4 Tips to Safely Return to Normal Activity After Concussion

Sharon Bonn, NP, and Caroline Sizer, MD, FAAPMR
Tips for concussion care 2019

The past 10 years mark a period of rapid and progressive change in concussion care.  Cutting-edge health care providers no longer prescribe complete brain rest until completely symptom-free. Instead they recommend strict mental and physical brain rest for only the first 24 to 48 hours after a concussion, then “gradually return to your normal daily activities.”

Here are four ways to get you started on your road to recovery:

1.     Avoid the dangerous

Do not return to activities that put you at risk for another concussion, known as Second Impact Syndrome. This carries a 50 percent risk of death and a 100 percent risk of permanent disability. Activities that place you at risk for another concussion include:

  • contact sports
  • gym class
  • riding a bike without a helmet
  • returning to a high-risk job like construction

Do not attempt any of these until you receive a medical clearance note from your health care provider.

2.    Minimize drains on your brain’s “battery”

Concussions interfere with the functioning of the energy-generators for your brain, the mitochondria.  Imagine your brain is fueled by a battery every day to get your daily tasks done. Your pre-concussion brain battery size might be a D battery fueling your brain for all the day’s activities.  

After concussion, that D battery is more like a AAA battery. Unfortunately, you can’t turn your brain off like a device to save the battery. But you can limit or avoid the activities that require the most energy from your brain, including:

  • screen time - smartphone, tablet, computer, television
  • driving or riding as a passenger
  • busy or noisy environments - grocery stores, crowded rooms, lunch hall, arenas
  • mentally draining tasks - reading, planning events, crosswords
  • physically draining tasks - heavy lifting, running

3.    Monitor symptoms and pace yourself to recharge throughout the day

Health care providers have a scientific scale to grade your overall concussion symptoms. It can be helpful for someone with a concussion to regularly grade their own symptoms using a scale of zero to 10. Let’s say you rate your concussion symptoms as four out of 10 in the morning. As you go through your daily routine, you will probably have symptom flares, with increases to five or six out of 10.

It’s important to know this does not mean you have harmed yourself.  But it is a warning sign. Take a break for 15 to 20 minutes in a quiet place until your symptoms go back to a four on the scale. If you find you are doing activities that cause your symptoms to increase on the scale by more than two points, up to a seven, then you should minimize those activities.

Here are some practical tips for adding activities to your day:

  • Add the easy activities first.
  • Choose activities with an exit strategy, so you can leave if you have a symptom flare.
  • Ask others for concrete help, such as asking a family member to write things on a calendar as reminders.
  • Don’t try to “go with the flow.” Others may not be aware that your brain battery is running low. If you need to rest, be sure to do so.

4.    Make good quality sleep a priority

Quality sleep repairs the mitochondria and recharges your brain battery.  Quality is far more important than quantity with concussion recovery. Many individuals do find they may need one or two hours more sleep than usual for normal recovery.  Be sure to follow strict sleep hygiene rules.  In particular, choose a specific bedtime and sleep routine and stick to it.  

Please remember that concussion is a serious brain injury never to be taken lightly. Learn more about our Concussion Care Center and how we can help.
 

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