Every so often, events coincide so as to heighten each other’s relevance. In this case, it’s the Start of the Sochi Olympics in one week, and the Fernie Screening of award-winning film The Crash Reel, on Monday February 3rd at 7pm, Vogue Theatre. The Crash Reel tells the story of Kevin Pearce, who sustained a traumatic brain injury (much larger scope than a concussion, but along the same spectrum) during his snowboarding training leading up to the 2010 Olympics. This film will say more about recovery from brain injury that I can in this blog, and may make you think differently about all you are about to see in Sochi. In case you can’t make the screening, and to learn more specifically about concussion recovery, read on (and consider trying to arrange your own viewing of this award-winning film).
Where did we leave off last time? Ah yes, without proper brain function, without a finely-evolved organ at the helm, none of the training camps, gym sessions or coaching in the world can keep an athlete going.
How long does recovery from concussion take? For athletes who want to be better 5 minutes ago, the average of 7-10 days for 80-90% of cases (longer for those under 18 years old) can seem like an eternity. But remember the statistic that about 350,000 concussions are diagnosed annually in North America (and we know that concussions are typically under-reported)? That means each year, about 28,000 concussions take longer than 7-10 days to recover. Those cases need just as much respect.
Here are the steps that need to be followed to return to play:
1. No activity. Mental and physical rest until symptom free. If you’re reading this blog, that’s mental activity. Get it?
2. Light aerobic Activity, like walking or stationary cycling
3. Sport Specific Activity, like skating or running
5. Training drills without body contact
5. Training drills with body contact – only once cleared by a physician
6. Game play
NO SAME-DAY RETURN TO PLAY SHOULD EVER HAPPEN WHEN A CONCUSSION IS SUSPECTED.
Each step should last at least a day. Move onto next step only when symptom free at current step. If symptoms flare at current step, return to rest (yes, step 1) until symptom-free, then try again. Consult a physician if symptoms persist, in order to help decide on the involvement of a neuropsychologist or other professionals.
In the meantime, managing the symptoms of a normal concussion recovery process usually requires life adjustments. In the fog, irritability and easy feeling of being overwhelmed that accompany a concussion, it is important to pace the amount of stimulation in the injured person’s life. Important decisions should be considered early in the day, when energy and rest are at their highest, and ideally in consultation with others. Shutting off loud noises and bright lights (this includes computer and phone screens) helps to prevent overstimulation. Earplugs and sunglasses throughout the day may be necessary. Engaging in relaxation exercises, becoming aware of how each body part is feeling and naming emotions that are surfacing are important components of processing the grief and loss associated with concussion.
It is important to know that concussion recovery has a big emotional component. Irritability, anger, depression and feeling overwhelmed are signs that a person is moving through the healing process from concussion. Difficult is such an annoying word to describe these abrupt changes and dealing with them, but it’s a limitation of polite language. Accepting that concussion recovery is a process that may cause emotional, physical and financial strain is in the end healthier than copping out to blame, excess anger or rushing, which all have a backward effect on recovery.
I have used the word recovery eight times so far in this blog. Concussion recovery (there’s the ninth!) is possible, common and realistic. How a person recovers from concussion sets the stage for future recoveries. Thinking of any injury in terms of recovery immediately puts a positive focus on the process. In Kevin Pearce’s words, “Healing never ends. I will win, not immediately, but definitely”.
And once recovery happens? Don’t get another concussion! Part Three of this series will cover Second-Impact Syndrome and what’s known about long-term effects of multiple concussions.
References
http://www.thinkfirst.ca/programs/concussionqanda.aspx#WhenshouldIreturntoactivity
http://bjsm.bmj.com/content/47/5/250.full
Fernie Physio Blog 