VERY LONG TRAUMATIC BRAIN INJURY
EFFECTS OF MILD ARTICLE TITLE GOES HERE
AND TAKES UPEXERCISE, AND RECOVERY
ON ANABOLIC HORMONES, LOTS AND LOTS OF ROOM
anabolic processes such as protein synthesis and glycogen uptake
(28). Thus, reduced GH concentrations will likely have a negative
impact on the concentration of circulating IGF-1 (27).
Like GHD, suppressed testosterone concentrations have been
reported to occur in those who have suffered a TBI (16).
Testosterone is an anabolic hormone that modulates lean body
mass, physical performance, and recovery (19). Additionally,
testosterone also functions to increase protein synthesis, regulate
body composition, improve muscle strength, and increase bone
density (7,10). Further, low testosterone concentrations have been
reported to either transiently or permanently occur in contact
sport athletes following TBI. A case study by Tanriverdi et al.
detailed a transient decrease in testosterone of an amateur kick
boxer after suffering a head trauma (34). Another case study by
Auer et al. detailing hypogonadism in a 27-year-old soccer player
further suggests that multiple mTBIs adversely affect testosterone
concentrations, and that pituitary evaluation is warranted in
athlete populations that have suffered mild, but frequent, repeated
head trauma (2). Chronic suppression of GH and testosterone
concentrations in tactical athletes may have deleterious
consequences on exercise capacity and recovery and will likely
impact performance of physically demanding occupational tasks.
Tactical athletes must be physically prepared to perform
occupational tasks, underscoring the importance of prescribing
an appropriate physical training program, performing ongoing
physical assessments, and monitoring recovery status. Highintensity exercise programs place a great amount of physiological
stress on tactical athletes and frequent exercise bouts with limited
recovery will result in plateaued or reduced performance (18).
Thus, adequate recovery is essential for exercise progression,
injury mitigation, and expeditious return to duty—necessitating
careful monitoring of recovery status by the tactical facilitator
(4). However, exercising too soon following an mTBI injury
is contraindicated, and can result in re-injury and/or delayed
recovery whereby concussion symptoms return (13). Once mTBI
symptoms have resolved, a graded resumption of premorbid
activity is widely cited in the athletic and military literature as
the recommended approach to re-establishing exercise routines
following mTBI. However, this timeframe is highly individualized,
ranging from days to months and should only begin after the
tactical athlete has been cleared by a license