DETROIT – The approach to managing concussions has evolved steadily over recent years thanks to improved awareness and more research.
Years ago, kids with concussions were given strict instructions to avoid any physical activity and even forced them into bed rest.
“Before 2017, really, the recommendation was to limit your physical and mental activity. There was a concept where they called it cocoon therapy really where they would ask individuals to stay in bed rest in a dark room.” said doctor Landon Lempke, a concussion researcher at the University of Michigan.
Since then, research has shown that cocoon therapy is counterproductive. According to Lempke, “It’s been shown that’s actually more harmful than helpful in the sense that people recover slower than if they were to be up and moving and just doing general activities of daily living.”
However, he cautions that a major concern is second impact syndrome, where a second concussion when the brain is still vulnerable leads to swelling and death. The trick to early return to activity is doing it safely.
His latest research in collegiate athletes suggests under medical supervision, and activity can be advanced quickly to light exercise.
“What we saw is with the collegiate athletes, those who started light exercise within 48 hours of their initial concussion actually had improved recovery outcomes. They experienced symptom resolution quicker than those who did no exercise at all, which was about two and a half days sooner,” said Lempke. “Light exercise means aerobic exercise or that light cardiovascular where your heart rate is getting up, but we’re not pushing it to the point of heavy breathing.”
Lempke can’t recommend this to every young athlete without supervision, but there is a good message for everyone, “You need to self-monitor. You can do activities around the home; you can walk around the house and get groceries. Those kind of things you have to do to live your daily life, but if your symptoms start to increase during that, that’s when you want to stop what you’re doing, take a moment to rest, and don’t push it beyond that comfort level.”
The bottom line here is that we’ve learned a lot about post-concussion care.
It’s become less conservative with a supervised early return to activity.
You still need to protect your head from a second concussion, but you can certainly go about with normal activity.