I remember hearing the word ‘neuroplasticity’ around 1990, about 2 years after I graduated from Physiotherapy. We were taught that the brain, once injured, could not heal itself. Neurons, the critical communication cells of the brain, could not regrow or proliferate (like skin cells could for example). Recovery from brain injury (stroke, trauma, surgery) was primarily attributed to resolution of the ‘shock’ phase and reduced swelling. There was a theory or belief at that time that other areas of the brain remote from the injury could partially ‘take over’ some of the functions of damaged areas, but this was the limit of the brain’s flexibility. I was also told that this recovery process lasted 6 months and that once the ‘window of recovery’ closed, no further brain repair and subsequent recovery of movement, thinking, language and other functions could happen.
Throughout my training and practice in physiotherapy I had a particular affinity for helping people recover from brain injury particularly due to trauma and stroke. I was fascinated by how movement would re-emerge in the paralyzed arm and hand over months and years. Even though I was a ‘new grad’ I could see that recovery continued after the 6 month ‘window of recovery’ deadline. I could also see that recovery was associated with what the injured individual DID after the event. I witnessed early on that those individuals who had a deep desire for recovery and were motivated seemed to do better than those who did not (independent of the severity of their paralysis). They tended to do their home exercises more diligently and force themselves to use the affected arm or leg in everyday activities despite the limb’s inefficiency. Family support and positive outlook seemed to be key ingredients for long-term recovery to take place. I knew that neuroplasticity existed before I came to know the word ‘neuroplasticity’.