The Virtual Vine Blog

Insights and information about concussion health and a smarter recovery. Plus timely tips for your everyday well-being – from food and exercise, to meditation and mindfulness.

 Tags: Concussion


After a concussion, people often experience symptoms that limit how much physical and mental exertion they can handle. Concussion and brain injury are often thought of as invisible injuries because their symptoms can’t easily be seen from the outside. These injuries can lead to brain fog, affect memory and attention, sleep, mental health, and coordination. For the person feeling these effects, they can bear a heavy weight.

Many of us can likely notice our body’s signals when we’re experiencing burnout, fatigue, or an energy crash. For those with a concussion, these can feel much more acute—and can lead to setbacks in recovery.

So how do you get the right level of exertion to promote a healthy recovery from concussion? That’s where cognitive pacing comes in. Beyond tuning into your body, cognitive pacing comes with tools and exercises you can use to optimize your healing.

What is cognitive pacing?

Cognitive pacing relates to activities requiring mental energy, like learning a new skill, memorizing information, or focusing on reading. Cognitive pacing is a strategy of modifying these activities so they’re easier to perform, while gradually increasing the level of effort given to them.

It aims to reduce cycling between high and low levels of activity and to allow for periods of rest. That goal is to improve overall cognitive function with time.

Activity pacing is a related strategy that’s focused on breaking down physical activities into manageable parts. It’s a key component of pain management programs, such as graded exercise therapy (GET), cognitive behavioral therapy (CBT), and acceptance and commitment therapy (ACT).

Why pacing is important to concussion recovery

Cognitive pacing and activity pacing are proving to be key to concussion recovery. Healing from a concussion takes time and continuous effort. But that effort needs to be sustainable and steady to promote brain health.

It’s much easier to push yourself too hard or become overstimulated when you’ve experienced a brain injury. Overexertion, or pushing through until you can’t go anymore, will lead to a crash, where you’ll need to spend more time in a resting state. 

Not only can this be a setback to recovery, but it can reinforce negative feedback loops—such as low self-esteem, frustration, and depression.

One study explored the relationship between pain acceptance, physical activity, and functioning. It found that moderate physical activity and walking, but not vigorous activity, were significantly associated with improved physical and psychological functioning.

In other words, while a cycle of overexertion and burnout can lead to discouragement, cognitive pacing can act as positive reinforcement, keeping you motivated during recovery.

How to practice cognitive pacing

So how can you actually introduce cognitive pacing to your daily life? Here are some strategies and examples of what it looks like in practice:

Get guidance from your health team

One of the key elements of cognitive pacing is getting feedback and checking in with yourself. Having a health specialist, like your doctor or physical therapist, can be a great asset. 

They can help you set goals, check in with you on your progress, and determine when to dial up or down the difficulty of your daily tasks.

Be consistent and turn up the challenge slowly

Activities that are good for your brain and physical health include reading, going for walks, socializing, and learning new skills. Make time for activities that keep your brain active each day, but take things slow.

Consistency is important, so making these tasks very manageable for yourself will help reinforce their positive outcomes.

When you feel comfortable with a certain level of exertion, it might be time to take it to the next level! Consider what your next step can be, lean on your support system, and keep your goals realistic.

Check in with yourself

Tune into your body regularly. Notice how activities affect you: do you get overstimulated in certain settings? Do you feel anxious or exhausted?

Cognitive pacing is personal to you. As you experiment with the amount of effort you give certain activities, sometimes you’ll bump up against your limits. 

You’ll also need to be aware of what else is happening in your life. On more demanding days or weeks, give yourself more grace or slow down your pace.

Make use of positive feedback loops

Positive reinforcement is one of the most powerful ways to keep your practice going, strengthening your brain and mental health.

When creating digital health technology and apps, user experience (UX) designers often think about how to use gamification to keep users engaged. 

Just think of Duolingo, for example, which uses fun characters, rewards, regular reminders, and satisfying sounds to give you a positive boost when you practice learning a new language a little bit every day.

Fortunately, all this means that the tools and practices that lead to better health outcomes can also be very fun to use!

Take breaks regularly

As much as it’s important to challenge yourself, rest is essential to recovery. 

There are practices you can use to get better sleep at the end of your day, but cognitive pacing is also about taking breaks and getting rest throughout your day. 

Consider breaking up your day into chunks, giving yourself time to walk outside, look away from your screens, or take a nap. Your brain needs time to process information, form synaptic connections, and heal. So remember, you’re not doing nothing when you’re resting.


The rise of digital health technology means that there are more tools than ever to support your brain health and recovery. 

For example, telemedicine can give you access to health experts from the comfort of your home—allowing you to meet virtually or by phone and check in more regularly with your support team. 

There’s also wearable technology to monitor everything from your fitness levels to your brain activity. Having these analytics at your fingertips can enhance how you check in with yourself, taking it beyond feeling to having concrete data.


Concussion recovery isn’t an overnight process. It’s a continuous commitment to improving your brain health. 

Cognitive pacing offers a strategy of gradually increasing your level of exposure to different mental activities. For that reason, it’s a more sustainable long-term practice—and it can even be fun!

With time, you can improve your attention, focus, and function, so be patient with yourself and keep going!


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