Think you or your child may have a concussion, now what?
If a concussion is suspected, the best thing to do until you are evaluated by a doctor is to rest both cognitively and physically.
Experts agree on this in the acute phase of concussion. It is noted in consensus statements published by the American Academy of Neurology, the American Academy of Pediatrics, the American Medical Society for Sports Medicine, the National Athletic Trainers’ Association, and the 4th International Conference on Concussion in Sport (8).
If you suspect a head injury, do not finish the school day and do not finish the practice or game. Immediately resting can help expedite recovery. In a recent study, teenage athletes who continued to play with a concussion required nearly twice as long to recover than those who were immediately removed from play (13).
Not only does it delay your recovery, but it puts you at risk for another blow to the head, which can lead to a much more serious injury (see “what is second impact syndrome”).
See a doctor experienced with concussion
When looking for the right concussion clinic, it's important to ask these questions:
What is the background of the doctors?
Does the clinic offer a multidisciplinary team?
How many concussion patients does the clinic see?
Do they have “return to learn” and “return to play” protocols?
Does the clinic have positive reviews from previous patients?
Does the clinic recommend exercise therapy as part of recovery?
Does the clinic have experience with Post Concussion Syndrome?
Will the doctor assess the patient's ocular-motor system, vestibular system, and neuropsychology?
It’s important to select a doctor and concussion clinic that is up to date with the latest findings, offers a rehabilitation plan, and has extensive experience in dealing with concussion. There are still many unanswered questions when it comes to concussion, but making sure your doctor is up to date with the latest findings is a good place to start.
Maintain a Healthy Diet
Most doctors encourage a brain healthy, high protein diet while recovering from concussion. It’s important to give your brain the nutrients it needs to make a full recovery.
Eat plenty of fruits and vegetables particularly those full of antioxidants and Vitamin E such as blueberries, spinach, and broccoli. This has been shown to help with memory and general neural function (24).
Consume protein. A recent study showed that having certain Branch Chain Amino Acids, the building blocks of proteins, following a concussion can improve cognitive deficits created by the injury (25). Great high protein foods include: meat, fish, nuts, greek yogurt, and beans. You can also try animal based protein supplements like Whey or straight BCAAs that can be purchased at your local GNC.
Eat foods rich in Omega 3s. Omega-3 fatty acids, specifically DHA, have been shown to improve cognition, plasticity, and recovery of neurons after traumatic brain injury (25, 26). The easiest source of Omega 3s is fish such as salmon but, they are also found in flaxseed, chia seeds, walnuts and soybeans (27).
Too nauseous to eat? Try smoothies! It is an easy way to get the required nutrients without having a full stomach. It might also help to have many small meals throughout the day instead of three large ones. Ginger gum, typically recommended to those suffering from morning sickness or side effects from chemo, can help curb nausea brought on by concussion. Ginger Ale and seltzer are also used to settle the stomach. You can find all of these at your local pharmacy.
Dehydration can mimic many typical concussion symptoms such as headache. Give the brain the optimal environment to heal by staying hydrated. To see if you are properly hydrated, check the color of your urine. Light yellow or clear coloration is an indicator for adequate hydration.
Turn off Electronics
Screens put unnecessary strain on an injured brain. Did you know, LCD screens (TV, smart phone screens, computer screens, etc.) constantly flicker (28)? This allows the screen to update new information in order to scroll or show video. The flickering is invisible to the naked eye, but it strains our eye muscles as they attempt to keep up with the new information. This is why sitting in front of the computer too long can give the average user headaches, let alone someone who has sustained a concussion (28).
Instead, try listening to a book on tape, drawing, or taking a walk. If using a screen is necessary, try lowering the brightness, placing a blue tint over the screen or, changing the white background on your computer to one that is easier on the eyes.
When a brain is injured, it is easily overwhelmed and overworked. After a concussion, there is a decrease in cerebral blood flow that creates an energy supply-demand imbalance (14). The brain is starved for energy to heal and function. This means it can use a break or two so it can rejuvenate! Here are some easy ways to ensure you rest enough during recovery:
Take a few short 10-15 minute breaks throughout each day. Pace yourself. If you have symptoms, a step back is necessary or else you could potentially set your recovery back.
- Set a timer when doing physical or cognitive work. Depending on where you are in your recovery, set the timer for 15, 20, 30, 45, or 60 mins. When the timer goes off, take a break, rest. Then repeat. If you know how long it usually takes before your symptoms return, be sure to set the timer as a shorter interval. Plan ahead of time to have breaks in your school day.
Talk to your school.
The school will play an important role in helping you or your child recover.
1) Notify the school right after a concussion is diagnosed by a doctor.
Get a note from your doctor explaining the diagnosis and recommending accommodations. This way, teachers will be made aware of the situation before your child returns to school.
2) Make sure your or your child’s teachers understand what a concussion is and its specific effects on you or your child.
Many schools are implementing their own concussion education programs, so the staff may already be familiar with concussion. Regardless, as concussion is an invisible injury and each one is unique, it is important that you share everything you or your child is experiencing so teachers will have a better understanding of the situation.
Emphasize the fact that even though you or your child may look fine and be in the classroom, it does not necessarily mean he or she is fully absorbing the information discussed.
3) Discuss Partial Days
Depending on how you or your child is feeling, it may be a good idea to ease back into school with partial days. You or your child should try and be in the classroom when you are at your best. For some, this might be in the morning. For others, it might be in the afternoon only. Experiment with different schedules and find which one works for you or your child.
Gradually increase to full days per your doctor’s orders.
4) Explore accommodation options
Below are some suggested accommodations taken from doctors from Children’s Hospital of Philadelphia and University of Pittsburgh to take to your school. Keep in mind, your doctor may have specific accommodations that they recommend.
Offer extended time for taking assessments and assignments (doctors note is usually required)
Extend time once the student has returned to school to make up assessments and assignments
Provide a copy of the class notes so the student does not have to multitask during a class and can focus on listening to the teacher
Allow students to leave 5 mins early from class so that they can travel the halls without crowds if needed
Have a “flash pass” that allows the injured student to leave class and go to the nurse or bathroom whenever they want during the day. Allows for frequent breaks throughout the day..
Allow concussed student to write on and answer on their test
Allow student to have food and drink with them throughout the day.
Reduce class work and homework by 50% (ex: 50 math problems given to class, concussed student only has to do 25 for the same credit)
Provide option to take tests in a separate environment (empty room, darker room, lying down, etc.)
Increase font size for tests
Provide option to have tests administered orally if the student requests
If you are having a tough time working with your school, consider creating a 504 plan.
A 504 plan is an official agreement of accommodations with the school system, which can be utilized to manage the long term effects of concussion or to simply enforce the doctor’s recommendations if certain teachers are unwilling to cooperate. Talk to your doctor and your school guidance counselor to see if this is the right next step for you.
Our brains rely on a good night’s sleep to recover from the day’s activities. When recovering from a concussion, the brain needs to rest even more, and it rests best when sleeping (29). According to the CDC, school aged children and teens should be getting at least 9 hours of sleep for optimal function (30).
Make sleep your top priority by following these tips:
Stick to a routine: Go to bed and get up at the same time every day.
Minimize distractions (TV, phones, computers) in your bedroom.
Wind down at least forty-five minutes before going to bed. Do this by limiting screen use, closing up your textbooks, and getting ready for bed.
Experiment with breathing exercises and meditation before bed.
Heat up some milk as a natural way for your body to get melatonin, which makes people feel sleepy.
Take short naps during the day as needed. Naps can be effective at “refreshing” the brain, but should be kept short so as not to disrupt the ability to fall asleep for a full night’s rest (29).
Stay Positive. Stay Patient.
This is the hardest part of concussion recovery and perhaps the most important. When you have a concussion it is easy to become frustrated and feel overwhelmed. Maybe you have a lot of make up work to complete or you are worried about your position in your team’s lineup. Maybe your brain isn’t working the way you want it.
Anxiety and depression are often linked to concussion (8). Stress can have a negative impact on concussion recovery.
Below are some helpful tips to relieve stress and improve your quality of life when recovering. Keep in mind, these are only suggestions! Whether or not you can do each option is dependent on the person and where he or she is at in recovery.
Practice Meditation and Deep Breathing Exercises - A study designed to evaluate the effects mindfulness based stress reduction for concussion and PCS had very positive results. It found that patients who practiced mindfulness had an increased quality of life and smaller but significant improvements in their working memory and regulation of attention (64).
Download an app - there are so many great mindfulness apps available for free.
Count 25 deep breaths - inhale for 3 seconds through your nose exhale for 6 through your mouth; breathe with your stomach. Pay attention to how your body feels while breathing.
Practice Yoga - Yoga combines meditation with controlled movements and balance exercises. Though there is limited scientific evidence, yoga is frequently recommended by doctors for stress relief.
Find a studio near you that offers rehabilitative yoga, flow yoga, and/or yoga for stress relief. Make sure you only do what feels good for you.
Look for videos on Youtube.
Order a yoga dvd on amazon.
Go outside - Walking outside has been shown to have a positive effect on mood and even cognition (23). Go for a leisurely walk, get the blood flowing, and enjoy the outdoors! Remember to not push yourself past your own limits though!
Listen to an audiobook - Headway’s personal favorite is the Harry Potter series, but any book will do. Books on tape are entertaining, engaging, and can be listened to on a low volume. Borrow some from your local library!
Cook or order in your favorite meal for dinner - Our favorite foods always have a way of cheering people up. Cooking or baking can also be a great way to pass the time if symptoms are not triggered. There are tons of recipes available online so, put your chef’s hat on and have some fun!
Do Art - Doing art and exploring your creative side is a fun way to relieve stress. Find some crayons or colored pencils and go to town!
Buy a coloring book to fill in.
Sign up for an art class.
Struggling to recover from concussion? Concerned your injury is taking a longer than typical time to recover? Click here to see our section on Post Concussion Syndrome.
Click here to see our sources.
DISCLAIMER: Headway is not a medical provider and does not provide medical advice. Any medical information included on this website is provided for informational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment.