When is it safe to return to activities after a concussion?

Concussion, Sports Medicine, Self Care

Doctor with a stethoscope on the helmet

When you experience injury, one fact is true. Your body needs time to heal.

But, when the injury is a concussion, walking, mental activity and auditory and visual stimulation may prolong the healing time or in some cases, cause more damage.

When a concussion occurs, it is important to seek medical attention as soon as possible and rest as prescribed by your healthcare provider. Under no circumstances should a person return to activity the same day he or she experienced the concussion.

How long does it take to heal from a concussion?

The answer to that question is as unique as the individual. Recovery from a concussion can take weeks, months and for some people, years. Supervised rest is the best treatment for mild concussions or “dings” to the head. Severe concussions require hospitalization and the care of a healthcare provider.

After a concussion, a person’s ability to recover will be affected by his or her ability to rest, both physically and cognitively. According to the Centers for Disease Control and Prevention, other factors that may affect recovery time include:

Overall health at the time of injury
Number of concussions
Severity of the concussion
Use of alcohol or drugs
Age. Young and growing brains may need more time to recovery
How diligently people with concussions follow their healthcare providers’ instructions to limit physical and mental activity

While the symptoms of concussion resolve over time, it often takes much longer for people who have suffered a concussion to return to activity without triggering headaches, sleeping problems, mood swings or concentration and memory problems.

What should you do after a concussive injury?

A concussion is a traumatic brain injury (TBI). Like other injuries in your body, your brain’s response to injury often includes swelling. Unlike other injuries, this swelling is encased within the skull, which compresses the brain cells and may cause serious consequences.

To minimize post-concussion risks, including permanent brain damage such as chronic traumatic encephalopathy or CTE, people should take precautions avoid additional concussions while their brains heal. People need physical and mental rest to reduce swelling and promote healing.

Rest physically

Stop the activity. Do not continue to play after a knock to the head.
Sleep and rest as prescribed. Try to go to bed earlier in the evening and sleep for at least eight hours.
Do not undertake physically demanding activities. Do not vacuum, go to the gym, go for a walk, or practice sports activities until your healthcare provider gives you permission to do so.
Do not drive, ride a bike, or participate in other high-speed activities or sports.
Avoid multitasking. Do one thing at a time.
Avoid changes in altitude.
Stop any activity that triggers concussion symptoms including balance problems, vision changes, neck pain, or mood changes such as anxiety and depression.
Do not take part in activities that increase the risk of another concussion.

Rest mentally

Avoid activities that require concentration. Do not play word games, work crossword puzzles, do homework, work from home, or balance financial accounts until released by your healthcare provider.
Do not use a computer or play video games during the first few weeks of recovery or later if symptoms recur.
Avoid stress.
Ask for trusted family members or friends to help you if you need to make important decisions during recovery.

When can I return to activity after a concussion?

After your concussion symptoms disappear, your healthcare professional may allow you to go back to your activities. However, your provider may suggest you ease into work, school or physical activities with a five-step progressive plan as recommended by the Centers for Disease Control and Prevention.

As you return to normal activity, make sure your symptoms do not return. If they do, take time for added rest.

If you are able to return to work or school without a relapse of symptoms, you are ready to progress through the five-step plan and slowly return to your activities. At each step, you need to be assessed for concussion symptoms If your symptoms return, do not move onto the next step until you can do so without any adverse effects.

The goal is to move through the five steps safely—not quickly.

Step 1: Light activity

Five or 10 minutes of activity
Walking
Light jogging
Low-intensity stationary bike riding
Do not lift weights

Step 2: Moderate activity

Moderate jogging
Brief periods of running
Moderate-intensity stationary biking
Light to moderate weightlifting

Step 3: Heavy, non-contact activity

Heavy, non-contact physical activity
Sprinting
Running
High-intensity stationary biking
Regular weightlifting
Sport or hobby specific drills

Step 4: Practice

Return to full practice mode

Step 5: Competition

The individual may return to competition or high-level activities.

Be aware. Take care. Prevent another concussion.

Repeated concussions can lead to long-term brain conditions that can affect memory, concentration, balance, and the ability to perform physical movements. Multiple concussions can also result in chronic headaches. Even mild concussions that occur repeatedly in a short period of time can have devastating results. They can cause cumulative neurological and cognitive impairments and sometimes death.

If you have experienced a concussion, it is important that you take the time to heal to avoid future health complications. Dr. James Messerly, provides concussion, orthopedic and sports medicine care to people of all ages. If you have questions about your concussion, Dr. Messerly can provide you with expert advice.

Sources:
https://www.cdc.gov/headsup/index.html
https://www.nfhs.org/sports-resource-content/a-parents-guide-to-concussion/

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