Treating concussion one step at a time

Treating concussion one step at a time

The vast majority of concussions resolve themselves within a few days to a few weeks. Concussion treatment should be supervised by a physiotherapist with expertise in concussion.

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.

It is therefore possible to progress faster in the return-to-work/school steps than in the return-to-sport steps.

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: Start 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

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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

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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 practices
  
  • 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

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Step 5: Regular and complete return

• Step 5: Regular and full return
• Step 5:Full practices and training with contact
  
  • Resume training as before, but without competition or matches for the moment.

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

YOU MUST COMPLETE ALL THE STEPS OF THE RETURN TO SCHOOL/WORK BEFORE MOVING ON TO STEP 6, EVEN IF STEP 5 OF THE RETURN TO SPORT IS SUCCESSFUL WITHOUT SYMPTOMS.

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Step 6: Return to play 

Step 6: Resuming matches and competitions

*If symptoms increase at any stage, return to the previous stage and wait for the symptoms to disappear before progressing again.
*If a person has difficulty completing a stage, they may need individualized accommodations.

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

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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

It is important to know that the treatment of a concussion must be adapted and personalized for each individual by the physiotherapist. The protocol may vary depending on your condition. If you are unable to progress through the steps, you should consult a physiotherapist immediately.

To learn more 

To learn more about concussion, see the concussion section (links to come) for more details on the steps of concussion treatment.

You can also listen to the podcast "Parle-moi de santé" created by one of our physiotherapists, Alexis Gougeon. Episode #6 discusses concussions.

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

You can also find the podcast episode on the following platforms:

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