Neuroplasticity is a term we often use in the physiotherapy world which relates to the brain’s ability to heal and restructure after injury. ‘Neuro’ relates to the brain or neurological system, and ‘plasticity’ relates to the ability for something to change or mould over time. Basically, this is the brain’s ability to ‘rewire’ itself after it gets damaged.
Why is it important?
Once upon a time, the medical community thought that damage to the brain was permanent. Any issues or symptoms that came from damage to the brain were considered irreversible. Thankfully, we now know that’s not true.
How does the brain work?
The brain is incredibly complex. The human brain is often referred to as the world’s best supercomputer. Just like a computer, our brain runs on electricity. Our brain is full of pathways (or neurons) that send this electrical activity from place to place. Through a complex series of activities involving electrical impulses and chemical transmission, our brain controls absolutely everything in our body.
I like to think of it in simple terms. Imagine a car driving through town. This car (electrical impulse) will travel down a series of roads (neurons) to get to its destination (the desired outcome such as pumping the heart, breathing, or moving a limb).
But what happens if there’s damage to the brain?
When there’s damage to the brain...
Injury to the brain can be caused by many things, like a car accident, Multiple Sclerosis or stroke. When there’s an injury to the brain, it’s a little like when the council does roadworks on the road you drive to work. Normally you drive that road every day. It’s quick and easy, and you don’t have to think about it very much. But as soon as those road works start, they put a detour in place. You might not be familiar with the new roads you have to travel, which takes more effort and concentration on your part to navigate. It might slow you down and take you longer than usual to get to work. Overall, the process is now more difficult and time-consuming than it was before. But in the end, you still get to work and that’s what matters. And over time as you drive the new roads, they become easier and more familiar to get you where you want to go.
The exact same is true with neuroplasticity. When there has been damage to the brain these ‘familiar roads’ are no longer usable, and you need to find a detour to get the outcome you’re used to. This is where physiotherapy comes in, because we help retrain the body and brain to find the most effective brain detours to achieve the desired outcome.
Is neuroplasticity hard to achieve?
Yes and no. On the one hand, it’s how our brain is built. Consider learning a new language. You have to learn all those new words, learn how to move your lips and tongue in new and unfamiliar ways, and process it all with your ears to decide if you’re getting it right. This is an example of a very normal way that we develop new skills and talents, and our brain moulds and changes to allow that. So, in that way, our brain is built to do this.
The difficulty comes when you’ve had damage to the brain that causes significant loss of function, like no longer being able to use your hand or walk like you used to. There are three difficulties here:
1. It takes a lot of repeated practice to form these new brain pathways, because they’re complicated movements with lots of different parts to get right. Depending on what is happening for you, you could have to practice a movement hundreds or thousands of times to build new pathways and achieve your goal. It takes time, but it can be done
2. It’s frustrating! We see lots of people who are fed up with the difficulties they’re facing and just want it to work already! That’s completely understandable, because neuroplasticity takes time and progresses slowly. So be kind to yourself while you’re working on things
3. Some people have progressive conditions that cause ongoing damage to the brain. If this is the case, things can continue changing despite your best efforts. This is where your physio comes in, to work with you to help you adapt and learn new skills to best suit your situation moving forward.
Don’t lose heart
That might all sound a bit daunting. We get it. And chances are, if you’re reading this blog then you or someone you know has probably been through something big that now has a really significant impact on life.
It’s true that neuroplasticity and recovery from neurological injury takes quite a bit of time. The good news is that it’s often possible to make improvements with dedication and the right guidance. This improvement can often occur years after the fact, so it’s always worth investigating.
We have several therapists at In-Balance who have a keen interest in all things neurological. They can help you better understand what’s going on in your personal circumstances, and what can be done to meet your goals. Feel free to come in and see us if you want to know more about how we can help in your specific situation.