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Neuroplasticity after Stroke or Traumatic Brain Injury – Rewiring the Brain

“Synaptic plasticity can be positively influenced by several things, including, but not exclusively, exercise, the environment, repetition of tasks, motivation, neuromodulators (such as dopamine), and medications/drugs.”

Matt Puderbaugh &  Prabhu D. Emmady


Neuroplasticity is a term you may often hear tossed around after you’ve experienced a stroke or traumatic brain injury, especially from your physical therapist, neurologist, or even in a support group. But what is neuroplasticity and what does that mean for you in your recovery?

Well, according to Britannica, neuroplasticity is defined as the “capacity of neurons and neural networks in the brain to change their connections and behavior in response to new information, sensory stimulation, development, damage, or dysfunction.”

What does that mean exactly?

Basically, it’s the ability of the brain to rewire itself after an injury, like a stroke or traumatic brain injury. So even if you experience loss or changes in physical, emotional, and cognitive functioning, you can regain some if not all abilities in these areas. You do this through active and consistent rehabilitation. 

Some common forms of rehab that can foster neuroplasticity after a stroke or TBI are physical therapy, speech therapy, cognitive therapy, or even music therapy. It may also be recommended to see your neurologist consistently as well as a therapist or psychologist to help with emotional and behavioral concerns that may arise. 

Stages of Neuroplasticity

But neuroplasticity is a bit more complex than just ‘the brain’s ability to rewire itself’. It involves a few different periods of change in structure, function, and development from the moment of injury and it can be helpful to know this process. Traditionally, it’s thought to occur in 3 different phases which are based on rough periods of time. 

      1) The First 48 Hours: initial damage which results in cell death. The brain then uses secondary neural networks to try to maintain functioning. 

      2) The Following Weeks: Support cells are recruited to help shift the cortical pathways from inhibitory to excitatory. This is basically the ‘go-ahead’ for your brain to use and create new networks and pathways instead of the injured pathways. Neural plasticity occurs during this time. 

       3) Weeks to Years After: Axonal sprouting and further reorganizing around the damage continues (often through continued rehabilitation). 

This process of axonal sprouting and reorganizing tends to slow down the more time passes from the point of initial injury, making recovery a slower and more time consuming process. This makes sense when you consider how many survivors have a significant or serious loss of functioning immediately after a brain injury, followed by a swift  recovery the follow weeks and months, and finally a slower recovery after the one year mark. 

This isn’t to say that recovery is impossible after a year after a stroke or traumatic brain injury. In fact, it’s the opposite. This plasticity, this ability to reform and create new connections in the brain, can be achieved years and years after the fact and can be positive influenced by exercise, motivation, repetition of tasks, and environment. 

While neuroplasticity can be fantastic for stroke and TBI to restore function to the body, it’s important to remember it’s not ALL beneficial. In fact, there’s the possibility of maladaptive plasticity

What is maladaptive plasticity? It’s when the brain makes new connections or pathways that result in a negative symptom. A good example of this would be phantom pain or dystonia (involuntary contract of muscles or muscle spasms). This can occur when the non-affected side (paralyzed or weakened side) is use overly more than the affected side, thus creating neural pathways and connections that inhibit the affected side from gaining function. 

So it’s important to maintain a consistent routine and practice with your rehabilitation!

And remember, recovery is possible at EVERY stage after a brain injury 🙂 


Sources: Introduction to Neurons and Neural Pathways; NIH Article: Neuroplasticity; NIH Article: Maladaptive Plasticity



Did you know that yoga has been shown to be beneficial for stroke and TBI in helping reduce stress, anxiety, and depression and to help improve mobility and balance. It also fosters neuroplasticity through movement, breath work, and mind-body connection. Learn more about our online chair yoga classes specifically for Stroke and TBI here!



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