There’s recently been some debate among medical experts about the issue of rest following concussions in young people. On the one hand, most doctors recommend one or two days of rest at home, followed by a gradual returning to school and physical activity. Other doctors have been recommending longer periods of inactivity.

Those two schools of thought were recently compared. In a trial of concussed youth ages 11 to 22 years old, those prescribed complete rest for five days by emergency room staff reported more symptoms than those who were told to rest for a day or two. The report indicated that recovery was slower for the group receiving longer rest.

I’d like to add my thoughts on this. The article pointed out the difference between 48 hours of rest and five days of rest. If anything, the body of the article suggested that individualized therapy was the best course of action. Any recovery has its social and emotional tolls. There is a 20 percent association of depression just from having a chronic disease. So in the case of a concussed teenager, removing him or her from friends, support and the distractions of their daily lives – takes a toll.

At Impact Urgent Care, we individualize the care for each patient. Some need one day of rest. Some need three days and others may require more days. The same is true of physical activity. Some may be allowed a rapid return to routine activity while others are prescribed a delayed return.
The point is: Some concussions resolve in one day while others take several weeks; some don’t resolve for nine months. But if a concussion resolves in two days, why push five days of rest?
I often compare a concussion to an ankle injury when I try to describe the healing process. People who return early to weight bearing and advance to routine activity usually do better than people who have prolonged immobilization for the same injury. The balance is always between too little, which can make the injury worse, or too much, which can delay healing.

Did you know that astronauts who spend prolonged time in space lose a lot of their bone density? This is because the pounding we take by moving on earth with her gravity stresses the bones. In response, they become thicker. Without the stress, they don’t need to be as strong so they become weaker.

So back to concussions. Initial prescribed rest is usually no more than 48 to 72 hours, guided by symptoms, physical exam and testing results regarding the return to different levels of activity.
As I’ve reported previously, every concussion is unique. So is every patient. This is why, at Impact Urgent Care, our diagnosis, management and treatment of a patient’s concussion is always unique to the injury and the patient.

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