A concussion is a mild form of traumatic brain injury (TBI) that temporarily alters normal brain function. It typically results from a bump, blow, or jolt to the head or body, causing the brain to move rapidly within the skull. This sudden movement can also stretch and damage brain cells, leading to temporary chemical changes in the brain. While concussions are generally not life-threatening, they require careful overall management to ensure a safe recovery.
Why Brain Rest is Essential
After a concussion, the brain needs time to heal and restore its normal function. The injured brain requires extra energy and fuel to repair damaged cells and rebalance neural networks. Too much physical or mental activity too soon can divert this necessary energy away from the healing process, potentially provoking more severe concussion symptoms and prolonging recovery.
Resuming physical activity prematurely carries several risks. It can exacerbate existing symptoms, making recovery a longer process. There is also a rare but serious risk known as Second Impact Syndrome (SIS). SIS occurs when a person sustains a second head injury before the symptoms of an earlier concussion have fully resolved. Even a minor second impact can trigger rapid and catastrophic brain swelling, which can lead to severe disability or be fatal.
Understanding the Return to Activity Protocol
A gradual, important multi-stage process is recommended for returning to physical activity after a concussion. This protocol should only begin once a healthcare professional has cleared the individual and they are largely symptom-free at rest. The progression through stages is individualized, considering the person’s symptoms and how they respond to increasing activity levels. Each stage typically lasts a minimum of 24 hours, with careful symptom monitoring before advancing.
The initial period often involves relative rest for 24 to 48 hours, avoiding activities that worsen symptoms. After this, light aerobic activity can begin, focusing on increasing heart rate without significant head or body movement. Examples include walking or stationary cycling for short durations, usually 5 to 10 minutes.
The next stage involves moderate exercise, incorporating limited body and head movement, such as moderate jogging or brief running. Progression continues with sport-specific exercise, which involves drills without contact, like running sprints or specific movement patterns related to the sport. Individuals then advance to non-contact practice, where they engage in more strenuous drills and strength training.
The final stages involve full contact practice, if applicable to the activity, and eventually, full competition. Any symptom increase during a stage indicates a need to stop the activity and return to the previous symptom-free level.
Monitoring Symptoms and Seeking Medical Guidance
Closely monitoring symptoms is important throughout concussion recovery. Common concussion symptoms include:
- Headache
- Dizziness
- Nausea
- Sensitivity to light or noise
- Fatigue
- Difficulties with concentration or memory
- Balance problems
- Confusion
- Irritability or other mood changes
Any worsening of these symptoms during or after physical activity is a sign to stop and return to the previous symptom-free level of activity.
Seek professional medical guidance if symptoms are severe or persist. Emergency care is needed for specific symptoms, such as:
- Repeated vomiting
- Loss of consciousness lasting longer than 30 seconds
- Headache that worsens over time
- Seizures
- Slurred speech
- Weakness in arms or legs
- Significant changes in behavior or confusion
If symptoms continue for more than a few days or weeks, consulting a healthcare professional trained in concussion management can help guide the recovery process and provide tailored treatment. This professional oversight is important for a safe and effective recovery.