Concussion is a common injury in children and adults. It is caused by a blow or jolt to the head. Concussion can result in symptoms that make it difficult for you to do your usual day-to-day activities. Traditionally, people with a concussion were instructed to rest until they no longer had any symptoms at all. Experts now agree that after a brief period of rest, most people with a concussion should start trying light physical and cognitive activity. Different activities can be slowly added, as long as your symptoms are stable or improving.
1
This education resource is designed to guide individuals with a concussion (or those caring for someone with a concussion) on how to safely reintroduce activity so that you can do the things you need, want, and love to do.
Possible symptoms after concussion
Concussion can affect:
- •How you feel physically. For example, headaches, balance problems, dizziness, and sensitivity to light and noise are common.
- •Your ability to think clearly and quickly.
- •Your emotional health. You might feel more emotional, irritable, sad, or nervous.
- •Your sleep, including trouble falling asleep or sleeping more than usual.
Concussions affect each person differently. Some people have 1 or 2 of these symptoms, and some people have many of these symptoms.
Note: Only a qualified health professional who personally examines you can diagnose a concussion. Many of the symptoms listed above are hard for people to recognize and having these symptoms does not necessarily mean that you had a concussion.
General recommendations for returning to activity
Here are a few general points you should keep in mind when returning to your usual activities after concussion.
- •Isolating yourself and stopping all of your activities for a long period of time is usually not necessary or helpful.
- •Each person will progress at his or her own pace.
- •Be patient. Taking small steps is most likely to help you return to activity comfortably and safely. Doing too much too soon may make you feel worse.
- •Once you can do an activity a few times without worsening your symptoms, try gradually increasing your activity level.
- •You can increase the frequency (how often or how many times you do something), duration (how long you do it for), or intensity (how much effort it takes) of an activity. It may be best to increase only 1 of these at a time.
- •If your symptoms worsen each time you try to do more, consider slowing the pace of your return to activity.
Importantly: While you are recovering, avoid activities that put you at risk for another concussion.
Tabled
1
Stages of Returning to Activity After Concussion | |
If you have been diagnosed with a concussion, following the stages can help you gradually return to your usual activities. | |
Stage 1: Initial Rest (first 24-48 hours after a concussion) | |
| |
Stage 2: Gradually Increasing Your Activity | |
| |
Stage 3: Full Return to Activity | |
| |
The Four Ps can help you gradually increase your activity after a concussion. 3 | |
Prioritize |
|
Plan |
|
Pace |
|
Position |
|
How long will it take to return to activity after a concussion?
Many adults with a concussion can return to full activity within the first 2 weeks. Children usually return to full activity within 1 month. However, each person will progress through the stages of returning to activity at a different pace. If you are struggling to return to full activity, consider asking your medical doctor for a referral to a specialist or multidisciplinary clinic.
More advice on return-to-school and return-to-sport
For detailed guidance on returning to sport or school, some additional resources are listed below.
- •Infographic: Consensus statement on concussion in sport. Available from: http://bjsm.bmj.com/content/51/21/1557
- •Canadian Guideline on Concussion in Sport (page 18 and 19). Available from: http://www.parachutecanada.org/downloads/injurytopics/Canadian_Guideline_on_Concussion_in_Sport-Parachute.pdf
- •Concussion Awareness Training Tool – Return to Sport Protocol. Available from: http://ppc.cattonline.com/resources/files/return-to-sport.pdf
- •Concussion Awareness Training Tool – Return to School Protocol. Available from: http://ppc.cattonline.com/resources/files/return-to-school.pdf
- •Military services members can obtain more guidance on return to duty from the Defense and Veterans Brain Injury Center Patient Activity Guidance after Concussion. Available from: https://dvbic.dcoe.mil/material/patient-activity-guidance-after-concussion-patient-education-tool
Authorship
This page was developed by the American Congress of Rehabilitation Medicine Mild TBI Task Force of the Brain Injury Interdisciplinary Special Interest Group. Mild TBI Task Force members: Nick Reed, PhD, Noah D. Silverberg, PhD (e-mail address: [email protected] ), Mary Alexis Iaccarino, MD, Michael McCrea, PhD, Karen L. McCulloch, PhD, William Panenka, MD, Emma Gregory, PhD, Kristen Dams-O’Connor, PhD, Grant L. Iverson, PhD, Chris Weyer Jamora, PhD, Heather Belanger, PhD, Gary McKinney, MS, and Alison M. Cogan, PhD. Other contributors: Christine Provvidenza, MSc, and patient partners.
Disclaimer
This information is not meant to replace the advice of a qualified health professional and should not be interpreted as a clinical practice guideline. This Information/Education Page may be reproduced for noncommercial use for health care professionals and other service providers to share with their patients or clients. Any other reproduction is subject to approval by the publisher.
References
- Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016.Br J Sports Med. 2017; 51: 838-847
- Guidelines for concussion/mild traumatic brain injury & persistent symptoms.(Available from:) (Accessed June 15, 2018)
- Holland Bloorview Kids Rehabilitation Hospital. Concussion & you: a handbook for parents and kids.(Available from:) (Accessed June 15, 2018)
Article Info
Publication History
Published online: January 30, 2019
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine All rights reserved.