The reasoning for physical and cognitive rest following a concussion is based on evidence of temporary chemical changes in the brain that occur immediately after a concussion to help the affected brain tissue recover. The recovery time can last for days to weeks and involves a period of inflammation and increased nutritional demand to the affected brain tissue. This contributes to the common symptoms of concussion.
For a successful recovery, the advice is to avoid non essential physical or cognitive activity that diverts essential nutrition from injured brain tissue, so as not to delay recovery. Therefore clinicians advise a period of rest in the early days following a concussion to reduce the risk of worsening symptoms and delaying recovery.
Recent evidence has shown that the return to normal brain chemistry did not always coincide with resolution of symptoms. Prolonged symptoms past the normal healing time is often referred to as Post Concussion Syndrome (PCS) and has now been associated with a prolonged dysfunction in certain pathways of the brain. Resting until symptoms have fully resolved is not advised and may even be detrimental to your recovery: We need to be active for our brain to figure out what it is doing wrong and re-learn how to function normally again. Activity also boosts chemicals in the brain that promotes healing makes you feel good. Getting active as soon as possible after a concussion has been shown to improve recovery time and well being, as long as this activity does not exacerbate symptoms.
To work out what level of activity is safe post concussion is vey individual and clinicians commonly use the Buffalo Concussion Treadmill Test (BCTT) to assess where you can comfortably exercise and then create a program to help you improve your activity tolerance without exacerbating symptoms.
As a Clinician who has used the BCTT with clients experiencing PCS, i have witnessed the effectiveness in facilitating a full return to exercise and speeding up recovery post concussion.
If you are 6 weeks post concussion and struggling to get back to your usual physical activity because of symptoms, then it would be worth contacting a Health Care Professional who is experienced in this test and help you back to your active self 🙂
This post was inspired by: https://www.researchgate.net/publication/297744198_The_Role_of_Controlled_Exercise_in_Concussion_Management, take a look for more info on the physiology of Concussion and more on the outcome of BCTT.