Significant Shift in Guidance for Concussion Rehabilitation

Sports-related concussions (SRC) are common but medical guidance is often incorrect, even from many medical professionals. The conventional wisdom used to be strict rest until symptoms resolved, but emerging research has challenged this approach. Unfortunately, most patients who have sought our guidance at Jackupuncture have been told by their doctor or neurologist to just rest and wait for symptoms to improve. These patients have waited and rested for months without improvement or receiving any guidance that meaningfully improves their situation. In this blog post, we will explore the findings of a 46-paper meta analysis that emphasizes the importance of physical activity and structured exercise in SRC recovery, debunking the myth of rest as the best medicine.

Rest Isn’t Always Best

One of the most significant shifts in the approach to SRC recovery is the recognition that strict rest until symptoms disappear may not be effective. In fact, prolonged inactivity can actually delay recovery. The key is to strike a balance between rest and activity.

Light-Intensity Physical Activity

Within the first 48 hours after an SRC, engaging in light-intensity physical activities, like walking, can play a crucial role in the healing process. Gentle movement like walking helps jumpstart recovery and promotes better blood flow to the brain without causing harm. Keep in mind, the choice of activity itself must be made carefully, as things that excessively jostle the head or neck may aggravate symptoms for some people even when speed and intensity is low. Being aware of the different factors affecting symptoms is key when making this early return to light activity. That’s where expert guidance and structured rehab exercise comes in.

Aerobic Exercise Is Concussion Medicine

A groundbreaking aspect of SRC recovery is prescribed subsymptom threshold aerobic exercise. This means aerobic exercise that gets the blood moving without exacerbating symptoms. This approach is based on systematic exercise testing that identifies an individual’s mild symptom exacerbation heart rate threshold. When applied within 2-14 days of the concussion, it can safely facilitate recovery and reduce the incidence of postconcussive symptoms persisting beyond one month.(1)

Incorporating personalized aerobic exercise into your recovery plan can be a game-changer. Not only does it promote physical fitness, but it also supports cognitive and emotional well-being. For injured athletes, in particular, the chance to return to even a gentle, modified version of their regular routine can be good for the soul. The key is to choose activities that do not worsen your symptoms. That’s where working with a concussion specialist can be helpful, as even relatively gentler activities can upset symptoms in the wrong context. Working with a professional in adequate guidance for concussion rehabilitation will help identify the aggravating factors so you can safely adapt the activity and keep your recovery on track.

Tailoring Recovery to Your Needs

Every concussion is unique, and what works for one person may not work for another. That’s why it’s essential to work closely with healthcare professionals who can provide guidance and monitoring throughout your recovery journey. In particular, it is key that you work with a provider who specializes in concussion. Not only can they help you find the right balance between rest, light activity, and prescribed exercise, a recent study shows that working with them as soon as possible helps accelerate recovery and reduce the likelihood of prolonged symptoms.(2)

Structured Activity Is Best

In the world of SRC recovery, the old adage “Rest is best” is being replaced by a more nuanced approach that encourages light-intensity physical activity and personalized aerobic exercise. It’s not as catchy, but “Structured activity is best” is more accurate and better medicine for athletes with a concussion.

Remember that your body is a remarkable self-healing machine, and with the right guidance, you can recover more efficiently and reduce the risk of lingering symptoms. Embrace the new understanding of SRC recovery and work with concussion specialists to create a tailored plan that promotes both your physical and cognitive well-being.

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1 Leddy JJ, Burma JS, Toomey CM, et al. Rest and exercise early after sport-related concussion: a systematic review and meta-analysis of 46 studies. British Journal of Sports Medicine 2023;57:762-770.
2 Claire L. Kowalczyk, Shawn R. Eagle, Cyndi L. Holland, Michael W. Collins & Anthony P. Kontos (2020): Average symptom severity and related predictors of prolonged recovery in pediatric patients with concussion, Applied Neuropsychology: Child, DOI: 10.1080/21622965.2020.1774376