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Prolonged rest slows recovery from Sports related Concussions

(AP Photo/Antonio Calanni)
When young athletes sustain concussions, they are typically told to rest until all symptoms disappear. That means no physical activity, reading, screen time or friends, and little light exposure, for multiple days and, in severe cases, weeks.

Restricting all forms of activity after a concussion is known as “cocooning.” But now new guidelines, written by an international panel of concussion experts and published this month in The British Journal of Sports Medicine, question that practice. Instead of cocooning, the new guidelines suggest that most young athletes should be encouraged to start being physically active within a day or two after the injury. Read more at NYTimes


Controversies have trailed how sports persons should be treated following concussions.
For decades the sports industry refuted claims that minor injuries had any significant impact till  Dr Bennet Omalu, a Nigerian physician and forensic pathologist was able to demonstrate that athletes and footballers were prone to a condition called Chronic traumatic encephalopathy (CTE). He reported this after examining brain tissues of footballers that had died suddenly.
It took the sports industry and physicians 7 years to openly acknowledge the link between football and traumatic brain injuries.
His struggle was controversially captured in the film, “Concussion” starring Will Smith in 2015.
A concussion is a form of brain injury that occurs following a blow to the head. Sports that involve contact such football, hockey and basketball have relatively high rates of concussion.

What are the common signs and symptoms of Sports related concussion?

  • Dizziness
  • Ringing sensation in the ears
  • Feeling like a fog
  • Difficulty maintaining balance and gait
  • Reduced concentration
  • Drowsiness
  • Disorientation
  • Headaches
Even one of the symptoms above may suggest sports related concussion.
Because these symptoms are usually transient, several players are allowed to resume play without proper evaluation. This is now considered unsafe because complications may occur long after the injuries.
According to the new guidelines published in British Journal of Sports Medicine
” A player with diagnosed Sport Related Concussion should not be allowed to return to play on the day of injury.”

Based on recent guidelines, all players that experience concussion s should rest for 24 to 48 hours before a gradual return to physical activities. Serial monitoring should continue for 3 to 5 days.

Limited rest coupled with minimal exercise was found to facilitate better recovery than prolonged rest.

What factors guide recovery?

According the consensus,
”The strongest and most consistent predictor of slower recovery from Sports Related concussion is the severity of a person’s initial symptoms in the first day, or initial few days, after injury. Conversely, and importantly, having a low level of symptoms in the first day after injury is a favourable prognostic indicator.”
Information on sports related concussion is especially important to players, coaches, parents, football fans, clubs who may want to insist that the game should go on when the stakes are high.

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