Rest Is Best: Concussion Recovery

The Fastest Way To Get Back In The Game After A Concussion Is To Take It Slow

Heidi Taggart was a 15-year-old goalie when she was hit in the head by a teammate’s stick during warm ups.

Immediately she began to feel the classic symptoms of a concussion – headache, disorientation and dizziness.

The next morning she was scheduled to take a required ACT Plan test at her school. Despite displaying the symptoms of a concussion, Taggart was not excused from taking the test by the school nurse.

Her mother, Dorothy Bedford, advised Heidi to simply skip the exam, but the tenth grade honors student didn’t want an unexcused absence. And she didn’t want to take more time off from school with midterms coming up, so she continued to work her brain.

In hindsight, Bedford realizes, “These choices made her injury worse and her recovery more difficult.”

What Heidi really “needed was complete physical and cognitive rest.”

As Heidi and her mother soon learned, the athlete’s motto, “No pain, no gain,” is not true when it comes to concussions. There is now scientific evidence that a period of comprehensive physical and cognitive (mental) rest can improve concussion symptoms dramatically.

A recent study conducted at the Sports Concussion Center of New Jersey and published in the Journal of Pediatrics shows that even when rest is prescribed months after a concussion, the benefits were just as strong as if the rest period was taken right after the concussion.

We understand that if you break your arm, you put it in a cast and don’t use it. But, if you hurt your brain, you can’t stop using it. It works 24 hours a day, directing all your physical and mental functions. The best you can do is reduce the amount of work your brain does by resting, so it can heal.

A concussion is a traumatic brain injury that occurs when there is a strong force to the head or body, such as a whiplash, that causes the brain’s delicate neural network to stretch, twist, and hit the inside of the skull.

As a result, the brain’s biochemical balance can go haywire and any of a variety of symptoms can occur such as headache, blurred vision, poor balance, dizziness, nausea, fatigue, confusion, mental fogginess, and amnesia (memory loss). Even the mild sensation referred to as feeling “dinged” is considered a concussion.

That is why, when in doubt, sit them out. If a Heidi Taggart, left, and her mother, Dorothy Bedford, knew there was something wrong after Heidi was hit in the head by her teammate's stick in warm ups.Heidi Taggart, left, and her mother, Dorothy Bedford, knew there was something wrong after Heidi was hit in the head by her teammate's stick in warm ups.coach or parent suspect a concussion, remove the athlete from play and seek a medical consultation before ever returning to play.

Michael Stuart, the vice chair of orthopedic surgery at the Mayo Clinic in Rochester, Minn., and the chief medical officer for USA Hockey, emphasizes the importance of concussion awareness and proper management, especially in youth players.

“It is wrong to think that young brains bounce back faster after a concussion,” Stuart says. “In fact, we know that young players may take longer to recover and have longer lasting symptoms than adult players. That is why it is so critical that we take concussions seriously and ensure a more cautious approach with kids.”

Any athlete with a suspected concussion should see a licensed health care professional who deals with sports concussions. After that, REST. No school, work, reading, homework, tests, computers, video games, phones, texting, travel, going out of the house, driving, parties, having friends over, or any kind of physical exercise.

“The best you can do is REDUCE the amount of work your brain does by resting, so it can heal.”­
—Rosemarie Scolaro Moser, PhD, & long time hockey mom

For some who experience light or sound sensitivity, sitting in a dark, quiet room may be necessary. As for TV, no TV or very time-limited TV, like listening to a sitcom while resting on the couch. But definitely no watching sports or intense movies that require sustained visual attention and tracking.

The trick is to apply rest immediately after the concussion. Too often, athletes say they feel fine after 5 or 10 minutes and try to return to the game. It’s a bad idea because some of the symptoms of a concussion don’t become visible until 24 hours more or later. And if you continue to trudge through your regular activities, despite the headache and mental fogginess, your symptoms could be harder to kick, lasting for months, and resulting in post-concussion syndrome.

Often parents and athletes resist the recommendation of comprehensive rest. In some cases, they are not properly advised by the school, team or doctor.

There have been numerous studies conducted over the years that show that youth players who return to the game or to school too soon after a concussion, without a significant down time, are the ones who are more likely to complain of headaches and slowed mental processing for weeks or months later. It is obvious that if you want to get better quickly and avoid persistent symptoms, you need to rest now, not later.

Rosemarie Moser is the director, RSM Psychology Center, and the director of Research Programs at the International Brain Research Foundation.

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The Symptoms Of A Concussion

>  Headache or “pressure” in the head
>  Nausea or vomiting
>  Balance problems or dizziness
>  Bothered by light
>  Bothered by noise
>  Feeling sluggish, hazy, foggy or groggy
>  Difficulty paying attention
>  Memory problems
>  Confusion
>  Does not “feel right”

Issue: 
2013-03

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