Rest after a concussion

What does ‘rest’ really mean?  What classifies as rest? Is there such a thing as ‘too much rest’? 

Immediate removal from activity and appropriately-timed rest are both directly linked to quicker recovery and less intense symptoms as a result of a concussion , .  For these reasons, the first line of treatment following a concussion (after immediate medical attention of course) is REST.  But, what does ‘rest’ really mean?  What classifies as rest? Is there such a thing as ‘too much rest’? 

First off, rest IS an essential part of concussion management and is best during the initial days following injury. The brain needs time to deal with the injury. It is a time where the brain’s need for energy is at an all-time high. The brain needs rest – both physical AND cognitive.  

Physical rest is probably the easier of the two to understand. Physical rest means:

• No sports, physical activity or workouts
• No strenuous house chores
• No work
• No gym class or leisure activities 
• No sexual activity

One VERY important point about physical rest –it does not mean complete bed rest. There are many documented negative side effects from prolonged bed rest.  Following a concussion, recommendations are that bed rest should not exceed 3 days and gradual return to normal activity should begin as soon as possible. 

Cognitive rest is a bit harder to ‘wrap your brain around’ (pun intended).  Examples of how to rest cognitively are:

• No work or school 
• No (or limited) homework
• No use of electronic devices (phone, computer, games)
• No reading or playing instruments
• Limited socializing 

Cognitive rest is best done by relaxing and sleeping more – again allowing your brain time to heal and deal with the ensuing energy crisis that occurs following a concussion.  

What CAN a person do when resting?

From the above lists there does not seem to be much left of daily or life activities that would qualify as ‘rest’ following a concussion.  Some recommended restful activities to consider are: 

• Meditating or taking a bath
• Sleeping
• Having a relaxing massage or spa experience 
• Listening to soft/relaxing music, audio books or tv
• Light home activities – folding laundry, setting the table
• Taking a slow, short walk
• Sitting outside

How much is too much rest?

As healing times are variable for each person and injury there is no hard and fast recommended amount of rest time.  

Most recent research suggests returning to light activity as soon as symptoms allow. Once concussion-related symptoms have reduced significantly, you can slowly and gradually reintroduce daily activities. 

Most concussion-related issues will resolve spontaneously within 7-10 days. However if symptoms persist it is best to consult with a health care professional with training and experience in concussion management. A knowledgeable professional can and will guide recovery.  

To find a Lifemark concussion therapist near you, please visit www.lifemark.ca or email concussions@lifemark.ca

Follow our blog for more concussion-related articles coming up on how long recovery from a concussion takes and how to tell when a concussion is healed.  

Asken, B.M., Clugston, J.R., Snyder, et al. ‘‘Playing Through It’’: Delayed Reporting and Removal From Athletic Activity After Concussion Predicts Prolonged Recovery; Journal of Athletic Training 2016;51(4):329–335 doi: 10.4085/1062-6050-51.5.02_ by the National Athletic Trainers’ Association, Inc.  www.natajournals.org

Elbin R, Sufrinko A, Schatz P, et al. Removal From Play After Concussion and Recovery Time. Pediatrics.
2016;138(3):e20160910

Silverberg ND and Iverson GL. 2012. Is Rest After Concussion "The Best Medicine?": Recommendations for Activity Resumption Following Concussion in Athletes, Civilians, and Military Service Members. J Head Trauma Rehabil. 2013 Jul-Aug;28(4):250-9.: