CHOC doctor suggests light exercise can be beneficial after sport-related concussion ...Middle East

By Dr. Aaron Yengo-Kahn

Contributing Columnist

For decades, clinicians thought that putting kids who suffered sport-related concussions in cocoons was the right thing to do – drawing the curtains and turning off the lights so they could get total brain rest while in bed.

Over the past decade, that thinking has changed.

As a pediatric neurosurgeon whose research focuses on sport-related injuries, my opinion is that kids and teens should get up and moving in a low-risk manner 48 hours after a concussion.

Why?

Their recovery is likely to be substantially faster than those who remain inactive.

Of course, concussion patients and their families need to check with their doctors about resuming light activity, but a recent first-of-its-kind study of patients at several pediatric hospitals nationwide backs this up. In the randomized clinical trial, patients who exercised 20 minutes a day on a treadmill were found to recover faster than those who engaged in a placebo-like stretching regimen.

A software reset

A concussion is a type of mild traumatic brain injury that causes chemical changes in the brain and sometimes damages brain cells.

I have found that with most of the kids I have seen who had complicated concussions that lasted a long time, the common denominator was they missed the opportunity to engage in aerobic activities early on – even light ones.

Post concussion, we know blood flow to the brain changes, and the autonomic nervous system also becomes abnormal.

Think of the effects of a concussion as a software problem (bleeding on the brain is a hardware problem that requires surgery to fix).

To fix the software problem, you need to do a reset – and you do that increasing your heart rate through activity. This helps the heart and blood vessels get back to working regularly, supplying the brain with the oxygen and nutrients it needs to recover.

A formula to consider

The typical time for recovery for a child or teen who has experienced a sport-related concussion is two weeks to a month. Exercise potentially can reduce this recovery time by a third.

Here is the formula I recommend:

A couple of days after the concussion, take a brisk walk, jog or use a stationary bike. Exercise to the point where you feel symptoms worsening, like a headache is starting or you are starting to get nauseous and then reduce your exertion by 20%. For example, if you feel a headache coming on when you are exerting yourself at a level of 8 on a scale of 1 to 10, back your activity down to level 6.

I am a proponent of activity for concussions and even more severe head injuries caused by other means, too. I recently treated a male teenager who was in a car accident. Three days after the accident, he was showing no serious symptoms while resting.

We got him up and walking around the hallways of the hospital several times a day. As long as he was able to tolerate it, he got in 20 to 30 minutes of aerobic exercise every day.  He recovered very nicely and had no lingering symptoms upon his return to my office.

Recommending that children and teens with concussions get up and move around after they suffer their injury may seem to fly in the face of reason, but it actually works.

Dr. Aaron Yengo-Kahn is a pediatric neurosurgeon at Children’s Hospital of Orange County, part of Rady Children’s Health.

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