Rethinking Concussion Treatment: Moving Beyond the Myth of Rest

March 20, 2024

Active Rehabilitation: The New Frontier in Concussion Recovery

Concussions, a common injury in sports and daily activities, have historically been met with a 'rest is best' approach. However, emerging evidence suggests we've been tackling concussion recovery all wrong. The narrative of patients like Conor Gormally, who found traditional rest advice insufficient for recovery, highlights a critical gap in our understanding of brain healing. Active rehabilitation, involving gentle physical and cognitive activities, is showing promise in facilitating better outcomes. Yet, this knowledge hasn't fully permeated medical practice, leaving many sufferers in the dark. The push towards embracing active recovery methods underscores the need for a revolution in how we address concussions.

Read the full story here: Concussion: there's an insidious myth about a common sports injury. Even doctors believe it.

Highlights

• Many concussion patients are still advised to follow 'rest is best' advice, despite substantial evidence showing that active rehabilitation can lead to more effective recovery.
• 'Cocooning,' or total rest, has been a standard recommendation for concussion recovery, but recent studies suggest it may actually prolong symptoms.
• Active rehabilitation including exercise and cognitive engagement shows promise in supporting brain healing post-concussion.
• Medical professionals often lack updated training on concussion recovery, perpetuating outdated treatment advice.
• Efforts to distribute evidence-based information on concussion treatment are crucial for improving patient care.
• Changing concussion treatment protocols to include active rehabilitation requires overcoming entrenched myths and providing updated education to healthcare providers.

The current consensus on treating concussions heavily leans towards prescribing total rest, a practice rooted in the belief that minimizing physical and sensory stimuli accelerates brain recovery. This approach, however, has been increasingly questioned. The narrative begins with Conor Gormally, a high school athlete suffering from a concussion whose recovery stalled under traditional rest directives. His experience reflects a broader issue, where even amidst emerging scientific evidence suggesting active rehabilitation yields better outcomes, many patients continue to be advised to simply 'cocoon' themselves away from physical and cognitive activities.

The shift towards recognizing the benefits of active rehabilitation in concussion care is supported by evolving scientific research. Recent studies have demonstrated that engaging in mild physical exercise and cognitive tasks soon after a concussion can significantly speed up recovery compared to the traditional rest model. Despite this, the implementation of evidence-based recommendations into clinical practice remains slow. Many healthcare professionals and patients are either unaware of or hesitant to adopt these newer approaches due to deeply ingrained myths about concussion recovery.

The lack of updated concussion treatment protocols reflects a broader issue within medical education and healthcare systems, which are slow to incorporate the latest research findings into practice. Organizations like Concussion Alliance and forward-thinking clinicians are working to bridge this gap by promoting patient and provider education. The rising acknowledgment of active rehabilitation’s role in concussion recovery signals a paradigm shift. Yet, the journey towards universally adopting these evidence-based practices is hindered by outdated beliefs and a lack of comprehensive education amongst healthcare providers.

Read the full article here.

Essential Insights

• Conor Gormally: A high school athlete who experienced multiple concussions and the inadequacy of traditional rest-centric treatment advice.
• Concussion Alliance: A nonprofit organization founded by Conor Gormally focused on educating patients and providers about effective concussion treatment and recovery.
• Consensus Statement on Concussion in Sport: An international expert report recommending active rehabilitation for concussion recovery.
• Mary Alexis Iaccarino: A physiatrist specializing in concussion recovery at the Massachusetts General Hospital Youth Sport Concussion Clinic.
• Centers for Disease Control and Prevention: A significant U.S. government agency that has reported millions of concussion patients yearly in the United States.