Concussions are one of the most common traumatic brain injuries (TBI) in the United States, and most are caused by sports and recreational activities. If you just suffered a concussion and fear you’ll be out of commission for the next couple of months, know that this won’t be the case.
Whether you’ve experienced a concussion before or picked up concussion treatment tips on television, you may be surprised to hear that strict rest is detrimental to TBI recovery. A 2019 study from Michigan NeuroSport found that lack of exercise does more harm than good.
Modern post-concussion therapy suggests that regular, daily activities during the first 24-48 hours after a head injury is essential for recovery. Doctors have found that you can prevent post-concussion syndrome, which results in exercise intolerance, through immediate exercise.
Unfortunately, no two concussions are alike, and there are no clinical tests that definitively diagnose concussions. If you’re an athlete, you may have undergone baseline testing, which includes reaction tests, memory exercises, and other cognitive and physical assessments.
If you haven’t participated in a baseline test, your doctor may test your alertness, memory, attention, problem-solving, vision, balance, hearing, and reflexes after the fact. However, if you passed out, can’t walk, or have difficulty concentrating, doctors will start treatment immediately.
After the initial assessment, your doctor will ask you to wait at least 24-hours before making jerky, sudden movements, or exercising. They’ll then test you against your baseline for any improvements. Once improvements are made, you’ll move to the next therapy stage.
Most physicians follow return to play (RTP) guidelines after a child, teen, or adult suffers a sports concussion. Each step can begin after 24-48 hours of physical and cognitive rest.
Symptom-Limited Activity (24-48 Hours After Concussion)At this stage in concussion therapy, patients are advised to do daily activities that don’t provoke symptoms. You’ll want to try to reintroduce work/school activities with the help of a doctor.
Light Aerobic Exercise (48-72 Hours After Concussion)If your symptoms are improving, you can start walking or cycling on a stationary bike at a slow to medium pace. Your goal is to increase your heart rate but avoid sweating too much.
Sport-Specific Exercise (72-96 Hours After Concussion)As long as your sport or exercise routine doesn’t involve head impact, you can start skating or running drills. The purpose at this stage is to add movement, but stop if you feel light-headed.
Non-Contact Training Drills (96-120 Hours After Concussion)With your doctor’s go-ahead, you’ll be allowed to progress to more difficult training drills, like passing drills in hockey. Your doctor will assess your coordination and problem-solving skills.
Full Contact Practice (120-144 Hours After Concussion)After 120-144 hours, you have to see your doctor to receive clearance. Following medical clearance, you should be able to participate in normal activities and regular training regimens.
If all goes well, you should return to your full exercise regime in a week or less. However, it’s essential that you don’t push yourself. If symptoms return, fall back to a previous stage.
While exercise therapy is important, you may start physical, neuromuscular, vestibular, cognitive, and occupational therapy as well as visual rehabilitation. However, these therapies will only take place if your symptoms are severe. A diet change may also be recommended.
Always speak to a concussion specialist before going back into contact sports or participating in high intensity interval training or other high-impact exercises that could shake or rock your head.