Brain Rest and Concussion Recovery for Children

Full rest—both brain rest and physical rest—is essential for concussion recovery. Sitting out of sports and other physical activities is not enough; children also need brain rest, or cognitive rest, during the early stages of the recovery process. Academics and even seemingly relaxing activities such as using social media apps on a cell phone, reading, and playing video games, can be taxing on the brain.

The Importance of Brain Rest to Concussion Recovery

Children’s developing brains need more time than adult brains to recover from a concussion. Studies suggest that pediatric concussion patients who participate in cognitive rest take less time to recover than those who do not. ¹ Brown NJ, Mannix RC, O'brien MJ, Gostine D, Collins MW, Meehan WP. Effect of cognitive activity level on duration of post-concussion symptoms. Pediatrics. 2014;133(2):e299-304. ^{, 2} Moser RS, Schatz P, Glenn M, Kollias KE, Iverson GL. Examining prescribed rest as treatment for adolescents who are slow to recover from concussion. Brain Inj. 2014 Oct 3:1-6. PubMed PMID: 25279423. In fact, some experts believe that getting adequate brain rest can shorten recovery time by 50% or more. ³ Brown NJ, Mannix RC, O'brien MJ, Gostine D, Collins MW, Meehan WP. Effect of cognitive activity level on duration of post-concussion symptoms. Pediatrics. 2014;133(2):e299-304, as cited in Straus LB. Full Cognitive Activity After Concussion Delays Recovery, Study Finds. momsTEAM.

See Concussion and the Importance of Recovery Time

What Is Brain Rest?

Just as the effects of a concussion can be hard to recognize, it can be difficult to gauge if a child is being too cognitively active or getting good brain rest.

According to concussion experts, brain rest means ceasing any activities—no matter how seemingly benign—that aggravate the child’s symptoms or are metabolically demanding. Cognitive activity, like physical activity, requires metabolic energy. After injury, the brain needs additional glucose energy to heal itself, but a concussive event will decrease cerebral blood flow. It is critical that children abstain from cognitive activities so the brain is protected, has the energy to heal, and symptoms are not prolonged or worsened. ⁴ Winston FK. TBI: What Does 'Brain Rest' Really Mean? Medscape. Aug 13, 2012.

Brain rest is indicated early in the injury recovery process, after which gradual reintroduction of daily tasks occurs. During this time, some school attendance is essential for socialization and will not prolong recovery. Parents, doctors, teachers and other adults must help the child find a balance between activity and rest.

Consult a Physician

Some schools and sports teams work with concussion specialists who treat young athletes as well as help them during recovery. These schools and teams may even have a written plan to help guide a student’s concussion recovery.

Many school teams work with certified athletic trainers (ATC). These professionals can be integral to the diagnosis and management of concussion in student-athletes. They can work closely with sports medicine physicians and schools to implement individual treatment plans.

Whether or not the child is treated by a school, team doctor, family doctor, or by a concussion specialist, the consulting physician should be able to help plot a course for returning to school, sports, and other daily activities. Specifically, the physician will consider the nature and severity of a child’s symptoms and recommend a timeline for when the child can return to school (and for how long each day).

See How to Prepare for an Appointment with a Concussion Specialist

A neuropsychologist or school counselor may suggest specific academic accommodations that can be made during recovery (e.g., postponing or granting extra time for tests).

Explaining Concussion Recovery

Young concussion patients should be educated about their injury and the recovery process. Children must understand that the recovery process is gradual and requires patience.

See Factors Affecting Concussion Recovery

Parents and guardians should check in regularly with their child’s coaches, teachers, and certified athletic trainers, and provide emotional support and understanding.

Additionally, parents should ask recovering children how they are feeling. Children may not be quick to alert parents to new symptoms if the symptoms are not painful or alarming. Monitoring how children feel before, during, and after physical activities will help parents and caregivers keep track of the recovery process and recognize any new or worsening symptoms.