October 18, 2021
Clinical contributors to this story
Christine Greiss, DO contributes to topics such as Physical medicine and rehabilitation.
Whether you are a professional or recreational athlete, it can be difficult to look aside as you heal from a concussion. However, taking time out from your sport is essential to your recovery – and returning to competition too soon can have serious consequences.
According to Christine Greiss, DO, a physical medicine and rehabilitation specialist and director of the concussion program at the JFK Johnson Rehabilitation Institute, doctors follow a step-by-step progression to ensure athletes are ready to return to play after a concussion.
âWe carefully assess the physical, cognitive and mental readiness of each athlete before putting them back to play,â says Dr. Greiss.
How to safely resume normal activities and exercise
Dr Greiss says athletes need to go through a series of âstepsâ before returning to compete in their sport. JFK Johnson Rehabilitation Institute concussion rehabilitation team follows HEADS UP concussion recovery advice from the United States Centers for Disease Control and Prevention. HEADS UP is a national initiative to raise awareness of brain injury, including how to recognize, respond, recover and reduce the risk of concussion.
A patient’s recovery is usually coordinated by a team that includes:
- A specialist in physical medicine and rehabilitation
- A physiotherapist
- An occupational therapist
- A speech therapist
- A neuropsychologist
- Sports coaches and trainers
- The patient’s family
The steps in the recovery process usually include:
- Rest. After 1 to 3 days of rest, the athlete can slowly return to normal activities.
- Monitor symptoms during routine activities. If symptoms do not worsen with daily activities, such as school, work, walking, or driving, patients switch to a progressive exercise protocol.
- Resumption of moderate activity. Starting with light aerobic exercise, athletes move on to moderate activity that involves more body or head movement.
- Resumption of intense activity. Eventually, athletes switch to strenuous activity, such as running, weight lifting, and non-contact exercise.
Throughout the graduated exercise protocol, patients and their healthcare team monitor the return of symptoms and adjust the recovery plan accordingly.
âIf an athlete notices symptoms after their heart rate has gone above a certain level or if they are running for a certain period of time, we will ask them to step back slightly and exercise below the threshold. maximum, âsays Dr. Greiss. “Eventually, an athlete may switch to full contact practices followed by competition as symptoms subside.”
Assess cognitive and mental recovery
A concussion can cause a range of cognitive symptoms, including problems with memory, attention, concentration, and processing. Dr Greiss says that a neuropsychological assessment is the gold standard for assessing cognitive recovery.
âBefore we get back into play, we want to make sure our patients are on the go,â comments Dr Greiss. “They should have the same grades or performance at work, and be able to engage in the same amount of social activity, reading and study as before their injury.”
Dr Greiss says patients should also demonstrate improvement in mental symptoms, including mood or adjustment disorders and sleep disturbances. Other symptoms, such as social interaction difficulties or headaches caused by exertion, can also lead to symptoms of depression or anxiety.
âThe brain is the master of the body, and when injured it goes on high alert,â says Dr. Greiss. “It can induce anxiety, so we follow patients every two weeks to make sure these symptoms are improving.”
Recovering from a concussion is not always a quick process and it can be difficult for athletes to be patient when they want to get back into play. However, Dr. Greiss says that recovering from a concussion is important. a situation where patience pays off.
Returning to sport too early can increase the risk of developing a condition called second impact syndrome, which occurs when a person has a second concussion before symptoms of a previous concussion disappear. Second impact syndrome can cause rapid and severe swelling of the brain which can lead to paralysis and death.
âEven if a patient wouldn’t have another concussion, returning to play too soon could prolong their recovery,â says Dr. Greiss.
When the time comes for the patient to return to the sport they enjoy, Dr. Griess says that doing certain things could help prevent future concussions.
âStrengthening and stretching the muscles in the neck can help the body absorb blows better,â Dr. Greiss continues. âNutrition and supplementation, protein intake, and optimal body conditioning can all help create a physical and molecular barrier that reduces the risk of concussion. “
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The material provided by HealthU is intended to be used for general information only and should not replace the advice of your physician. Always consult your doctor for individual care.