You've just had a concussion and you're unsure what to do. Complete rest? Go back to school? When can you restart sports? The protocol can seem complicated, and you're worried about doing something wrong. This concern is valid; every step is important for a good recovery.

• Prolonged complete rest hinders recovery; relative rest is preferable¹.
• Light physical activity can begin 4-5 days after the injury.
• Returning to school/work and returning to sports happen in parallel.
• Each step requires 24 hours without symptoms before progressing

This article provides you with the step-by-step protocol. To understand the symptoms, consult our article on concussions.

Guidelines for the steps to take to recover from a concussion:

Step 1: Activities with limited symptoms (0-72h)

• Avoid any activity that significantly increases the intensity of symptoms. As long as the symptoms are controlled, you can do things like:

Light reading

• Taking short walks
• Light cooking

• When symptoms increase, you should rest until they decrease.
• Do NOT remain completely inactive lying in a dark room. This will hinder your recovery.

AFTER 24 HOURS WITHOUT SYMPTOMS, MOVE ON TO THE NEXT STEPS

After step 1, the return to work/school occurs in parallel with the return to sport. You must follow the steps for each.

RETURN TO SCHOOL OR WORK

• RETURN TO SPORT: Wait 4-5 days after the concussion to begin the return to sport

Step 2: Start light cognitive activities 

• Step 2: Begin light cognitive activities (start with 45-minute periods)

Examples of activities to start with:

Reading

• Crosswords
• Simple tasks
• Answering emails

Step 2: Light physical activity

• Start moving, without contact, alone or with a friend.
• Start with a short duration
• The effort should feel easy
• Examples: brisk walking, light jogging, swimming, cycling, elliptical trainer, etc.

• AFTER 24 HOURS WITHOUT SYMPTOMS, MOVE ON TO STEP 3

Step 3: Gradual return to part-time

• Step 3: Half days at school or work. Start with 1 day out of 2, then progress
• Step 3: Sport-specific activities

Do exercises or gestures specific to your sport individually or with a friend.

• Examples: dribbling a ball, throwing, handling a puck, skating without a stick, etc.

• AFTER 24 HOURS WITHOUT SYMPTOMS, MOVE ON TO STEP 4

Step 4: Gradual return to full-time

• Step 4: Full days at school or work, start with 1 day out of 2, then progress.
• Step 4: Non-contact training and practice

Team sport: start practices with the team without any contact

• Individual sport: start training sessions that are without risk of falls or impacts

• AFTER 24 HOURS WITHOUT SYMPTOMS, MOVE ON TO STEP 5

Step 5: Regular and complete return

• Step 5: Regular and full return
• Step 5: Full-contact practice and training

Resume training as before, but without competition or matches for the moment.

• AFTER 24 HOURS WITHOUT SYMPTOMS, MOVE ON TO THE NEXT STEP 

Step 6: Return to play 

Here are some examples of accommodations for students at school:

• Start with homework without returning to the classroom
• Resume classes without additional pressure (no exams or homework)
• Be able to take breaks in a quiet place
• Allow students to go to their classes before everyone else to avoid an overly noisy and busy environment.
• Limit physical education classes

10 mini-tips to understand your pain

Those who have had the greatest impact on my patients' lives. 1 per day, 2 min.

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Here are some examples of accommodations for work

• Start with telecommuting tasks without returning to the office
• Be able to take breaks in a quiet place
• Be assigned to less stressful tasks without too much pressure

To learn more 

Episode #6 of Parle-moi de santé (concussions)