Los Angeles Brain

When is is safe to return to normal activities?

 

Whether the head injury happened in an NFL football game, as fall in the kitchen, or as a result of a motor vehicle accident, it is normal to be concerned about returning to normal activities,  There is no "one size fits all" rule when it comes to returning to activities, and here are some rules of thumb we recommend when getting "back on the horse" after head injury:

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• Listen to your body, it will let you know when you are ready to do more

• It's okay to push yourself, as long as brain injury symptoms don't dramatically worsen afterwards

• Rest is important in the aftermath of brain injury

• Returning to normal life is a type of "real life rehabilitation"

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Listen to your body

 

Learning to listen to our bodies is critical when determining what activities okay to return to and what is "too much, too soon."  After professional football players suffer a concussion, the training staff creates a Return to Play program.  For example, neurologist caring for professional football players will recommend a return to plan in this way:

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• The player stays away from the practice facility until severe dizziness, nausea, headaches, light sensitivity, and fatigue improve

• Once the most severe symptoms have improved (to some degree), return to meetings, watching video, and reading is approved

• After additional improvement in symptoms occurs, light exercise is approved.  If severe headaches, dizziness, nausea, and other symptoms occur after light exercise, recommendation is made to back off and allow for a few days before restarting light exercise

• After more improvement in symptoms, workouts including running and catching are approved.  If symptoms worsen after these workouts, the player backs off and takes a few days before workouts are reintroduced

• After a player is able to perform contact-less workouts for several days without worsened symptoms, return to light contact is reintroduced.  If worsened symptoms occur once light contact is re-introduced, the player steps back and exercises without contact

• Finally, once light contact can occur without worsened symptoms, the player can restart normal activities unrestricted

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Most of our patients aren't professional boxers or football players, but the concept is the same: we let the symptoms determine what level of activity is okay to return to.. This is true for exercise, leisure activities with family and friends, and returning to the workplace.

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It's okay to nudge recovery along

 

Healing in general, whether from a traumatic brain injury or other injury, requires us to push forward the process a bit.  It would be a mistake to push too far and too fast, because in that case further injury could occur.  However, if nudging our capabilities forward doesn't result in dramatically worsened symptoms, these steps forward can be absolutely essential to long-term recovery.

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Rest is important

 

Particularly in the early stages of recovery from traumatic brain injury, rest is vital. Taking extra time for sleep, delaying work or family obligations, and limiting physical activities that could result in additional falls or head traumas is recommended while severe head trauma symptoms persist.

 

In the past recommendation was made for "brain rest" where patients would sometimes be recommended to stay in a dark and quiet room for days, weeks, or even months. Today, we recommend observing our symptoms to determine which activities do not result in worsened symptoms., including such activities as using a smartphone, watching television, returning to work on a part-time basis, exercise, and socializing.

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Returning to normal life is a type of "real life rehabilitation"

 

When we start to exercise, work a limited schedule, and socialize with family and friends, it is normal and expected to be worried that TBI symptoms will worsen.  Many people worry that returning to normal activities will interfere with eventual recovery. We have found that to the contrary, starting to return to our normal activities is vital to resetting and retraining brain circuits injured in TBI.

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As long as we listen to our bodies and make slow, mindful steps forward in our activities, there is no concern for preventing long-term recovery. In fact, these steps forward are essential to regaining normal and healthy brain function.

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