How to Treat a Concussion (Hint: It’s Not Rest)
If you visit a healthcare professional for a concussion, you’ll probably be told to lie down in a dark room until all your symptoms go away. If you get any other advice, it’s usually just another way of saying, “Rest.” But in most cases, that’s not the best way to treat a concussion. And in our experience treating hundreds of patients, many of whom have had symptoms that lasted for months or years, we know that it can be frustratingly ineffective.
Fortunately, there’s another way. In this guide to treating a concussion, we’ll answer commonly asked questions and share our findings after years of research and treating patients. We’ll cover:
As you’ll see, there’s a lot more you can do to recover from a concussion than lie around in bed all day.
Note: Have your concussion symptoms lingered for weeks, months, or even years? On average, our patients improve by 75% after treatment at our center specializing in post-concussion therapy. To see if you are eligible for treatment, sign up for a free consultation.
Signs and Symptoms of a Concussion: Do You Have a Concussion?
A concussion is the same thing as a mild traumatic brain injury (mTBI). You don’t have to receive a blow to the head to get a concussion: A concussion may occur whenever you receive a hit, shake, or jolt to the head. For example, if your car stops suddenly, your brain might be jarred enough to hit your skull. If it does, that jostling is enough to cause concussion symptoms.
If you have any of the symptoms of a concussion listed in the checklist we created (see below), and you received a known bump or shake to the head, you probably have a concussion. You can learn more about concussion symptoms, when they appear and disappear, and why in our guide to the symptoms of a concussion.
If you or someone you know is experiencing any signs of a concussion that constitute an emergency, such as loss of consciousness or convulsions, seek medical care at an emergency room immediately. If you’re experiencing less dangerous but still serious symptoms such as memory loss, confusion, or notable balance problems, it’s not a bad idea to see a medical professional.
Otherwise, most concussions can be treated at home, at least for the first three weeks. If after three weeks your symptoms haven’t resolved, you’ll need more targeted therapy than you can receive at home. But we’ll revisit that topic later.
What to Do after a Concussion
What you do after a concussion depends on the severity of the head injury. If you have significant bleeding, structural damage, or any of the emergency symptoms listed above, you should see a doctor immediately.
If you’re not in immediate danger, then you have a choice. You can see a doctor just to be safe, or you can try to treat the concussion at home. Here’s what to expect in either situation.
How Do Doctors Treat a Concussion?
If you visit a general practitioner, you probably won’t get any treatment you couldn’t get at home. Most family doctors stick to old concussion advice: bedrest in a dark room with no screens or strenuous activity. If any structural damage is suspected, they might order a CT scan or an MRI. Unfortunately, those scans don’t provide information about the cellular damage caused by a concussion. (For that, you would need an fNCI).
If you visit a sports medicine practitioner, there’s a chance that you’ll get more up-to-date medical advice. But concussion healthcare definitely varies from doctor to doctor.
Here’s what we recommend as a first step.
How to Treat a Concussion at Home
Rest is an important aspect of treating a concussion. But it’s not the only thing you should be doing. A good concussion recovery includes exercise and cognitive stimulation. Why?
When you get a concussion, there is an initial period of inflammation and a temporary breakdown of tiny structures in and around the brain cells at the site of your injury. Because of that, the affected cells can’t signal for oxygen. When they don’t get enough oxygen, they can’t complete the cognitive processes — like seeing, thinking, or reading — they were trying to achieve. As a result, other neural pathways pick up that task, but it’s harder on your brain.
Ideally, your brain will return to the normal, more effective neural pathways when inflammation goes down. Unfortunately, that doesn’t always happen. When it doesn’t, patients can be left with lingering symptoms for weeks, months, or even years.
Physical exertion and cognitive exercise, in reasonable quantities, will increase your chances of healing properly. Here’s the specific regimen we recommend:
1. Do cardio for ~30 min/day, or as tolerated.
Don’t do any exercises that would result in jostling your head. For example, you shouldn’t go for a run as your cardio workout. If you have access to a stationary bike or an elliptical machine, those are ideal for getting your blood pumping without making your concussion worse.
If you don’t have access to exercise equipment, do your best to get your heart rate up with calisthenic exercises. If you have any dizziness or difficulty balancing, switch to something that doesn’t aggravate your symptoms. You can read more about how to exercise after a concussion here.
If you can’t make it thirty minutes without a sharp increase in symptom severity (such as dizziness or headaches), just go as long as you can. Physical activity once per day makes a big difference in healing.
2. Immediately after exercising, engage in cognitively demanding activities — like reading.
Now that you’ve gotten your blood pumping, use that extra oxygen to reinforce healthy pathways. Try reading a book or having an intellectually demanding conversation with someone. If that’s not an option, solve a puzzle like Sudoku. Do that for another thirty minutes or as tolerated. Here is a list of cognitively stimulating activities you can do at home.
3. Calm your autonomic nervous system.
Your autonomic nervous system (ANS), which controls the processes in your body that you don’t think about, can be impacted by a concussion. Damage to that region can cause everything from heartbeat irregularities to skyrocketing stress.
While exercise will help, it’s also good to relax in any way you can. People turn to meditation, prayer, soothing music, yoga, and other calming activities to ease the strain on their ANS. There’s also an app called 35 Binaural Series that will help.
Plan on resting for the majority of your day.
4. Rest from screens and try to do some normal activities, if you can.
This part of traditional concussion advice is good: If you can, give the electronics a break. That’s not to say you can’t have any time in front of screens, but you shouldn’t spend the whole day playing video games.
Exposure to normal non-screen activities will help your brain recover. Doing chores, chatting with friends, and even light work could be helpful. Remember to rest in between these activities as needed.
5. Return to work or school gradually.
If at all possible, gradually increase your return to everyday obligations. Be it work or school, try to start at 10 hrs your first week back, then try 20 hrs the following week. By gradually working your way up to full-time attendance, you’re giving your brain the space it needs to finish healing. Even if you feel better, this step is important (if you can make it work).
Bonus advice: If you’re looking for something else you can do to help your brain heal, consider an anti-inflammatory diet. If that’s too much, reduce your intake of processed foods and refined sugar. Above all, make sure you eat regularly: six small meals per day or three normal sized meals.
How to Treat a Concussion Headache
Head trauma never feels good. You can take over-the-counter pain medicines like Tylenol, Advil, Motrin, Ibuprofen, Aleve, etc. to reduce your pain while you recover from a concussion. Follow the directions on the bottle suitable for your age, and never take more than the maximum dose without a doctor’s approval.
For a severe headache that isn’t controlled by OTC pain medicine, speak to your doctor about alternatives.
How to Treat a Concussion in Children
While all the advice above applies for children as well, it can be difficult to put into practice (depending on the age of your child). If they’re old enough to listen and follow instructions, you can help them with their daily physical and cognitive exercises. Listen to their feedback; if they’re in too much pain or getting overwhelmed, help them calm down. It’s important for their autonomic nervous system (discussed above) to recover in a low-stress environment.
If your toddler has a concussion, then follow-up care is more difficult. Do what you can to protect them from falls and encourage as much rest as possible. If you can get them to solve some puzzles, that’s great. You may need to work with your family physician to set up a realistic care plan.
What Not to Do After a Concussion
What are some things you should avoid while you heal from your concussion? Don’t push yourself to do more than you can handle, don’t rush your recovery, and don’t return to sports or work environments that put you at risk for another concussion.
Here’s the most important rule of recovery: Do not engage in activities that put you at risk for another concussion.
This holds true for athletes in any sport, but especially for athletes who play contact sports. When you’re recovering from a concussion, your brain needs time to heal, and your symptoms may affect balance, coordination, and other skills necessary for staying safe while you practice. You’re more likely to get another concussion when those abilities are compromised. Even if you’re the kind of person who would push your limits with other sports injuries, don’t put your brain at risk.
If you get a second concussion while recovering from the first, you risk longer-lasting symptoms and brain damage. And in extremely rare cases, some patients die from a rapid swelling reaction in their brains (known as second impact syndrome). Given the possible consequences, it is never wise to engage in activities that put you at risk for a second concussion while you’re healing from the first.
It’s also best to avoid screens whenever possible. They won’t help your brain heal.
What to Do If Concussion Symptoms Persist (Post-Concussion Syndrome)
For most concussions, symptoms should resolve within two weeks. In some cases, it may take up to three months for a full recovery.
Unfortunately, not all concussion symptoms resolve within those time frames. Sometimes, it takes additional treatment to repair the communication pathways in your brain affected by the concussion(s).
At Cognitive FX, we have a one-week long, intensive therapy regimen that we custom-build around the needs of each patient. After a battery of testing (including fNCI), we’ll know which areas of your brain are affected and in what way. That allows us to tailor a week’s worth of physical training, cognitive drills, and emotional therapy to your specific needs.
On average, our patients’ brains show an improvement of 75% by the final, end-of-week scan. And they go home with a concrete plan to continue improving on their own.
Many patients are told that their symptoms are incurable. Or worse, they’re told to stop faking their symptoms and get back to work. Your symptoms are real and they are treatable. To discuss your experience and determine your eligibility for treatment, sign up for a free consultation with our staff.
About Dr. Mark Allen PhD
Mark D. Allen earned a PhD in Cognitive Science at Johns Hopkins University with post-doctoral training in Cognitive Neuroscience and Functional Neuroimaging at the University of Washington. He has 15 years of research and clinical experience in fMRI, with 22 publications in tier-1 peer-reviewed scientific journals, 3 book chapters, and dozens of presentations at scientific and professional conferences in neuroscience, neuroimaging, and neuropsychology. Having collected and analyzed fMRI data from over 1,000 experimental subjects and over 300 clinically-referred patients, Dr. Allen is a pioneer and expert in the development of fMRI for use in clinical settings.