New advice to move more after a concussion

When young athletes suffer concussions, they are typically told to rest until all symptoms disappear. That means no reading, screen time or friends, and little light exposure, for multiple days and, in severe cases, weeks.

Restricting all forms of activity after a concussion is known as “cocooning .” But now new by an international panel of concussion experts and published this month in The British Journal of Sports Medicine, question that practice. Instead of cocooning, the new guidelines suggest that most young athletes should be encouraged to startactive within a day or two after the injury.

“The brain benefits from movement and exercise, including after a concussion ,” said Dr. John Led dy, a professor of orthopedics at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, and one of the co-authors of the new guidelines.

There has long beencourse, about the best ways to identify and treat sports-related concussions. Twenty years ago, athletes who banged their heads during play were allowed to remain in the practice or game, even if they stumbled, seemed disoriented or were“seeing stars .” Little was known then about any possible immediate or long-term consequences from head trauma during sports or about the best response son the sidelines and afterward.

Since then, mounting evidence has indicated that sports-related concussions are not benign and require appropriate treatment. The question has been what these appropriate treatments should be.

Int he early 2000s, dozens of the world’ s premier experts on sports-related concussions started meeting to review studies about concussions, with plans to issue a consensus set of guidelines on how best to identify and deal with the condition.

The panel, called the Sport Group, does not make formal clinical practice guidelines. But the group’ s findings do represent the latest thinking about sportsthe world’ s experts, based on the newest published science, said Led dy, who is also medical director of the Buffalo Concussion Management Clinic.

In its 2012 guidelines, the Concussion in Sport Group recommended broadly that if an athlete of any age was found to have a sports-related concussion, he or she should rest as completely as possible, remaining in a darkened room with little visual or physical stimuli, until all symptoms had gone away and did not return once the athlete began ea sing back into normal activities, which could be a week or more.

This approach was thought to “promote recovery by minimizing brain energy demands following concussion ,” the authors wrote in thenewstatement.

But since then, a number of studies in animals and people with diagnosed concussions have indicated that prolonged physical rest may delay the brain’ s recovery.

So this month, the group new set of guidelines that significantly revise thephysical rest. Now the advice is that after a athlete should remain quiet for 24 to 48 hours, but then should begin to get up and move.

Being physically active in this context“does not meanthe soccer field or football practice ,” L eddy stressed .“This is about meeting certain lowstarting with agent le walk aroundtheblock.