realizing the need for regulation. The video concludes with a call to action for viewers to adopt these habits consistently, acknowledging that change is gradual but achievable. The tone is conversational, empathetic, and motivational, aimed at individuals suffering from PCS seeking actionable guidance.
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On this channel, I'm looking to help dispel the myths and create a better understanding of what someone with post-concussion syndrome can do to better their situation. Today, I want to talk about why you still have PCS. Now, let's start with a bit of a definition. So persistent post-concussion syndrome, or post-concussion syndrome, means that you've had your symptoms for longer than a month. Now, a lot of people start to panic when that happens, but around 20% of all cases last longer than a month, and actually up to about 2 to 3% last longer than a year. Now, I know this all too well. I had 2 cases of PCS that lasted longer than a year. Now, it wasn't until I learned some of the things we're going to talk about today was I able to stem those symptoms and get my life back to normal. Now, the key here is that you are not alone. This is not some kind of genetic anomaly. Or you are the only one feeling this way. Here's the common story, and this happened to me as well. First thing you're told is rest. Go in your room, make it dark, take all the stimulus away. So whether that's light, that's sound, anything that's going to cause a disturbance in your systems, and you rest and you wait. And in time, the thought is, or the thought was, that your brain would heal on its own. Now, that has been dispelled. The concept that if you're resting for longer than 24 to 48 hours, you're actually doing yourself more harm. Now, think about it this way. When you have a concussion, your blood flow is dysregulated. So you're not getting the same amount of blood flow to your brain and the rest of your body that you normally would. The best way to increase blood flow is to move. So by sitting still in a dark environment, you're making that situation worse where you're having less and less blood flow, making this a harder and harder thing to overcome. Second to that, you might be— you might have gone to see multiple specialists. Maybe you saw a neurologist, a functional neurologist, multiple physical therapists, occupational therapists, chiropractors, whatever the case may be. Maybe even some specialists that work with your vestibular system. But in many cases, they weren't able to fully resolve the problems. The reason for that is that a lot of these specialists are working on their own. For example, if I'm a neurologist, I'm going to focus on the neural networks of the brain. But if I don't understand that a lot of the problems that are creating the symptoms that I'm feeling in my brain are coming from either my neck or my dysregulated autonomic nervous system, I won't be able to correct those systems and therefore stem all the problems. And lastly, losing belief. If you do not believe that there is a way out of this, if you do not believe that there is a path for you to take where you can become the person you used to be, or even better yet, a better version of yourself, Then there is really next to no hope in your resolution. So how do we change that? That's another thing we're going to talk about today. Real reasons why you still have PCS. I know maybe you've seen a neurologist, maybe you've seen your, your family physician, and they've talked about the concept of your brain just needs to heal. Your brain has been damaged by this traumatic injury and it needs time to heal. Now, that might be part of it. Those who have a more severe TBI, you might have had some brain bleeds, some fractures of the skull. But for most people, if you have a mild TBI, it's more so the fact that the systems in your body have now been dysregulated. So let's start with this. The first thing that needs to be corrected is your autonomic nervous system. Now, you might have heard that before. When we think of the autonomic nervous system, we think of stress, and we think of that rest and digest. Okay. The problem lies in the fact that once you have that concussion, your body tends to lean unjustly more on the stress state, your sympathetic state. So we think again of that car analogy. The foot is on the gas and it doesn't want to be released. So you always feel like your wheels are spinning. You always feel like you're this close to being burnt out. You always feel like any little incident in the day will put you over the edge. That is not a normal feeling. Your body is taking that sympathetic state and it feels like there is an actual threat. When in doubt, Your body is just dysregulated. So how do we get to a place where we can actually come back to a baseline, where we can actually toggle in and out of that parasympathetic to the sympathetic based on our life circumstances? Now, again, being in a stress state is not inherently bad, but chronically being in a stress state when you need to be oscillating between this parasympathetic and the sympathetic is what's harming your body. Secondly, your energy threshold. One of the biggest things I noticed when I was suffering from my second stint of PCS was that I had little to no energy. Even if I wanted to get up and walk around to go help around the house, to go to work, I did not physically have the energy to do so. I wanted to lay in bed and not get up. You have this energy threshold. Your body at this point is struggling to create enough ATP or energy So that you can actually function. And anytime you get up, you move, you actually cause a disturbance in the system, creating the symptoms that we think causing greater stress and greater strain on the system. Symptoms are not a sign that you're causing greater damage to your body, in this case your brain. Symptoms are signs. They are not setbacks. They are your body's way of telling you you've met a threshold. Okay? If I get up and start walking around, And I start to get lightheaded. I start to get brain fogged, and I start to get dizzy. Does that mean I just stop and never get up again? Of course not. What that means is that that is my threshold. That is my limit for right now. Again, for right now is, is the most important part of this because we can build this up. We can use exposure training by working just below that threshold to try to increase our ability to sustain any kind of work, whether it's walking, whether it's any kind of physical work, or cognitive work, that we can actually do so without symptoms. But it takes time, it takes patience, and it takes a plan. Another reason why you still have PCS is that you have whole body inflammation, and this whole body inflammation isn't allowing the certain parts of your brain that need to be healed to heal. You also might have neck, vestibular, maybe ocular issues that haven't been addressed. I did not realize this, that a lot of the issues that come from eye strain and pain are a result of a neck issue. Those small little muscles in your neck innervate through your eyes and actually allow your eye to move from side to side. So if you have an eye strain problem, a lot of times you could have a neck issue that needs to be worked on. Same thing with headaches. A lot of times headaches are based on a neck issue. If you work on that neck, a lot of times the headaches will reside. Let's talk about reframing. Start with regulation. When you get up, if the first thing you do is look for your phone or think about all the negative things that are going to come, And this day, you're setting the stage for what will happen for the rest of the day. You're creating a negative tone that will carry forward. You will feel symptoms before you feel any joy. So we have to find a way to help change that baseline. When you get up, I want you to come up with a mantra that reminds yourself of the good in life. Have an attitude of gratitude. This is the one I use. It's called the Maui Habit from BJ Fogg. It is, Today is going to be a great day. Even when you don't think it's possible, maybe today is going to be a great day, or today I'm going to do the best to make it an okay day. But you have to start with a layer of positivity. The second thing you're going to do is you're going to actually get into some breathwork. Any kind of breathwork that has an elongated exhale, so I would always say twice as long on the exhale as on the inhale, is going to help your body downregulate. Get into the parasympathetic state. So when you get out of bed, not only are you thinking positive thoughts, but you are also regulating your system to be ready for the day. The second thing you're going to do is pace yourself. Now, I came up with an acronym for PACE, and that stands for pause, anchor, close the cue, and elongate your breath. So whenever you start to feel like your stress is rising, you feel like, I'm about to go into a point where I don't think I'm going to say or do something I'm really all that proud of, I want you to think about the concept of pace. So whatever you're doing, pause, stop, anchor yourself. Usually that means sit down, stand still, look through a window, some way that you can help downregulate your system. Close the cue for C. Close the cue means stop all those negative thoughts, all those negative automatic thoughts that are entering into your mind. I want you to stop it. Okay? And lastly, elongate the breath. So what is that going to look like? I'm sitting down, I'm stopping what I'm doing, I'm closing that cue. So no longer am I having that steady line of negative thoughts entering through my subconscious. I'm going to stop it, then I'm going to do some breathwork. What that does is it gives your body a reset. Use this anytime in the day where you feel like you are so close, you're teetering on the edge of breaking. This will stop it and help you reset the system. And the last thing I want you to do is I want you to rewire belief. Before you go to bed, as soon as you get up, remind yourself belief is possible. Remember, your brain is not broken. Okay? There are systems that are dysregulated. I can tell you from firsthand experience. I had 7 concussions in my life. Okay? Some more serious than others, but I've had 7 distinct concussions and PCS on 2 separate occasions. I can tell you that I am now feeling better than I did prior to my first concussion. Because I worked on the systems that were dysregulated. I probably had dysregulation issues before my first concussion anyway, so I've been able to hone in on those problems and regulate my body and create the protocols that make me successful. I want to give you a personal example of how this played out in my life. Partway through my second stint of PCS, I was sitting outside my daughter's room waiting for her to go to bed. Now, part of the routine, our nighttime routine, was that I would sit outside her room and wait till she went to bed. Now, that was usually not an issue. It was usually 20, 30 minutes, and she would eventually fall asleep. But for some reason this night, I was overly anxious to leave. I was a little flustered and frustrated from the day that I had at work, and I just was not in a good state. Unfortunately, this night it took a lot longer for her to fall asleep. So while waiting, I was sitting and just stewing, and just the anger was festering. I had a stool that was right beside me. A wooden stool, and that stool had a glass of water on it. And I was just, I was feeling, I was grabbing for that stool and I knew I was going to do something stupid. She spoke up, Dad, I can't go to bed. And then that frustration boiled to a point that I'm not proud of, but it is probably the tipping point of my recovery. I turned and punched the stool, in the process breaking my hand and breaking the trust with my daughter. What happened from there is that I had to walk around with a cast on my hand. People would ask, you know, what happened? Did you have a sports accident? No. I'd have to tell them. I'd have to be— show a little bit of humility. I actually punched a stool out of frustration. And having to say that story multiple times told me a little bit about myself, that I wasn't where I needed to be, that frustration was guiding every single behavior that I had. I was stuck. The gas pedal was pushed. I could not get my foot off the gas. So what did I need to do? I needed to find a way to regulate. This was the start of my recovery, and the protocols that I use are the protocols I'm going to talk to you and show you in the coming videos. Healing starts when you shift from fear to curiosity and eventually to consistency. This is not going to change overnight, but you can start layering those good habits that will create a pathway for you to be successful. If you like this video, please like and subscribe to this channel. Thank you.
