Exercise or rest after a concussion?
Once a no-no, activity does help some patients heal
When it comes to concussions, rest is often recommended as the first line of treatment.
But, in the last couple of years, staying sedentary while waiting for a concussion to heal is no longer a given.
Instead, physical activity is now considered a viable part of an overall treatment plan — especially in those crucial first few days post concussion.
It turns out that the science behind rest after receiving a blow to the head isn’t as strong as previously thought.
There’s even discussion suggesting it may be more harmful than helpful, leading to increased risk of lethargy, anxiety and depression, especially among the active set for whom exercise is a vital part of their lifestyle.
The support behind the idea that exercise can help heal concussions is the result of a growing number of studies posting positive results when exercise is introduced sooner rather than later during post-concussion care.
One of the most recent studies, performed by a team out of the Children’s Hospital of Eastern Ontario Research Institute, reported that “resumption of physical activity within seven days post concussion was associated with a lower risk of Persistent Post Concussion Syndrome as compared to no physical activity.”
“Preliminary studies in concussed adolescents found that participants engaging in moderate levels of activity reported lower symptom levels and superior neurocognitive performance compared to those with physical rest,” researchers said.
No one is ready to go on record to explain why exercise is so beneficial, though there has been plenty of suggestion that the boost in oxygen flow associated with exercise allows the brain to heal more quickly as compared to the more sluggish cerebral blood flow associated with sedentary behaviour.
For concussion specialists like Scott Delaney, a sport medicine and emergency physician at the McGill University Health Centre, all this isn’t exactly breaking news.
He’s been gently introducing exerciseto some of his concussed patients for the last couple of years.
As for the type of physical activity, he suggests aerobic exercise is the best option for those early days after being diagnosed with a concussion.
And since guidelines regarding the specifics around an early return to activity are scarce, Delaney has devised a series of tests to help determine just how long and how hard his concussed patients should exercise.
The first physical task is walking on a treadmill or riding a stationary bike at a moderate pace, gradually increasing the incline or resistance until symptoms start to appear.
If symptom-free, the next step is to pick up the pace to a run, checking to see if the additional impact could trigger symptoms.
If all goes well during the running test, Delaney suggests starting to lift weights or perform body weight exercises like squats, lunges and pushups.
If concussion symptoms resume at any point, Delaney suggests reducing the intensity and volume back to where exercise can be comfortably resumed and then maintaining this new level until additional healing has occurred.
This type of gradual resumption of exercise is good news for anyone who feels the effects of sitting still more than the effects of being active. Most of the research in the area of exercise and concussions involve children, but Delaney says there’s no reason to believe adults don’t benefit in the same way.
What’s interesting about the idea of incorporating exercise into concussion treatment for children, however, is that exercise has been linked with better grades in school and healthier physical and mental development. Kids are meant to move, which makes long periods of rest counter productive to their health and welfare.
So, while there’s no incentive to get concussion sufferers to push through the pain in favour of getting a good workout or to return to contact sports before they are symptom-free, the idea that riding a bike or going for a brisk walk a few days post concussion is welcome news.
Consult with your physician if you think light exercise will help you feel better while recovering from a recent concussion.