Does Cognitive Effort Delay Recovery From Concussion?
Most of us find it hard to be truly still and rest our minds. Sure, we veg out on the couch at the end of the day and binge-watch a favorite series or play games on our phones (or sometimes both simultaneously). But it’s surprisingly hard to let your mind do…nothing. Unfortunately, if you have suffered a concussion, cognitive rest, as well as physical rest, is just what the doctor ordered. It’s important to understand how rest and effort affect your brain’s recovery from a concussion.
What is a Concussion?
A concussion is actually a form of mild traumatic brain injury. Usually caused by a blow to the head, concussions often have neck involvement as well. The chemical process in the brain caused by a concussion can affect memory, vision, mental focus, and balance.
Loss of consciousness, no matter how brief, after a head injury signals a concussion. However, if an injured person does not lose consciousness after their injury, that doesn’t mean that they do not have a concussion. Loss of consciousness is present in about 5-10% of concussions.
Other observable signs of concussion include:
- Loss of memory of events shortly before or after injury
- Appearing dazed or stunned
- Behavioral or personality changes
- Acting “foggy” or “out of it”
- Repeatedly asking the same questions
- Struggling to answer simple questions
- Clumsiness or poor balance
Someone with a concussion may experience some or all of the following symptoms:
- Blurry or double vision
- Sensitivity to light
- Difficulty concentrating
- Feeling “out of it”
- Feeling extra emotional or sad
- Changed sleep patterns
If you suspect that someone close to you has suffered a concussion after a head injury, get them medical help immediately, and immediately treat them as if they have suffered a concussion. That includes making sure they get plenty of physical and cognitive rest, especially in the 48 hours immediately following their injury.
Don’t wait for a doctor to diagnose concussion, and don’t assume someone doesn’t have a concussion because they don’t have all of the symptoms described above. Some concussion symptoms may appear immediately, and some may not show up for hours, days, or even weeks, if at all.
Why is Brain Rest Important After a Concussion?
In the past, people with concussions were advised to rest quietly in darkened rooms. While updated guidance no longer requires sitting in the dark for extended periods, recent concussion studies have shown that cognitive rest in the first 48 hours after a concussion significantly shortens recovery time. As noted above, it can be hard to rest your brain, but doing so speeds healing.
What is “cognitive rest” or “brain rest?” Those terms refer to limiting any activities with the potential to aggravate concussion symptoms or which could be metabolically demanding. A healthy brain requires a lot of energy to function; a brain that is trying to heal needs even more. Devoting energy to cognitive activity means there is less available for the brain to heal itself. A concussion can also decrease blood flow to the brain, which limits the brain’s ability to access the energy it needs to heal.
Activities to avoid after a concussion include:
- Working on a computer
- Doing work that requires concentration or is mentally taxing
- Watching television
- Playing video games
- Listening to loud music
- Text messaging
- Being in environments with lots of stimuli such as flashing lights or noise
School-aged concussion patients are often worried about falling behind on schoolwork, and student athletes are typically eager to get back to practice and playing their sport. Even adults may be in a hurry to get back to their regular daily routine. However, premature efforts to “get back to normal” may backfire and result in an even longer recovery time.
Resuming Cognitive Activity After a Concussion
Fortunately, after the initial 48 hours of cognitive rest following a brain injury, many concussion patients can gradually begin to resume their regular activities. “Gradual” is the key word here. After 48 hours, the brain is still recovering. The best practice is to slowly add the most essential activities back for brief periods.
If concussion symptoms do not return or worsen, the patient can resume a little more activity. If the patient can tolerate, say, reading for 20 minutes one day, they might move on to reading for longer periods or to other activities the next. The important thing is not to push oneself and delay the recovery period. Returning symptoms are a sign to cut back on cognitive effort. Physical rest is, of course, also part of a concussion recovery protocol.
How Common is Concussion?
Somewhere between 1.6 and 3.8 million sports-related concussions occur in the United States each year; that’s not counting concussions from other types of events. With an injury that’s so common, you would think that doctors would always recognize the signs. Sadly, sometimes even professionals get it wrong. A doctor who fails to properly diagnose a patient with concussion, or who clears a patient to return to full activity before their brain has healed, may be liable for medical malpractice.
If someone returns to full activity before a concussion is fully healed, they could be at risk of Second-Impact Syndrome (SIS), which can lead to permanent brain damage or death. SIS is rare, but it is most common in young athletes who return too quickly to the activity that injured them in the first place.
To learn more about concussion, cognitive rest, and what to do if a doctor misdiagnoses or mistreats concussion, contact Huegli Fraser to schedule a consultation.
The information in this blog post is provided for informational purposes only and is not intended to be legal advice. You should not make a decision whether or not to contact a qualified medical malpractice attorney based upon the information in this blog post. No attorney-client relationship is formed nor should any such relationship be implied. If you require legal advice, please consult with a competent medical malpractice attorney licensed to practice in your jurisdiction.