After concussion: When can an athlete begin to exert himself?

WESTBOROUGH, MA March 10, 2016 There is a growing consensus that sooner rather than later may be a better return to play protocol among high level athletes.  The notion that they undergo complete and total rest after being injured may be an unreasonable expectation.  I have previously espoused “total rest” for some athletes I see in practice but I am now realizing an important shift in the current standard of care.

Given the proclivity toward years of daily training among elite athletes – and not so elite athletes I might add, allowing a modest amount of noncompetitive, non-contact exertion may facilitate the recovery process.  The athletes should remain well below his or her cardiac maximum – some say 50-65 % of maximum

Michael Sefton is an avid cyclist and sees concussion patients at Whittier Rehabilitation Hospital in Westborough, Massachusetts

for 10-12 minutes while taking the initial steps toward recovery.  Changes in balance is a common consequence that may result from subtle changes in the vestibular system in the middle ear and/or decreased neurocognitive efficiency. This too can be worked slowly in a controlled rehabilitation setting.

Concussion is a serious injury or force applied to the skull transferred to the brain. It is now well known that injuries to the brain have lasting impact – especially among younger athletes.  The second or third concussion may be vastly different from recovery to the number one injury in terms of recovery time.  This should be monitored by a concussion specialist.  Returning to work and school will also require support.  Return to play protocols are also key for athletes who are injured in season.



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