COGNITIVE REST IN CONCUSSION

After a concussion there is an energy crisis of the brain, basically meaning there is not the right balance of “fuel” to make the brain work right. An analogy would be putting 89 octane gas in a car requiring 93 octanes; thus car will not function right. So after a concussion, a person needs to reduce the demands of physical and cognitive rest in order to keep energy, or “fuel levels” at the correct balance. An energy mismatch most often manifests as increased symptoms (e.g., headache, dizziness, fatigue, concentration difficulties) with cognitive tasks or physical tasks.

How Much Rest Should I Be Getting?

Current literature supports physical and cognitive rest for 24-48 hours with a subthreshold progression back to full activity. Subthreshold, meaning only performing activities that do not cause symptoms. With the typical recovery time for concussion being under 10–14 days in adults and under 4 weeks in children.2 When diagnosed with a concussion, physical rest is commonly stressed, but cognitive rest is just as important. But, what exactly is cognitive rest?

Cognitive Rest

Cognitive rest is interchangeably known as brain rest. Brain rest doesn’t mean you need to sit in a dark room all day and try not to think about anything. Rather, you avoid activities that are mentally taxing that require attention, focus, concentration, or multitasking.

Examples of difficult cognitive tasks include:

• School or work

• Family gatherings

• Reading on a computer or book

• Taking tests or studying

• Playing on your phone or texting

• Driving, especially on unfamiliar or longer trips

• Making financial decisions

• Group gatherings with a lot of noise or conversation

• Busy environments: like grocery stores, airports, or concerts

Participating in the above activities within the 24-48 hour time frame after a concussion can be overwhelming and increase symptoms, actually slowing concussion recovery. As busy as life is, it is a better idea to take a brief break from mentally taxing activities so recovery can occur as expected.

How to practice brain rest

Here are some brain rest ideas for concussion recovery:

1. Take time off work and/or school.

It’s difficult to step away from your work responsibilities for a few days, but consider using some sick or vacation time to take a break and allow your brain to heal. However, if that’s not possible, talk to your employer about a temporary reduction or reassignment for your most mentally taxing projects.

For students, ask your teacher and school administrators to work with you to modify your workload. Diving right back into complex problem-solving can exacerbate concussion symptoms. Click the LINK BELOW for a full list on how to help kids get more brain rest and navigate a return to school.

How to Help Kids Get Brain Rest After Concussion.

2. Focus on one task at a time.

Multi-tasking may have come easier to you prior to your concussion. But after a concussion, it’s helpful to give multitasking a rest and focus your mental energy on one task at a time.

Give yourself a break and know that it will likely take you longer than usual to get things done.

3. Steer clear of large group gatherings

It is tempting to keep up with your social calendar and attend that family birthday party coming up, but large group gatherings are very stressful on your mental energy. Having multiple conversations, gatherings with a lot of noise, and excessive visual stimulation very often lead to exacerbation of concussion symptoms, so should be avoided temporarily.

When you're ready, consider visiting with 1 or 2 people that don’t increase your stress, can be soft-spoken, and will not overstay their welcome.

4. Decrease your drive time

While recovering from a concussion, operating heavy machinery and relying on quick reaction time should be avoided. If you need to get somewhere, don’t drive a car or ride a bike. Instead, ask a family member or friend for a ride, or use a ride-sharing service. These options keep you and others around you safe.

5. Relax with comfortable, simple hobbies.

Skip stimulating pastimes, such as strategy games, complicated books, or word puzzles. Consider playing easy games like Legos, simple puzzles, listening to podcasts or music, or watching calm tv programs.

Many people progressively add cognitive activities back into their routines as concussion symptoms fade. When you add a new activity—whether it is a mental or physical activity—pay attention to how your body reacts during and after. Keep in mind the subthreshold principle of adding an activity up until or just shy of causing symptoms. If you feel fine after 24 hours, consider adding another activity to your routine. If symptoms worsen, scale back activity and rest.

Precisely how long you should practice brain rest depends on how recovery progresses. A physician, therapist, or athletic trainer should closely monitor your recovery and adjust recommendations as symptoms improve. At Custom Care Rehab we have helped hundreds of clients recover from concussions, improve function, and return them to sports! We would love you to get started on your journey back to health.

If you are currently struggling with concussion symptoms or want a second opinion on your recovery plan we’d be happy to offer you a Free “Discovery” Call. This is a 15-minute call to cover your injury, screen your symptoms, and discussion of your treatment options.

Call 330-618-5703 to schedule or Click HERE to schedule your Free Discovery Visit.

Resources

• https://www.physio-pedia.com/What_is_Concussion%3F#cite_note-:0-2

• https://bjsm.bmj.com/content/51/11/838

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC155411/

• https://www.sciencedirect.com/science/article/abs/pii/S1047965115001254?via%3Dihub