🧠 The Power of Self-Regulation in Concussion Management

💡 Why Self-Regulation Matters More Than Ever in Concussion Care

In the evolving landscape of concussion rehabilitation, self-regulation has emerged as a critical yet under-discussed component of recovery. While rehabilitation traditionally focuses on symptoms, physical tolerance, and return-to-play progression, patients’ ability to recognize, interpret, and respond to their internal and external cues can fundamentally shape their outcomes.

Self-regulation supports:

• More accurate symptom appraisal

• Reduced anxiety and maladaptive behaviors

• Improved adherence to activity guidelines

• Greater confidence and autonomy in recovery

• Better long-term self-management of daily demands

As rehab professionals, weaving self-regulation strategies into our clinical approach can significantly enhance patient engagement, reduce fear-avoidance, and support safe progression.

🔍 What Is Self-Regulation?

Self-regulation is the conscious effort to control thoughts, emotions, and behaviors in alignment with one’s values and goals. It is composed of four key elements:

• Standards: What does successful behavior look like?

• Motivation: What drives the individual to meet those standards?

• Monitoring: Are they noticing cues that signal a need to adjust?

• Willpower: Can they resist urges that derail progress?

In sport and rehab literature, strong self-regulation skills are associated with:
✔ Lower anxiety
✔ Improved preparation and decision making
✔ Enhanced motor learning
✔ Better endurance and performance

🧠 Self-Regulation in Concussion Recovery

Concussion introduces rapid changes to physiology, cognition, and emotional stability. Patients must frequently judge what they can tolerate, whether to adjust activity, and how to navigate internal and external pressures.

Recovery self-regulation refers to:

Recognizing one’s current state, identifying the desired future state, and taking actions to minimize the discrepancy while navigating recovery demands.

This becomes especially important when symptoms fluctuate or when external demands—school, sport, work—exceed the patient’s perceived capacity.

🧩 Process Model of Recovery Self-Regulation

1. Self-Monitoring: “What am I noticing right now?”

Patients learn to recognize:

• Internal cues (symptoms, fatigue, mood, cognitive energy)

• External cues (environment, expectations, stressors, rewards)

Key questions include:

• How are my current symptoms influencing my behavior?

• What environmental factors are helping or distracting me?

• What pressures or opportunities are impacting my decisions today?

2. Identifying Alignment or Misalignment

Patients examine whether their actions reflect their actual physiological state.
This stage builds awareness of over-pushing, over-resting, or ignoring signals.

3. Making Small, Meaningful Adjustments

Patients choose the next best step, not the perfect step.
Examples:

• Adjusting study time

• Choosing a shorter walk instead of full avoidance

• Using pacing instead of rest-only strategies

4. Guiding Adaptive Decisions

This coaching-based approach helps patients interpret cues, maintain tolerance, and build confidence.

🎯 Clinical Takeaways for Rehab Professionals

1. Self-regulation skills are teachable.

Integrate cue recognition, pacing, and decision-making into your daily sessions.

2. Fear-avoidance is common—and treatable.

Validate the fear, then introduce small, safe exposure steps.

3. Self-monitoring tools help.

Consider:

• Symptom tracking

• Activity logs

• Thought logs

• Internal vs. external cue mapping

4. Your language matters.

Use reflective questions:

• “What do you notice in your body right now?”

• “How do your thoughts and environment influence your symptoms?”

• “What’s one small adjustment you can try today?”

5. Self-regulation reinforces resilience.

Patients develop confidence, autonomy, and adaptive behaviors that extend far beyond the clinic.

📚 Interested in Measuring Self-Regulation?

The Self-Regulation of Sport Practice (SRSP) Survey may offer insight into your athletes’ tendencies regarding planning, monitoring, evaluation, and decision-making.

Becky will be giving a 1 hour CEU Webinar this week related to this specific area! 

Foundations of Concussion Management for the Rehab Professional

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