Q&A About Prolonged Recovery After a Concussion

Q&A About Prolonged Recovery After a Concussion

Parent: How much rest is too much rest?

Christina L. Master, MD: Rest is the most important treatment for a concussion.

Matthew Grady, MD: At some point in time, rest becomes too much rest. In our adolescent populations, we advocate rest for only a few weeks at the most, depending on the severity of the injury. If an individual can be back in school in two or three days, that's ideal. If the injury is more severe, it may take them more than a few weeks to get back to full school.

In a subset of patients who have prolonged symptoms, usually about 10 percent of adolescent concussions, rest is no longer a benefit for them. And so, as a general guideline, after the three- to four-week mark, we're going to have individuals do activities, regardless of symptoms. And at that point, we're thinking of this more as rehab rather than as a rest for spontaneous recovery.

In general, schoolwork functions as cognitive rehabilitation, and so we like to get students into schoolwork as quickly as possible during the rehabilitation phase. In individuals with prolonged symptoms, who are unable to do schoolwork, then occasionally we have to do additional therapies. At that point, speech therapy, which specifically works on memory, is one of the additional therapies we may add. For individuals with eye tracking problems that do not respond to this particular therapy, occasionally we'll add vision therapy.

In individuals with prolonged concussions, mood disorders are common. In general, we'll look for mood disorders for people with prolonged concussion symptoms. If they have mood disorders, then they will be referred to the appropriate specialist. However, we do know that allowing people to be physically active and doing aerobic activity and getting them back to school sooner reduce the number of mood symptoms that we see, and so we like to keep them as active as possible during the rehab phase.