THERAPEUTIC ACTIVITIES

While the cornerstone of older concussion treatment protocols was rest, it is now recognized that in order for the nervous system to recover, a balance between rest and activity must be found. Therapeutic activity is an incredibly broad term that can be applied to diverse activities for various purposes.
Therapeutic activity can be any activity that has a positive psychological effect. The goals could be improving mood, reducing stress and anxiety, enhancing focus, or promoting a sense of calm or relaxation. Often when individuals experience concussion, they tend to avoid a lot of the activity that they typically find meaningful, or that makes them happy, for example, nights out with friends or playing sports. This can lead to patients feeling down or sad. Does it surprise you that the brain does not function as well when feeling like this? Therapeutic activity can be applied purposefully to combat this withdrawal. Psychological well-being is an essential component to recovery as it facilitates an advantageous neurological state for healing and performance. Therapeutic activity can be anything from engaging with a close friend to something relaxing like a warm bath or an adult colouring book.
This may come as a shock to many: What if we told you that for optimal performance rest must be included in your daily schedule…it’s not to be just reserved for bed time. Does that surprise you? Imagine your children not resting at all, from the time they get up until they go to bed…what kind of performance would you expect at school? What happens if fun, pleasurable activities ‘just for kicks’, were not part of their days? How do you think that would affect your children’s cognitive performance, energy and personality? Do you have a double-standard? Do you treat your children one way and you a different way?

Therapeutic activity can be specific activity applied purposefully with the goal of enhancing function or reducing concussion symptoms. For example, therapeutic activity may be listening to pleasant music at progressively louder volumes to reduce noise sensitivity, or it could be playing challenging board games to work on one’s problem solving abilities. Ultimately, withdrawing from activity can be harmful, instead, engaging in activity at the right level of challenge is a terrific way to promote recovery.

Therapeutic activity can be any activity you do that you feel is meaningful and that contributes to health and well-being. Often when we’re truly engaged in something, we experience that feeling of being in the zone, focus, and absorption in the activity. Many times, this experience can promote happiness and enjoyment, and these feelings do contribute to one’s well-being. Whether recovering from a concussion, or physically healthy, it’s the reason for the age-old advice to do the things that you enjoy.
Therapeutic activity can also be a rest strategy. Athletes are known to try to hone as much performance as possible from their neurological systems. Did you know that rookie athletes tend to equate rest with sleep but more seasoned athletes tend to have more variety in their rest and relaxation armementorium. Adopting multiple areas of interest and achievement guard against burnout that occurs from a single-minded obsession gone awry. For concussion patients, that obsession can be something as simple as recovering from an injury or getting back to your previous activities. Just like for high functioning athletes who want to perform better, they are often guided to think outside the box to get ahead. Don’t be surprised if it takes 3-4 weeks to start realizing the benefits, it happens to these athletes too.   Rest and relaxation serves many purposes:
  • To store energy to prevent fatigue and exhaustion
  • To help the body recuperate
  • To be able to do more activities and to ensure adequate energy level for leisure
  • To feel better overall and decrease fatigue signs
Many patients refer to shopping and retail therapy. Some patients will spend 4 hours to go to a remote town to pick up some antique candle holders. While we don’t dispute that that may be fun, there are some things to consider when comparing materialistic past-times vs. ones focused on experiences. Now, even talking the dog with you on a long country drive to that remote town to get those antique candle holders can be an experience, but every decision has an opportunity cost. That is, if you weren’t taking that long drive out to the country to get those candle holders, what else could you have been doing? What would have been better for you? It’s good to keep in mind that material pursuits and experiential pursuits are different birds and more often than not, it’s worthwhile to opt for an experiential pursuit over a materialistic one. Material object pursuits are often short-lived and leave a kind of addiction to “retail therapy” in its wake:
  1. Adaptation to your new object happens quickly. It doesn’t take long before your are more preoccupied with that scratch on the candle holder than the joy it bring you.
  2. “Candle holder envy”. After a while you start looking at candle holders that have different features that yours doesn’t have. Rather than bringin you joy, it can be a reminder of what you don’t have.
  3. The bar keeps rising. Soon you may want a new dining set to go with your fancy candle holders
Experiential pursuits, on the other hand, like participating in toast masters, provide people with:
  1. An experience becomes part of identity. A witty, well-spoken person who can enjoy communication more fullly; or a piano player who can play Christmas carols at the family get together.
  2. Comparison matters little when seeing how each others’ experiences measure up. Your great date could have been just as good as the next persons although you may have done totally different things.
  3. Anticipation is pleasurable rather than causing impatience. Waiting to see the outcome of all your gardening is a joyous experience; whereas waiting to get the new iPhone may cause you to test your patience.
Materialism’s fallacy
  • Happiness doesn’t last as long as you have the item. Experience becomes part of who you are.
  • People report being more inclined to talk about their experiences rather than their material purchases and derive more pleasurable benefits as a result (Kumar et al., 2015)
  • In China were wealth is growing quickly and families are indulging in materialism more than before, a study found that more joy is derived by spending money on experiences rather than materialism (Yu et al., 2016)
  Kumar, Amit & Gilovich, Thomas. (2015). Some “Thing” to Talk About? Differential Story Utility From Experiential and Material Purchases. Personality & social psychology bulletin. 41. 10.1177/0146167215594591. Yu, Ying & Jing, Fengjie & Su, Chenting & Zhou, Nan & Nguyen, Bang. (2016). Impact of Material vs. Experiential Purchase Types on Happiness: The Moderating Role of Self-Discrepancy. Journal of Consumer Behaviour. 15. 571-579. 10.1002/cb.1598.
Ikigai a Japanese concept that means “a reason for being.” It is used to indicate the source of value in one’s life or the things that make one’s life worthwhile. There have been TED talks, Forbes magazine articles, Toronto Star articles, etc. on this topic. In the Toronto Star Article “Why North Americans should consider dumping age-old retirement” b
  1. What you love
  2. What you are good at
  3. What the world needs
  4. What you can be paid for
  en:User:Nimbosa derived from works in the PUBLIC DOMAIN by Dennis Bodor (SVG) and Emmy van Deurzen (JPG), CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons   There are several studies, mostly out of Japan, that equates Ikigai with positive neurophysiological and psychological benefits. Have you seen retirees going back to work? Or, some people are not retiring at all? How many have noticed that a family member feels more connected by continuing to work past the traditional retirement age? It’s a great cognitive exercise and keeps one more social in addition to many other benefits.

Do you sometimes feel that your life is dull since having this injury? Perhaps it is time to widen your list of activities. First, make a list of your current hobbies. Why not add those activities to your weekly planning? It can help to increase your energy level.

 

List of Possible Activities

Artistic Activities Photography, Music, Writing, Painting, Drawing, Listening to music, Acting, Going to a concert, Going to the movies, Seeing a play, Making a Visualization/Aspirations Board
Intellectual Activities Reading the paper, Reading textbooks, Reading novels, Classes, Meetings, Computer, Scrabble, Crossword puzzles, Chess, Puzzles
Manual Activities Gardening, Sewing, Landscaping, Crafts, Mechanics, Woodworking, Knitting, Cooking, Interior decorating
Physical Activities Walking, Cycling, Skiing, Training, Swimming, Volleyball, Bowling, Tennis, Hockey, Baseball, Soccer, Weight training
Social Activities Card games, Monopoly, Bingo, Committees, Shopping, Dancing, Familial activities, Activities with friends or a group, Going out, Camping, Having friends for dinner, Visiting friends or family, Eating out, Romantic relations, Clubs (e.g., Toast Masters)
Entertainment  Watching TV, Watching a DVD, Listening to the radio, Video games
Other Traveling, Religious/spiritual practices, Looking after a pet, Making/preparing Christmas gifts, Improving nutrition, Volunteerism, +/- Shopping **
Relaxation Forest bathing, float tank, Music, Bathes/Spa, Meditation, Sleep, Vacation, Yoga
Reduction of Alcohol, Screen time, Marijuana, Overwork, +/- Shopping **
  **See section “Materialistic vs Experiential Therapeutic Activities”
  ***Note: some of the above activities may not be recommended and will depend on your level of recovery. You should run any activities passed your treating team before adding them to your regimen.

Research & writing: Dr. Taher Chugh

Last update: September 2019