Concussion Confusion – You’ve Sprained Your Brain…Now What?
There are many myths and confusion about how to care for your brain after experiencing a concussion. Many people don’t realize the severity of even a mild concussion and that they can be caused by a direct or indirect hit to the head or body. Not all concussions are suffered by athletes while playing sports; falls and accidents can cause them too. All concussions are serious injuries that can have severe repercussions if not managed properly. Proper care during the first 7 – 10 days is crucial to ensure your recovery.
- Blurry Vision
- Emotional symptoms (moody, irritable, sad, worried)
- Sleep issues (drowsiness, trouble falling asleep)
- Mental Fog
- Slow Thinking
- Difficulty Concentrating
Symptoms are not always immediately present and may take up to 24-48 hours to manifest.
A concussion takes an average impact of 95 Gs of force, but a neck injury occurs at only 4 Gs of force. You cannot sustain a concussion without also experiencing an underlying injury to the neck. Both injuries need to be managed appropriately. An Upper Cervical chiropractor will work to balance and stabilize the neck, which is vital for optimal communication between the brain and the body.
Immediately following the incident:
- You should remain awake for two to three hours and be continually monitored.
- You should NOT DRIVE or be left alone.
After 3 hours you may sleep for 2–3-hour increments. Someone should wake you every 3 hours and ask simple questions to ensure that a more serious brain injury hasn’t occurred.
If you feel fine following the incident but notice any of the following symptoms, you should seek emergency care as soon as possible:
- Rapid deterioration of symptoms
- Severe headache with sudden onset
- Inability to be woken up
- Repeated vomiting
Think of a concussion like any other injury such as a sprained ankle or a broken arm. What would you normally do to manage those types of injuries? Rest!
A major problem is that many people don’t know what it means to ‘rest’ a brain. If you go right back to work or school, or resume any physical or mental activity, it’s as though you are going for a run on a sprained ankle. Remember the brain needs a LOT of energy to heal.
There is a 30-day window following the incident in which you are most vulnerable. It is crucial that during the first 10 days you refrain from any activity that could put you at risk for any kind of physical contact, even if you are feeling recovered and asymptomatic. The brain is extremely vulnerable after a concussion; even if you feel no symptoms, any further jostling or sudden movement, even small impacts, can actually cause a more severe brain injury. How you feel doesn’t always coincide with how well your brain has recovered.
The Recovery Process
Step1: First 3-4 Days
- Physical and cognitive REST is critical.
- No driving, no screen time, no reading, no school, no homework, no physical activity.
- Rest in a dimly lit room with minimal stimulation.
- When you no longer exhibit symptoms for at least 24 hours, you can move on to the next step.
If after 4-5 days you are still symptomatic with complete rest, return to your Upper Cervical chiropractor for re-evaluation. The underlying neck injury needs to be assessed and addressed, and there are other exercises that may facilitate the recovery; this should be monitored very carefully with your practitioner.
Step 2: Light cognitive activity allowed. You should still be resting for the majority of the day, but you can attempt to read a book or do homework for a 30–45-minute daily maximum. If symptoms occur during or in close proximity to the cognitive activity, this is considered a failed step and you need to go back to Step 1 for a minimum of 24 hours.
If no symptoms occur after 30-45 minutes of cognitive activity, you should still discontinue the activity for the remainder of the day. The following day you can proceed to Step 3.
Step 3: You are now ready for a half day of work or school. No driving, no tests, no homework, no recess, no gym, no manual labor or heavy equipment usage (this includes power tools and saws, etc.)
If any symptoms arise while at school/work or later in the day, return to Step 2 for the next 24 hours. If no symptoms occur, proceed to Step 4 the following day.
Step 4: This step involves exactly the same recommendations as Step 3, but you may attend work or school for the full day with restrictions. If any symptoms occur, return to Step 3. If no symptoms occur, proceed to Step 5.
Accommodations that should be made during this step include allowing for frequent breaks, no tests or heavy thinking, having another student take notes, doing 50-70% of the normal workload, avoiding over-stimulating environments, crowds, loud noises or jostling in crowded hallways.
Step 5: Slowly start removing restrictions and prepare for a full return to school or work as tolerated. It is recommended that you lift one restriction per 24-hour period, and once again, if no symptoms are provoked, continue to lift one restriction until a full return can be tolerated.
Step 6: A full return to work or school with no restrictions. Driving is now permitted. Physical activity should be kept to light walking or gentle range of motion exercises until you have fully reintegrated your normal daily activities. At this stage, another evaluation should be done by your Upper Cervical chiropractor to begin the process of returning to full physical activity or sports. For more information about your concussion and recovery, schedule an appointment with an Upper Cervical chiropractor.