Get moving after a concussion to heal faster

A new study from the University of Michigan found that people who underwent light exercise within 48 hours after a concussion resolved their symptoms in about half the time compared to those who waited a week or more.

The study adds to the evidence suggesting that post-concussion “cocoon therapy,” which involves minimal emotional stimulation and rest in the dark, is not good for patients.

Instead, exercise is preferable if it’s done under the guidance of a trained clinician, says Landon Lempke, a researcher appointed to the UM Concussion Center and the Exercise and Sports Science Initiative, both in the athletic department. said. Landon is the lead author of a study published in the journal. sports medicine.

Research shows light exercise speeds up healing

In this observational study, more than 1,200 college athletes were monitored at 30 facilities nationwide from pre-injury and injury until medical diagnosis. Although this study was not designed to establish a causal relationship between exercise and concussion recovery, the results are in line with previous small randomized controlled trials that have identified a similar relationship. Match.

• Athletes who began light exercise within 48 hours were significantly more likely to experience symptom recovery than those who did not exercise, with a time to symptom recovery approximately 2.5 days faster.
• Athletes who began exercising after approximately eight days after injury experienced significantly less recovery and took approximately five days longer to recover than those who did not exercise.

Lempke said the biggest beneficiaries of early exercise may be those who are more likely to develop persistent concussion symptoms — those who have symptoms for more than four weeks.

• Athletes in the early exercise group had a lower prevalence of persistent symptoms (3%–4%) compared with the non-exercise group.
• The late-exercise group had an 11% higher prevalence of persistent symptoms than the no-exercise group.

The way we think about exercise during concussion recovery has evolved

Lempke said it has been suggested for 20 years that people who have had a concussion should avoid physical and mental activity while they are symptomatic and recovering. Concerned was that athletes who returned to play too soon could suffer recurrent concussions or a more serious condition called second impact syndrome, a rare but potentially fatal complication. There was a risk of injury. Some studies suggest that vigorous exercise may prolong recovery.

That view evolved as the benefits of early exercise became clearer. In 2017, the international consensus and return-to-play guidelines were revised to recommend light physical and mental activity after a 24- to 48-hour recovery period, unless symptoms worsen.

best exercise after concussion

Lempke stressed that the findings do not mean that athletes will return to competition sooner. A gradual return-to-play protocol should always be followed. All exercise after concussion and during recovery should be supervised by a trained clinician.

The Buffalo Concussion Treadmill Test is the most frequently used and studied post-recovery exercise protocol. Participants begin walking at 3.3 miles per hour and increase the incline until symptoms begin to increase, which is the exercise threshold. The patient then exercises 5-6 times a week, at 80% of her maximum heart rate, which initially exacerbated the symptoms.

“Historically, the adage that ‘the dose is the poison’ applies to post-concussion exercise,” Lempke said.

“Too much, too soon” or “too little, too late” can both be detrimental. Although this observational study did not identify exercise type, duration, or intensity, it did identify a clear positive effect of exercise on recovery time.

“Perhaps there is a slightly unique Goldilocks zone for each individual,” says Lempke.

What are the benefits for athletes? doctor? coach?

“For athletes, choosing to delay or not report a concussion is directly linked to longer recovery and potential harm, so reporting is the first step,” Lempke said.

“It is important for health care providers to stay up-to-date on concussion assessment and management practices. Our findings and many other studies show that exercise can be initiated before symptoms subside, in a safe and controlled manner under the guidance of a trained clinician.”