How to set goals for your recovery from Post-Concussion Syndrome

As I write this post in January, the whole world seems to be reflecting on the past year and thinking about making resolutions for the year ahead. This got me thinking about how helpful it can be to set goals for recovery from post-concussion syndrome (PCS), no matter what time of year it is. If you’re recovering from PCS, then now is as good a time as any to take stock of how your recovery has gone so far and to set some recovery goals for the days, weeks and months ahead. 

Some of the benefits of setting goals include the following: 

1. Giving you a sense of direction. Goals help you to avoid feeling overwhelmed by all the many different things you could be doing for your recovery. This frees you up to focus your limited energy on finding and pursuing some treatments, therapies and techniques that will take you to the next level of your healing and give you the best outcomes.  
2. Helping you stay motivated and committed to your recovery.  
3. Giving you a sense of achievement, which can boost your self-confidence and help you feel more positive about your life. 
4.  Saving you time and money. By prioritizing what to focus your efforts on, you’ll save both time and money, have fewer setbacks and be less likely to go down dead ends. 
5. Helping you manage your symptoms more effectively and improving your overall mental and physical wellness. 

Before setting some PCS recovery goals, take a look at the following questions to help you evaluate where you are at the moment. It’s fine to just read through the questions and answer them in your head, but I recommend getting a pen and paper or using your laptop or note-taking app on your phone to write down your answers, as this will cement things more clearly in your mind. Your responses can be really short, and you don’t have to do this exercise all at once; it’s fine to do it in small manageable chunks, and you can just answer a few of the questions if you want. Taking time for reflection will help you focus your mind; see your situation from different angles; see where things are going well and where things need improvement, and hopefully provide you with some encouragement and determination for the next steps of your recovery journey.  

Here are some questions to ask yourself: 

• What has gone well in my recovery so far?  
• What and who am I grateful for? 
• What hasn’t gone so well so far? 
• What am I going to continue doing? 
• What would I like to do differently? 
• What are some of my biggest struggles and challenges? 
• What challenges have I overcome? 
• What have I learned from the challenges? 
• Have I grown through my experiences in any way? 
• What are some of the things preventing me or making it challenging for me to move forwards with my recovery? 
• What are some thoughts I’m holding onto that are stopping me from moving forwards? What positive thoughts can I replace those with? 
• What do I want to achieve in my recovery moving forwards? 
• What are some steps I can take towards achieving that? 
• What do I think will help me move forwards? (Think about treatments, mindset shifts, lifestyle changes, relationships with different people, etc.) 

Now it’s time for you to set some SMART goals. You may already know about the importance of making SMART goals, but as a reminder, here’s a summary of what SMART stands for: 

S – Specific:

By making your goals specific, you remain focused on the next step. 

M – Measurable:

By making your goals measurable, you give yourself some data and information to decide whether or not something is working or not. You can also see whether or not you’re progressing, and you can decide if something is worth pursuing or not. 

A – Attainable:

By having attainable goals, you reduce the chances of setting yourself a goal that’s too big and daunting, which may result in you giving up too soon or failing. Start small and build up gradually. This way, you will see progress and can celebrate each step forwards which will boost you to keep going and provide momentum for the next steps. Be realistic about timings, and don’t expect to see success overnight. You may have some quick breakthroughs, which is wonderful but don’t expect that all the time.  

R – Relevant:

Make sure your goals are relevant to where you are now on your journey and are related to your reasons for wanting to get better. Another way to look at this is to think about priorities. You might set yourself a goal to get back to work, so then you’ll need to prioritise the relevant symptoms and areas you want to focus on fixing or managing in order to be able to do that. Or you may want to make your goal resolving the symptoms causing you the most challenges or discomfort. So, identify between 1 and 3 symptoms and tackle those first. Sometimes healing one symptom will have knock-on effects on others. So, for example, when I addressed my dizziness problem, I found I could also focus my eyes better. Then after that, I could move on to working on other symptoms.  

T – Timebound:

Having a set timeframe or a deadline gives you a sense of control, helps you to measure your results, keeps you on track, helps you manage your time better and hopefully helps you to see faster results. This one is perhaps less relevant for recovering from PCS as it’s impossible to set an exact timeframe for recovery. However, you could, for example, say that you’ll do all the exercises required by your physiotherapist by the next session. Or you’ll try as hard as possible to do the journal work your neuropsychologist has given you by the next appointment. Another example would be if you’re following a concussion recovery programme, whether online or in person. The course may be within a set timeframe so make the most of the time you have but be flexible and realise some things will take longer than you expect. 

With recovery from PCS, there’s a lot you can’t control, but setting SMART goals will give you a better chance of seeing positive results.  

Below are a few ideas for goals you could set. You may wish to make them relevant to your own situation, break them down and create specific steps or habits relating to each one. I’m sure you’ll have plenty of your own too: 

1. Keep working with your healthcare providers, such as your GP, specialists, physiotherapist and other providers. Follow your treatment plan, take any medications and/or supplements prescribed that are working, attend your appointments and follow any other recommendations. Communicate clearly with and stay in regular contact with them. Be clear, open and honest about your symptoms, concerns and needs. Discuss what’s working and what isn’t. They can help you adjust your treatment plan as necessary, help you set new goals and provide ongoing support and guidance. 
2. Eat a healthy and balanced diet. This can help you manage your PCS by providing the nutrients your brain and body need to function properly. Make sure you eat a variety of fruits, vegetables, healthy fats, whole grains and lean proteins. Limit processed and sugary foods. 
3. Drink plenty of water daily, as this contributes to keeping your brain and body healthy and working well. 
4. Get regular exercise. Regular physical activity can help improve your overall health and well-being, as well as manage stress and your PCS symptoms. It's important to work with your healthcare team to create an exercise plan that's safe and appropriate for you. 
5. Practice stress management techniques, as living with PCS can be stressful. Also, if you’re like me, you may feel that your injury has caused your fight-flight response to be activated quite a lot of the time. Chronic stress can have a negative impact on your health, so you want to find and use techniques that can help you relax and destress, such as meditation, yoga or deep breathing.  
6. Educate yourself about PCS to better understand it, take an active role in managing it and make informed decisions about your health and healing. 
7. Create a gratitude habit. This can be as simple as writing down three things you’re grateful for each day. These can be big or small and can include things like your health, relationships, going for a lovely walk or drinking a cup of tea in your favourite chair. Practising gratitude has numerous benefits, including making you happier and more positive. 
8. Incorporate mindfulness into your daily life. Focusing on the present moment and being aware of your thoughts and feelings can help you stay calmer and more grounded. 
9. Stay organised. PCS can be overwhelming, so put in place a few things to help you stay on top of your tasks and responsibilities. Create a daily routine for yourself. Use a planner, calendar or digital tools like an app, tracker or spreadsheet to manage your schedule and health information such as appointments and medications. Try to keep your living and working spaces as clutter-free as possible.  
10. Practice self-care. PCS can be physically and emotionally draining, so it's important to take breaks and practice self-care so you can relax, unwind and regain your focus and strength. Examples include having a warm bath, walking, cuddling a pet or diffusing some essential oils.  
11. Get enough sleep. Getting enough restful sleep is important for healing your brain and recharging your body. Aim to get between 7 and 9 hours of good quality sleep each night.  
12. Maintain and improve your relationships. This may include making an effort to stay in touch with loved ones, setting boundaries with people who may be draining or negative or working on communication skills. 
13. Consider taking up a new hobby or learning a new skill, such as cooking, a craft or a new language. You could also identify existing skills you have which have been impaired by your injury and work on improving those, for example, communicating, reading or swimming. To learn, you could read a book, watch YouTube videos, take a course or attend a workshop online or in person. This could be related to brain injury recovery. For example, there may be a workshop about managing symptoms and recovery held by your local brain injury group. 

As time goes by, and as you reach some of your goals, you’ll find you have new ones you want to set. So, make goal-setting an exercise that you do fairly regularly.  

It’s over 6 years since my concussion, so my goals now are very different from the ones I originally had. For example, I’m currently working on overcoming social anxiety, decluttering my home and doing more gardening. At the same time, I still use some of the tools and strategies I learnt at earlier stages of my recovery journey to continue managing lingering PCS symptoms such as headaches and fatigue, which still affect me from time to time.  

Reaching your goals can take time and requires patience and consistent action, which can be hard when you have PCS. The following suggestions should help to make working towards your goals less challenging: 

1. Find someone to be accountable to. This will make it more likely that you take the steps towards your goals and will also encourage you when things are getting tough. This could be a friend, a healthcare provider, a neuropsychologist, a counsellor or someone in a support group for people with PCS/brain injury.  
2. Surround yourself with supportive people who can give you emotional and practical support. PCS can be isolating, so having a strong support system of friends and loved ones who believe in you and encourage you can help you to feel less alone and can be a powerful motivator.  
3.  Take inspiration from your heroes and people you admire and look up to. These may be people you know personally or well-known people in the world. If they’re the latter, then read books or watch YouTube videos or documentaries about them or follow them on social media. 
4. Break your goals into smaller, more manageable steps: This can help you feel a sense of accomplishment as you see yourself progressing towards your goal.  
5. Write your goals down and post them somewhere you'll see them regularly, such as on your fridge or on your desktop. Research shows that writing your goals down means you’re more likely to achieve them.  
6. Reflect on your progress. At the end of each day, week or month, take a few minutes to reflect on your progress, check you’re on target and course correct if you need to.   
7. Celebrate your achievements: It's important to recognise and celebrate your accomplishments, no matter how small they may seem. 
8. Be flexible and open to change as you work towards your goals.  
9. Be realistic, and don’t place too much pressure on yourself. Progress takes time, and it's okay to have setbacks. Be kind to yourself and focus on what you can do rather than dwelling on what you can't do. 

Overcoming and learning to manage post-concussion syndrome doesn’t happen overnight. It takes time to find the approaches that work best for you. Everyone's journey with PCS is different, and everyone has individual needs and circumstances, so what works for one person may not work for another. While it’s possible for you to make a full recovery, this isn’t always the outcome for everyone. What’s certain, though, is that PCS can be managed with a combination of treatments, techniques and tools and lifestyle changes. So be encouraged and keep setting those goals!  

If you hit some obstacles and setbacks on your recovery journey, it can be helpful to remind yourself of all the reasons you want to get better. Move your focus away from feeling frustrated with where you are right now and instead focus on what your life could look like if you keep going with your recovery and continue to pursue your goals.

So keep going, and don’t give up.