How Long Does It Take To Recover From a Concussion?
How long it takes to recover from a concussion can vary. If you were to ask a coach or athlete how long they’d recommend waiting before returning to sport after concussion, they’d likely say 2 weeks. I’ve heard coaches and athletes repeat this time and again, so I thought it best to help set the record straight. Let’s dive into some of the research to help you make informed decisions about your return to sport.
True Concussion Recovery Takes Time
2 Weeks Is Not Long Enough
Concussions are a common injury in sports, and returning to play too soon can have serious consequences for athletes. While many athletes might feel symptom-free after just a week or so, it is crucial to understand that true concussion recovery takes longer.
Concussions can impact various systems of the brain and body that have their own timeline and rehab approaches required for healing. Symptoms may resolve in 7-10 days, but for many of these systems, recovery takes 3-4 weeks. In a study looking at sports related concussion (SRC) published in Neurosurgery, it was found that “[r]ecovery time across all outcomes was between 21–28 days post SRC for most athletes.”¹ This highlights the fact that even when symptoms seem to disappear, the brain is still healing.
It is true that symptoms demonstrate the greatest improvement in the first 2 weeks after SRC. Therefore, this is likely why many coaches and athletes believe 2 weeks is enough time out of sport. However, the above mentioned study found that neurocognitive impairment can linger across various domains for up to 28 days post-concussion. Vestibular-oculomotor (VOM) decrements also typically resolve between one to three weeks post-injury. VOM impacts how well your eyes can move and track moving objects with your eyes, which is important for sports (and overall safety in many daily activities). So, at the very least, a month seems to be a safer starting point for most athletes’ return-to-sport timeline.
Don’t Just Trust Your Gut (Data > Symptoms)
Hopefully, it is now clear that symptoms should not be the sole guide for returning to play. So, how do we know when it’s safe to return to sport? The best recommendation is to base return to sport decisions on assessment findings. Let’s look at why.
In an attempt at better understanding this gap in timelines between symptom resolution and neurological healing, another study used the ImPACT computerized test battery to evaluate athletes a week after concussion. Here’s what they found: “[…] concussed athletes who denied subjective symptoms demonstrated poorer performance than control subjects on all four composite scores of the ImPACT test battery (Verbal Memory, Visual Memory, Reaction Time, and Processing Speed). However, the concussed but asymptomatic group demonstrated significantly better performance than did the concussed and symptomatic group.”² This suggests that relying solely on athletes’ self-reported symptoms may not provide an accurate picture of their cognitive function. The researchers concluded that objective assessment tools like the ImPACT test battery can offer more insight into the readiness of an athlete to return to sport.
Now, let’s hop back and take another look at our study in Neurology. While the researchers in that study found that gender differences did not significantly impact neurocognitive recovery, they did note gender differences in some symptoms and assessment outcomes. Specifically, “Males were more likely to be asymptomatic by the fourth week and reported less vestibular-oculomotor impairment than females at weeks 1 and 2.”¹ So, every athlete will have a unique healing timeline after SRC, and without using objective measures as part of their individualized assessment, returning athletes to play after concussion based on symptoms and a standardized one-size-fits-all timeline likely exposes them to risks that could otherwise be avoided.
Wrapping It All Up
Together, in the context of returning to sport after concussion, these two studies highlight the importance of
- not relying solely on symptoms
- using objective assessment findings to guide decisions
- tailoring rehab to address individual athlete’s needs
Returning to sport after a concussion is a critical decision that should not be taken lightly. While symptoms may subside relatively quickly, it is essential to understand that true recovery takes longer. Relying on assessment findings rather than just symptoms is crucial to ensuring the safety and well-being of athletes. Consult with a concussion-literate provider who can use a multimodal clinical assessment approach to guide the return-to-play decision. Ultimately, prioritizing safety over the desire to return to sport quickly is the wisest choice for all athletes.
1. Henry LC, Elbin RJ, Collins MW, Marchetti G, Kontos AP. Examining recovery trajectories after sport-related concussion with a multimodal clinical assessment approach. Neurosurgery. 2016; 78(2):232–234.
2. Fazio, Vanessa C. et al. ‘The Relation Between Post Concussion Symptoms and Neurocognitive Performance in Concussed Athletes’. 1 Jan. 2007 : 207 – 216.