Although most point to physical rest as the major component of concussion management the truth of the matter is that all activity that affects brain activity needs to be limited after a concussion. If we use the “snow globe” analogy; all the flakes in the globe must come to rest before exposing it to further activity. What excites the “flakes” or brain, honestly, just waking up does this. That is why I have been hammering on the need for COMPLETE rest after a concussive episode. It is also why I am a firm believer in getting kids out of school while the brain injury heals.
This information is not new to you that read the blog, but it seems that this management technique is just catching on as a principal protocol, rather than using it if there are setbacks;
“There is so little we really know about concussions,” said Dr. Mary Dombovy, vice president of Unity Neurosciences, which includes physical medicine and rehabilitation, neurology and neurosurgery. “We’re learning more as time goes by. What we’re learning is it’s not just physical exertion that is making the brain work harder. School tasks, studying for tests, trying to write a paper, these things are very stressful for people who’ve had a concussion.”
It is not that it is stressful, per se, it is that the brain is FUNCTIONING to do those tasks and like getting on crutches for a broken leg, the only way to get the brain on “crutches” is to not give it any stimulation. Along with that comes how long and what to do when symptoms have gone, to me it is obvious that this is where you then begin the Zurich RTP protocol (the current concussion management protocol I use).
What I am having a hard time fathoming is that doctors are now just figuring out that rest is key, and comments like this from a doctor just work to confuse everyone;
“The science is not quite to the point where we can think of an antibiotic to treat pneumonia,” said Dr. Jeff Bazarian, associate professor of Emergency Medicine, Neurology, Neurosurgery at the University of Rochester Medical Center. He specializes in concussions.
“It looks like it’s helpful, but if you don’t do it, does it cause injury? We don’t know. … Are you doing some kind of damage to the brain when you don’t rest, or just not getting better quick?”
Without the results of clinical trials to guide them, doctors err on the side of caution and recommend cognitive rest.
“There’s lots of evidence it’s a good idea,” said Bazarian, noting that symptoms can return if the brain doesn’t have time to heal.
Maybe I am wrong here, but yes you can do damage to the brain when you are not resting it, especially when the brain is still in the traumatic phase of the cascade. Am I missing something here?
Even if it is “conservative”, cognitive rest can only help an injured brain. With pre-teens and adolescents getting them off the technology, especially the video games, will allow the brain to begin the important process of healing, at the very least it will not delay symptom recovery.