Concussion Rehabilitation
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For years the advice was to shut it all down. Dark room, no phone, no practice, wait until you feel normal again. Most places have moved off that, because sitting still for two weeks leaves a kid out of shape, sleeping badly, and pretty miserable, and it doesn't make the concussion go away any faster.
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Movement helps. But only the right amount of it.
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Here's what's actually going on. A concussion throws off how your body manages itself when you work — heart rate, blood pressure, how much blood the brain is getting. Those systems are running a little off for a while. That's why a kid feels fine on the couch and awful ten minutes into a jog. There's a level of effort that sets symptoms off and a level right underneath it that doesn't, and time spent in that second zone is what moves things along.
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Concussion Rehabilitation: A Symptom-based approach
The other thing worth knowing is that feeling fine comes before being fine. A symptom checklist never asks anyone to react to something they didn't see coming or stay balanced when their legs are shot. Those are the moments that go badly when somebody returns to sport too early, and it's usually a knee or an ankle that pays for it, not their head.
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So I check those things. Reaction, cuts, actual speed once they're tired. Anything that's still off, we fix before a game does it for us.
Concussion Rehabilitation: Getting it right
There's a level of effort that helps and a level that sets someone back, and the line between them sits in a different place for every person. Finding it takes testing.
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What's easy for one person is a setback for the next. Go too light and nothing changes. Go too hard and you lose most of a week. It moves as recovery goes on, too, so Monday's number is usually wrong by Thursday. That's not something you hand someone on a sheet of paper and hope for the best.
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Somebody has to be there watching heart rate and asking how they feel, and adjusting it while it's happening.Â
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This is TRUE concussion rehabilitation.
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