Concussions differ so widely that it takes skilled health care providers and trainers to properly assess, treat and make decisions on return to play (RTP) with a variety of assessment tools. Remember that nerve cells in the brain are extremely fragile and vulnerable to re-injury at this time and there are good systems in place to minimize the individual’s risk of further damage. Premature mental tasks, physical tasks and stress delays healing and therefore direct communication amongst school staff, coaches, trainers, physical therapists and providers offers maximum success for a full recovery.
Once the person’s symptoms have subsided at rest and with mental challenges (headaches, dizziness, visual disturbances, increased sensitivity to light and sound, agitation, loss of memory, uncoordinated movements and loss of balance are examples), they are likely ready for conditioning. According to the American College of Sports Medicine and other published literature on the safety and efficacy of the rehabilitation process, the following 5 day progression can be implemented.
Day 1: Light aerobic exercise for 5-20 minutes which can include a stationary bike, stair climbing, rowing, a brisk walk, or elliptical machine, to name a few options.
Day 2: Aerobic exercise at moderate intensity and to continue up to 20 minutes, as tolerated
Day 3: Interval training, sprinting or otherwise high intensity aerobic exercise
Day 4: Contact exercises begin but in controlled, supervised setting
Day 5: Return to sports without limitations/restrictions
It is so important it bears repeating that this is not “one size fits all.” Individuals must be assessed all along to observe for any changes in coordination, balance and ability to concentrate and follow directions, as well as be symptom free.