I was hit with a spinnaker pole when sailing four years ago which resulted in a concussion. I have an ongoing problem with fatigue and, in particular, exercise intolerance. While I am fine at rest and doing gentle activity, any kind of more strenuous activity results in fatigue and headaches. Often these symptoms are delayed and appear after activity or the next day.
While the symptom threshold has improved over the four years (i.e., I can do more activity before symptoms appear), it is still a problem and a normal level of physical activity is beyond me (i.e., sailing for 30 minutes in moderate winds results in a return of symptoms). I would like to know if this is a common problem, why this might be happening, and if there is anything I can be doing to improve my exercise tolerance.
You are right, fatigue and headaches are frequent problems following traumatic brain injury, and your experience of having this occur only with greater amounts of activity is common. It’s also common to experience these symptoms following activity or exertion.
The reasons for these phenomena are unknown. Pain medications, ice, and certain select exercises might be beneficial for the headaches. Gradual and systematic increase in activity levels might be helpful for the fatigue. And finally, it might be beneficial to seek the advice of a specialist in traumatic brain injury for additional assistance.
Elliot Roth, MD is the Paul B. Magnuson Professor and chairman of the Department of Physical Medicine and Rehabilitation at Northwestern University Feinberg School of Medicine, and chairman of the Department of Rehabilitation Medicine at Northwestern Memorial Hospital.