Medical Doctorate student, Université de Sherbrooke

A New Perspective on Recovery

 

This article is meant to inform and is in no way meant to be taken as medical advice. If ever you have any sports related injury or questions regarding your health, do not hesitate to contact your local health professional for more information on how to deal with the symptoms. 

 

Chances are if you are involved in sports, you’ve heard of the term “concussion”. Most people know this as a vague cluster of symptoms that happen after a traumatic head injury. Aside the headache from the trauma itself, some of the most common impairments include short-term memory loss, trouble concentrating, sluggishness, decreased coordination and disorientation (1). If you have heard of it then you’ve most likely heard that when it comes to treating a concussion, “rest is best”. Many still believe this to be the case. However, as modern sports medicine evolves, new research is beginning to question this common saying. Most athletes want to get back to the field as fast as possible after a concussion. What if training early after a concussion wasn’t as bad as we thought? What if exercise was the best way to treat a concussion?

 

Scientists have been toying with the idea of a quick return to sport for many years. In a controlled setting, scientists were able to show that mild aerobic exercise (e.g. cycling) could be beneficial in reducing symptoms severity as well as decreasing the time to recover after a concussion (2,3,4). The data is still quite limited so it’s hard to say how beneficial this approach actually is. On the other side, full rest seems to make things worst. Ceasing all physical, social and mental activity until full recovery could actually be detrimental by prolonging recovery or increasing concussion symptoms (2). Although the exact benefits of physical activity after a concussion may not be well understood, it seems to at least be on par or better than the old notion of “rest is best”.

 

Perhaps one of the most surprising findings was the difference in recovery between concussed athletes versus non-athletes. Both animal and human models showed that bodies who were physically active before the incident were much more protected and recovered better from a concussion than a body which didn’t exercise much (2,4). When it came to exercising after a concussion, these gains were even more pronounced.

 

What do we do with this information? In 2016, the 5th international conference on concussion in sport was held in Berlin, where the experts on the subject came together to make their new recommendations. Known as The Concussion in Sport Group (CISG), they have been giving expert concussion guidelines for decades including the “Return-to-sport” strategy (5). Briefly, this strategy starts by a 24-48 h rest period followed by increasingly active steps towards returning the athlete to their sport. The goal being to do exercises within the athlete’s tolerance before moving on to the next step. If symptoms were to worsen, one would return to the previous step. Because the knowledge surrounding concussion treatment is still limited, the CISG has taken steps to give a simple and clear template to allow athletes an optimal, efficient and safe return to the playing field (5).

 

Despite all the data we currently have on concussion recovery, there are still many unknowns. For example, we don’t know which type of exercise, the intensity of the work-out nor how often one should. Until we discover more about how the brain and the body work together after a concussion, the best course of action is prevention. Protect yourself, protect others and recognize the early signs.

  1. https://www.uptodate.com/contents/acute-mild-traumatic-brain-injury-concussion-in-adults?search=concussion&source=search_result&selectedTitle=1~69&usage_type=default&display_rank=
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089233/
  3. https://www.ncbi.nlm.nih.gov/pubmed/31522997
  4. https://www.ncbi.nlm.nih.gov/pubmed/31739694
  5. https://bjsm.bmj.com/content/51/11/838

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