Complete brain rest is recommended immediately post-injury, but complete cessation of cognitive activity is not required or recommended for an extended period of time. Patients may believe that brain rest is only effective when complete avoidance of daily life takes place—for example, lying in a dark room and abstaining from all cognitive activity—but a recent study has shown that engaging in minimal to moderate cognitive activity post-concussion may be acceptable.1
Patients are encouraged to take note of how they feel before, during, and after cognitive activities, and to adjust their behavior accordingly.
Reduce post-concussion workloads
Maintaining minimal to moderate cognitive activity can still be challenging for busy people. Cutting back on work and chores and simplifying tasks can help.
Stay home. Taking time away from work or family obligations may be hard, but it is necessary in order to attain brain rest. After a few days of complete brain rest, if symptoms are diminished, concussion sufferers can often return to work. If patients are not sure when a return to work is appropriate, they are encouraged to consult their physician.
Complete one task at a time. This helps minimize distractions and reduces the stress of concentrating on too many tasks.
Limit household chores. The physical and cognitive demands of maintaining a household can put strain on a recovering concussion patient. If possible, more physically involved housework, bill paying, and other chores should be undertaken by others or left until recovery is well underway.
Health care providers can provide information to help patients communicate with bosses and family about the prescribed rest.
Avoid mentally taxing activities
Even activities that are not labeled as “work” can still demand a lot of cognitive energy. People with concussions are advised to limit activities such as those described below:
Participating in activities for which reaction time is important. Driving, bike riding, operating heavy machinery, playing many sports, and similar activities may put the patient or others in danger.
Making important decisions. Decisions about finances, personal or professional relationships, and other large decisions should be shared with trusted friends or family or delayed until the patient is further along in recovery.
Relying heavily on short-term memory. Memory and recall may be affected by a concussion and may not improve until the late stages of recovery. Concussion sufferers are encouraged to write down anything that is difficult to remember and refer to their notes as needed rather than struggle to retain information.
Eliminating as many mentally taxing activities as possible during concussion recovery can help reduce recovery times. While it may not be feasible for patients to postpone everything until recovery is complete, asking friends, family, and coworkers for help can help reduce mental stressors.
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Relax and rest
Reducing physical and mental workloads can also make it easier for patients to get the needed amount of physical rest during recovery.
Sleep. Keeping a regular sleep schedule—supplemented with short daytime naps, as needed—and practicing good sleep hygiene (e.g., avoiding caffeine and snacks before sleep, keeping the room dark, sticking to a bedtime routine) is important to the recovery process.
Limit physical activities. Sports, exercise, and other activities should be reduced. Activities that put patients at risk of another blow to the head should be initially avoided and then resumed slowly.
No non-prescribed drugs or alcohol. Drugs and alcohol are known to slow neural recovery and impair judgment, and should be avoided during concussion recovery. Substances that impair judgment and dull pain can encourage concussion patients to try to rush their recoveries.6
Minimizing physical activity can help patients ensure they won’t aggravate physical and mental symptoms and help protect against additional injury.
- Brown NJ, Mannix RC, O'Brien MJ, Gostine D, Collins MW, Meehan WP 3rd. Effect of cognitive activity level on duration of post-concussion symptoms. Pediatrics. 2014 Jan 6.
- Concussion: What Can I Do to Help Feel Better After a Concussion? Centers for Disease Control and Prevention. Published October 16, 2012 http://www.cdc.gov/concussion/feel_better.html. Accessed October 10, 2014.