Not only do we continue to understand more about the process of concussion, but we have seen a big shift in how we manage concussions. We know that concussion is more than just a bruise on the surface of the brain. It is a more substantial injury that results in a force that goes through the brain, causing microscopic damage to nerve cells as it occurs. The resulting energy expenditure by the nerves in the brain causes a shortage of energy in the brain, which takes weeks to regain. It is during this time that we must be mindful of the concussion and recovery process.
It is no longer necessary to wake someone every hour following a concussion. This process is only beneficial if you are suspicious of a more substantial brain injury (like active bleeding in the brain). Immediately following concussion, a person may be more tired or more alert than normal. They should be mindful of the cues their body is giving them to rest when needed.
Spending weeks in bed until symptoms are gone is also outdated. Concussion recovery has moved to an active process. It is important to have cognitive rest the first 24-48 hours following concussion and then slowly work into increasing activity as symptoms allow. Now it is actually ok to do activity if it just slightly increases symptoms (by 1-2 points on a 0-10 symptom intensity scale). It is also important to begin light low-impact cardiovascular activity, such as walking or stationary bicycle riding, for 20-30 minutes per day after the initial rest period is over.
Following a proper concussion program following recovery helps to ensure that you do not have prolonged concussion symptoms, lasting weeks to years following the initial injury. Jumping into activity too soon following concussion puts the individual at risk for a more substantial second-impact injury and delay of the normal healing process.
If you have questions regarding treatment for concussions, we are always here to help!