New Guidelines for Concussion Treatment

“Cocooning,” once the recommended treatment for young athletes who have experienced a concussion, has fallen out of favor.

Instead of prohibiting physical activity, reading or even visits from friends for weeks at a time, doctors are now advising their concussion patients to start being physically active within a day or two after experiencing the concussion.

An international panel of concussion experts wrote new guidelines which were published this month in The British Journal of Sports Medicine.

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 their injury.

“The brain benefits from movement and exercise, including after a concussion,” said John Leddy, M.D., a professor of orthopedics at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, and one of the co-authors of the new guidelines.

Leddy noted that a number of studies in animals and people with concussions have indicated that prolonged physical rest may delay the brain’s recovery. The advice now is that after a concussion the athlete should remain quiet for 24 to 48 hours, but then should get up and begin to move.

Leddy stressed that he is not suggesting that injured players should return to their football practice or game. Instead, he is suggesting something like a gentle walk around the block.

“If they walked for 15 minutes and then felt a headache, we’ll suggest they walk 10 or 12 minutes the next day and see if that feels okay.” The idea, he said, is for the injured player to walk enough to stimulate brain recovery without exacerbating symptoms.

The new guidelines include a scientifically validated checklist that parents or coaches on the sidelines can use to help determine whether a young person has experienced a concussion and what actions should be taken.