Latest / Understanding Your Concussion / Episode 12: To Push or Not to Push Through Symptoms?
Transcript
- Jana: ⁓ Hi, I am Jana Kapp. I know the concussion recovery journey deeply, ⁓ both personally ⁓ and professionally. Join me in understanding your concussion, ⁓ where I empower you in navigating the complexities of a concussion recovery journey by sharing the science of what is going on behind the scenes, the stories of why we feel the way we feel, and how we can work with our brain to find our way back to feeling and functioning like ourselves again. To push or not to push through your symptoms. How many times have you asked yourself this question? Should I push through? Should I not push through? What is the best practice for me? How do I know? There's a lot of mixed information about symptom management. Some people do encourage to push through, and others do not. How Are you supposed to know what is the right answer? The question of should I push or should I not push was constantly running through my head after years of living with concussion symptoms. I didn't know. What was the right answer? And I know that many of the concussion clients that I work with, and maybe you as well, have been in this space where you have asked yourself, should I be pushing through Should I not push through? I do have an answer, and many people don't really love the answer that I give. And that's because it is not clear-cut and it's not straightforward. in a concussion recovery journey, we are looking for that clear cut, straightforward answer. I cannot say that the right answer is to push or to not push, because the reality is, the answer is it's both. There is a time when you should push through your symptoms. There is a time where pushing through symptoms might not be an option, and that's the only choice you have. There are times where you're unaware that you are pushing through symptoms. And then there are times where you know you cannot push through your symptoms. There are times where you know that holding back, doing less is the right answer for you. And that's why the answer is both. Because there is a time and a place to push through your symptoms. And there is always a time and a place where you should not. It's just being able to determine what is the right answer for you. If you listen to the episode on mindset, episode eight. I discussed how in a concussion recovery process We often adopt an all or nothing mindset. And that comes along with this option of Do I push through or not? That is, do I do it all or do I do nothing at all? That all or nothing mindset really brings in more of a black and white approach. recovering from a concussion requires more nuance and us to learn how to navigate the gray. I know when I'm working with someone who has sustained a concussion and they're in the acute stage, I will instruct individuals at that point in time that the best advice I can give them is to not push through their symptoms. But when you've been living with long-term concussion symptoms, it's not so straightforward. There are times when you will need to push through, will choose to push through, or have no choice to push through. And there are times where you can choose not to push through. Because the reality is, it's both. With long-term concussion symptoms, it leads to a choice. With an acute concussion situation, it's not going to set the individual up for success to push through their symptoms. When you are navigating persistent symptoms, or long-term concussion or chronic symptoms, there is a time and a place to push through. It's learning when is the right time to push through and when is not. And that comes down to the individual. To begin to understand when it is the right time to push through and when it's not, it brings us back to the conversation around capacity. there is a whole module dedicated to understanding capacity, especially related to a concussion recovery journey, in lesson two, understanding your symptoms. I'm going to give you that introduction today. If you're looking to dive in through more, check out the link in the show notes for you to access the website for you to get more information on understanding your concussion courses. For me, capacity is about the amount of information or stimulus one can tolerate in real time. We are all individuals when it comes to our capacity. Every single human being on this planet has a level of capacity that is unique to themselves. But once you sustain a concussion, Your capacity will automatically lower. And part of the recovery process is to build your capacity back up to what you once remembered. When we don't have enough energy or capacity to sustain a task or activity that we're doing in a day, through the week, through a month, through the year, then We can experience symptoms. being able to understand how to work with your energy levels and your capacity is a key component to living symptom-free. I always like to give people a visual when it comes to capacity. And the visual that I often give is similar to a traffic light. A traffic light has those three colors: green, orange or yellow, and red. When we are in the green zone, this can also be known as our safe zone. That green zone or safe zone is when we are typically symptom free or symptom limited. As we start to engage in our daily tasks or return to work or sport or just generally living our lives, when we start to experience symptoms, that is our brain's way of communicating to us. That we are starting to move towards the yellow zone. The yellow zone is your threshold between being symptom-free and not being symptom-free. The more you continue to push through your symptoms, avoid, or ignore your symptoms, it is most likely that you will end up experiencing being in the red zone. Red zone is more of your danger zone because that's where you are experiencing intense and really frequent symptoms. We often can label the experience of being and living in the red zone as a setback. But for me, I realize that setbacks don't actually exist. Because we're never actually taking away anything from our healing. We have pushed through our symptoms, pushed ourselves beyond our capacity into that red zone. And now we are very symptomatic and overstimulated. That's why for me, setbacks don't exist. It's just a reality that I have really pushed myself and made myself symptomatic and overstimulated. when you think about your capacity and these different zones, green, yellow, and red. The goal that we often want to achieve is for us to try and stay in that green zone throughout our day as much as possible. One, because we are gonna feel better. We're gonna feel symptom free or symptom limited. And when we feel at our best, we have more energy. We're within our capacity. We can tolerate more and it gives us more energy. and longevity throughout our day. but many of us are not really sure how to stay in our green zone throughout the day. we do tend to experience symptoms. when we reach that yellow zone is where we have that choice to either continue to push and experience more symptoms Or take the opportunity of realizing our brain's communicating to us that it's getting beyond its capacity and adopt a restful moment or a break in order to bring us back down to our green zone. Initially, I wasn't aware of how I was engaging with my concussion recovery and my capacity. I was fluctuating all over the place. There were times where I was in the green zone and I felt symptom free and okay. And I figured, great, I'm getting better. So I would do more and I would push myself more. And then all of a sudden, I would get more symptoms and they would keep coming and coming because I wasn't aware that my brain was communicating to me my capacity is. overloaded and I can't tolerate anymore. If I continue to push and push all the way up into that red zone where I felt extremely symptomatic and overstimulated, I got to a point where I could not push anymore. And I would find myself crashing and getting stuck in rest because I had no energy, no capacity, and was overwhelmed with symptoms that I had to just stop everything in my life and wait until symptoms settled. I was fluctuating between green and red and green and red for four years. I would push myself too much and then I would crash. It would take time, I'm talking days to weeks to recover, and then I would feel better and think, okay, I'm good. The setback's over. And I would try all over again. And I followed this pattern for four years. I call it the push crash pattern. I started realizing that this pattern was not supportive, but I wasn't really sure how to get out of it. So pushing through my symptoms was not working. On the flip side, when I would crash and I would get stuck in rest, there were times where I would feel better. But then I was afraid to do more because I didn't want to end up back in that pattern again. And so I stayed in what was my green zone at the time. So that I could continue to feel symptom free and symptom limited. I was avoiding participating in life in fear of getting stuck back in that heightened state of symptoms in that red or danger zone and then crashing and not knowing how long it was going to take for me to recover. I call that the avoidance pattern. The push crash pattern and the avoidance pattern was getting me nowhere in my recovery process. I was not healing. I was just stuck on this hamster wheel of pushing through or not pushing through. That all or nothing mindset. That's just a different way that that all or nothing mindset can show up. In our recovery process. As a healthcare professional myself, I'm a registered physiotherapist in Canada. I was fortunate to be able to take courses on concussion management for healthcare professionals. I knew this was something I was passionate about, being able to help other people navigate. But at the time I needed it for myself. Currently in the research, what is recommended is that as you participate in a task. You compare your baseline symptoms before the task on a scale of zero to ten. To then how you feel during or after the task. If your symptoms have increased more than two points from your baseline, then that is your cue to stop and take a break. That two-point scale is what really does benefit us to understand that we should not push through our symptoms. And this is a key successful component for that acute stage. But it's very difficult when you have been living with long-term symptoms to navigate those nuances of the yellow zone Why I say it is important for you to push through symptoms is because overstimulation or that yellow zone when you're starting to get symptoms is actually your growth zone. We are repairing, rewiring, and creating new neural pathways as we heal from our concussion. When you were starting to engage in a new Task or activity, a new level of your return to work protocol or sport protocol, when you start to do something new or more of something in your recovery process. It does come with symptoms, especially if you've been living with chronic symptoms. Symptoms are a part of this experience. What we want to focus on is more of the nuances of our symptoms and the intensity of those symptoms. If we are repairing, rewiring, and creating new neuropathways, that will come with symptoms when we are trying to do something new because there isn't that established pathway already laid down. Our brain is trying to figure it out. It's working at building these new neuropathways, and sometimes that can be associated with symptoms. If you do not allow yourself to push at times, your capacity will not grow. That's why it's okay to experience symptoms. It's okay to push through at times. What you need to be mindful of is the intensity of those symptoms that you're pushing through. It's not ideal to be pushing through. High intensity symptoms, anything really above a five. If your symptoms are reaching that six or seven out of ten, you're not going to be helping your brain to make good changes. It's going to contribute to more symptoms, more overstimulation, more fatigue, more delay in that recovery time. Whereas when you allow yourself to push a little bit, but keep the intensity of the symptoms low, then your brain is starting to build and grow those neuropathways, but without those symptoms associated in that pathway. So you do need to push. But it's more about what you're pushing through and the intensity that you're pushing through. Because if you don't allow yourself to push. A little bit, then nothing is going to change. You will be stuck in that space of the capacity that you do have. We ideally want a linear recovery to our concussion process. We want healing to be clear-cut and straightforward And if you listen to the all-or nothing mindset. Episode, you will know that what I talked about is that a concussion recovery process isn't a straight line. Healing is never a straight line. It's more of a zigzag line or hiking a switchback road on a mountain. There are always new levels and layers and phases of healing that we are going to go through. If we don't allow ourselves to move through those phases and work with the intensity of our symptoms, we're not going to be making progress up the mountain. We're not going to be making progress in our recovery process. But then on the flip side, is that if we are constantly pushing, our brain will hit that level of capacity in the red zone where it can't tolerate anything anymore. And it just causes you to tumble all the way back down to what feels like the bottom of the mountain, but it might just be the bottom of that switchback section. That's why the answer to do I push or not push is both. And you need to be able to determine what zone you're in. Are you in a green zone and hitting a little bit more of that yellow zone? And your intensity of your symptoms are kind of subtle. Is that worth pushing through for you? Or is continuing to push through going to drive you into that red zone? where your symptoms are now gonna be really intense, and you are going to have to spend some time recovering from that push being in the red zone. Being able to get to know your zones will help you navigate your capacity. What does green feel like to you? What does yellow feel like to you? And what does red feel like to you? Because it's all about how you want to feel and function. And that's why your yellow zone is your growth zone, but it's also the zone. Where you get to empower yourself to choose. Do I want to feel more symptomatic or do I not? We may not get to choose if we experience symptoms or not through the recovery process or at certain phases during our recovery process. But we can choose how intense we want those symptoms to feel. When it comes to trying to choose, should I push or should I not push? You want to ask yourself some questions. You need to zoom out and decide for yourself in that moment. Is this a good choice for me? Can I handle the intense symptoms that I will experience if I continue to push? What else do I have coming up later today, tomorrow, or through the end of the week that if I continue to push myself into the red zone, do I have the time to recover? Cause we often don't have control over how long the recovery time will be. Have I taken a break recently? Is it that if I continue to push, I'm gonna end up in the red zone? Or can I allow myself to return back to green before I move through the next part of my day Have I put energy back into my body? I've been putting energy out and now I'm experiencing symptoms and I'm in the yellow zone. If I give myself energy back in will that help my symptoms and my capacity and bring me back into my green zone? How do I want to feel? Is it worth it to push through these symptoms so that I can continue to enjoy this task or activity that I'm participating in? Is it worth it to push through? Or not? in the end, if we are pushing through symptoms for someone else, to stay that little bit longer at work, to stay that little bit longer at that social event, to add another task or activity for someone else, if we know we're already in the yellow zone. And we do choose to push through. We are the ones that are going to have to deal with the repercussions. Not the person we stayed the extra hour for, not the extra shift that we took for that person, not the extra task that we ended up doing to help someone else out. They sure are going to reap the benefit of you helping them. And that's a choice in itself. But you have to also ensure it's not going to jeopardize how you want to feel and function and your overall recovery process. It is your choice, but you have to make sure that you're okay to be able to handle those repercussions. I know when I was going through my return to work protocol, in the beginning, I was only doing about three hours a day. That's not a lot. And of course, my employer wanted me to increase my hours. But I knew that if I pushed myself beyond my capacity at that time, I was the one that was going to suffer. And what I found is that by pushing through on a Monday would impact how I would feel by the end of the week on the Friday. So pushing through on the Monday. Would end up me calling in sick on the Friday. So how was that helping my employer in the first place at all? I could do the three hours on Monday and push it to six, but then I wasn't able to do any hours on the Friday because I was dealing with that recovery time from pushing into the red. It also meant that I wasn't able to do anything else outside of work. my rehab would fall to the wayside. My social life fell to the wayside. And yes, of course, return to work is a priority and does impact our financial stress. But if we are only focusing on return to work, we're not actually allowing ourselves to heal as a whole person. And that's why I had to set a boundary to say, This is what I can do because it will keep me in that green zone. And yeah, usually by the end of the three hours, I had a headache, I was feeling fatigue, and my brain was getting foggy. So that was me pushing already into the yellow, experiencing low-level intense symptoms. And then that was my brain saying, that's it. That's all we can tolerate for now. by recognizing that that's what my brain was communicating to me and taking the opportunity to say, now I need a break, allowed me to live within that green zone, gently pushing into the yellow where I was able to Allow the neuropathways to start to build and then back off a little bit. now that threshold line of that yellow zone where it started, it was starting to increase, get pushed up, which meant my green zone grew. my green zone just continued to get larger, and that yellow zone continued to get further away. And I knew that healing was happening because I could end a three-hour shift and not have symptoms. I could work a whole week. three hours three times a week and at the Friday at the end of my week still not have symptoms. I still had energy. And now I was actually doing things on my weekend because I still had energy and capacity because I hadn't pushed myself up into that red zone and crashed. I allowed myself to gently grow that green zone by just pushing a little bit into that yellow zone and then backing off a little bit. That is the process of healing, is to allow yourself to push into that yellow zone just enough. And then take a step back. And then the next step is to keep it consistent. Repetition, a principle of neuroplasticity. By pushing it a little bit and then continuing that repetition of the same action of the same schedule for a few weeks, allowed that line of the yellow zone. To grow because now I grew those or built or created those neuropathways to support me and how I wanted to feel and function by staying within my capacity. And by doing so, my capacity grew. And that was the process that I started to follow. That was the pattern that I started to follow in order to. Grow my green zone. Grow my capacity back to what I once remembered pre-concussion. That's why the answer is both. So yeah, you do need to push through symptoms, but it's more about how you push through symptoms. Cause if you do nothing at all, you will not experience healing. If you do all of it, everything, all the time and push, you will not experience healing. That's your push crash pattern and your avoidance pattern. The pattern to healing is the duality of both, is embracing the duality of both. That yes, at times I need to push and at times I need to hold back and create a process or a schedule or a structure or routine that is going to support me to stay in my green zone and grow my green zone. The initial step is going to be you needing to return to your green zone before you can start to grow it. If you've been living in the red for many years like I was, yellow is gonna feel a hell of a lot better than red because your symptoms do come down. The intensity comes down. the frequency has come down. You are feeling better. But we can often mistake yellow for green. Yellow is better than red, but green is ideal Sometimes it can take us longer. To return into that green zone, then we realize. when you've been living with symptoms long term, we can forget what green feels like to us. We can forget what symptom-free feels like. We can forget what calm feels like. Like if you think of a pot of water, green would be still. Yellow would be starting to simmer. And if you continue to keep the pressure on, keep the heat on, and you continue to push through, that simmering is going to start to increase more towards a boil. Once you're boiling, you're at red. Now, if you turn off the heat, so you've hit that capacity, you can't function anymore, and you've crashed. while you're taking time to settle your symptoms, the heat is dissipating away from that pot. But it doesn't automatically go from boiling to still. It will start to take the heat away, and over time it will go from boiling. Back to simmer. Simmer is different than boiling. Yellow is different than red. But if you don't allow yourself to completely turn off the dial, turn off the heat, take the pot off the element, it will stay at simmer. It can take longer. to actually get the heat to dissipate, your symptoms to dissipate, so that now you are truly back in green and calm or still waters again. That's just a little analogy for you to kind of think about how you can return to your green zone and ensuring that you're truly in the green compared to yellow. When I share this information with clients, a light bulb goes off and you can see it. they start to understand, aha. I can be more in control of this process. If I allow myself to pay attention to the nuances of my symptoms, I know that tracking symptoms and paying attention to symptoms isn't always attractive to people living with concussion symptoms. Because when you've been living with them for months or years, you don't want to pay attention to them. You've been living with them. You want them gone. And I get that. But we do need to pay attention to the action that we're taking and how it makes us feel and function. Because we know we're gonna have symptoms. But in order to help them not to be there, we do need to pay attention to what our brain is communicating to us and to pay attention to the intensity so that that can help us be more empowered in how to engage with our brain, with our capacity, in order for that green zone to grow. I don't know if you like that answer. Let me know in the comments. I would love to hear your feedback. If this resonates and makes sense and you're having that light bulb moment, or if you're still feeling a little bit confused, kind of makes sense, but not sure how you can start to move this into a practice for yourself. That's what the courses are designed to do, is to help you have more information. Along with tools and strategies of how to start to live within your green zone, so that then you can start to grow your green zone. tools and strategies for you to be able to understand your zones. When you can recognize you're in the yellow, then you get to choose. Do I continue to move forward to red, or do I choose to return to green? Those tools and strategies are there for you in understanding your concussion course, lesson two, understanding your symptoms. This is a huge component of concussion recovery that not a lot of people talk about. If You choose any course to work with, I highly recommend lesson two. Because it's really going to give you that understanding of how to work with your symptoms, how to work with your brain to promote healing. So that you can get yourself out of either of those patterns, a push-crash pattern or an avoidance pattern. So that you can start to grow your green zone, to have more capacity, so that you can start to feel and function like yourself again. This was what I credit recovering from my concussion to was navigating the zones. The tools and strategies that I used to help me navigate my capacity, I still do to this day. after four years of living in that push-crash cycle or pattern, I did not like living that way. And I made a promise to myself that I would never live my life that way again. So when I'm starting to get communication from my body, my nervous system, my brain, my energy levels and I can recognize that my capacity has changed. I show up differently. Just like I did in my concussion recovery journey, I recognize I have the choice. I can empower myself to choose how I want to feel and function. And it can come with difficult decisions, saying no to things, canceling plans, not making plans. not being as consistent as I want to be. But in the end, the bigger picture or my goal to stay feeling and functioning like myself is more important to me. that's what comes with those choices. So as you can see, to push or not to push is not a straightforward answer. And I probably could keep rambling on about this. But I think I've given you a really good understanding about capacity, about your zones, green, yellow, and red, about when to push, when not to push. And that experiencing symptoms isn't always a bad thing. It can be that you're growing. It's your growth zone. But if you push too hard, it will impair your healing. And if you don't push at all, you won't experience healing. So there's your not so straightforward, clear-cut answer to the question to push or not to push. Let me know your thoughts. I would love to hear from you. Comment below or email me at concussionhealingspace.com. I would love to know. Do you push or not push? Does this answer your question? Thank you for joining me in understanding your concussion. I hope that you are leaving this episode feeling empowered in understanding what is going on behind the scenes of your injury, why you feel the way you feel, and how to begin to take action to move forward in your unique healing journey. Interested in checking out understanding your concussion course? Head to concussion healingspace.com or the link is in the show notes. You can purchase lesson one through four, reminder lesson one is free. If you're interested in connecting with me for mentorship and support, one on one consultations are available online or join the Concussion Support Club where you get access to all four courses and weekly drop in support club options