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What Are the 6 Stages of Concussion Recovery?

Article by Moody Neuro

Recovering from a concussion differs for every person. Some return to their normal life days after their injury, while others suffer physical and mental effects months or years after the incident. 

Fortunately, 80% of concussed patients recover in 10 days, on average. In this case, the recovery period only has two stages: an acute phase (the period wherein concussion symptoms manifest) and a recovery phase (a period of healing where patients experience a gradual decrease in symptoms).

The recovery takes longer for patients whose symptoms persist and increase in severity. This blog covers the six stages of concussion recovery for patients with long-term symptoms. 

What You Need To Know About Concussions and Post-Concussion Syndrome

A concussion is a form of traumatic brain injury (TBI) that occurs when a strong force hits the head or upper body and causes the head and brain to move forward and backward rapidly. Such an event disrupts the brain’s normal function and affects the patient’s memory, consciousness, speech, muscle coordination, balance, and memory. 

People who get a concussion experience immediate side effects and symptoms like dizziness, nausea, confusion, a headache, double or blurry vision, ringing in the ears, and vomiting. Other short-term symptoms are memory loss, balance problems, loss of smell or taste, and trouble sleeping. Patients should seek medical care if they experience these symptoms after getting into an accident, falling, or bumping their heads against a hard surface.

Concussion symptoms may not appear severe, but two or more at once are debilitating. Worse, patients may experience post-concussion syndrome wherein mild TBI symptoms continue to show long after the incident. 

Post-concussion syndrome often develops during the stages of concussion recovery. It occurs when neurovascular coupling (NVC), or the process of neurons receiving oxygen and nourishment from blood vessels, gets interrupted. 

When you get a concussion, the site of the injury gets inflamed, and the tiny structures around the neurons that help establish NVC temporarily break. Neurons don’t get enough oxygen and cannot power the brain to send signals as quickly as usual. As a result, people with post-concussion syndrome have trouble retaining new memory or keeping up with a rapid-fire conversation because their neural pathways aren’t functioning correctly. 

Post-concussion syndrome can go on for weeks, months, or even years. It is a tough situation because the symptoms can significantly affect your everyday life. Moreover, there is no particular treatment; specialists can only treat the symptoms and help patients manage them. 

Getting Well: The Six Stages of Concussion Recovery

Concussions are challenging because you don’t receive a prescription to restore your body’s physical condition before the injury. Doctors will only tell you to rest, avoid physical activities, and allow your brain and neurological functions to recover from the trauma. 

You should know that recovering from TBI can take a long time. The recovery period can also vary per patient. Some go through the stages of concussion recovery within a year; for others, it takes years. 

With that in mind, people who suffered a concussion typically experience these six stages: 

Stage 1: Acute injury

Doctors call the next 24 to 72 hours after a concussion the acute phase. They will strongly advise resting and cutting back on all activities. This means calling in a sick day at work or school and refraining from doing any housework. Patients should also refrain from drinking alcohol and taking any medication, including painkillers, without getting clearance from their doctor. 

People who’ve sustained minor concussions may start feeling better hours after the incident. Some will even feel well enough to get back to their regular activities. Still, they must take things slowly and not jump into physically strenuous activities like lifting heavy objects, playing sports, exercising, or doing manual labor for at least three days.

Stage 2: Physical rest

Contrary to popular belief, sleeping won’t do further damage in a concussion. In fact, sleep is necessary for the brain to heal. Shaking awake a person suspected of having a concussion every hour is counterproductive to their healing. Doctors will recommend rest and sleep unless they have good reason to say otherwise (i.e., the patient needs further treatment requiring them to be conscious). 

That being said, patients should always have a companion within the first 48 hours who’ll help observe for symptoms and call the doctors if the patient’s condition turns bad quickly.

Stage 3: Observation period for post-concussion syndrome

Patients with active lifestyles or who are used to working will find it challenging to do nothing during the resting period. At some point, they will feel like they’re back to normal and can already go back to work, drive around and do errands, resume physical activities, continue their travel plans, etc. That would be good news, but to be safe, patients should still check in with their doctor and get an all-clear. 

Why is a follow-up check necessary? Because sometimes the symptoms don’t appear until days or weeks after the incident. Moreover, there is a risk of developing post-concussion syndrome. Symptoms persisting months after the injury is a red flag for that.

Once diagnosed with post-concussion syndrome, the patient will have more frequent visits with their doctors as the latter will do their best to address the symptoms.

Stage 4: More physical rest

The hardest part about having post-concussion syndrome is there is no single cure for it. Patients may experience similar symptoms, but the duration, severity, and how they respond to treatment differ. So it will be frustrating, but expect doctors to recommend even more rest. What they want more than anything is to prevent any incident that might aggravate the patient’s symptoms. 

This is a difficult period for most patients as post-concussion syndrome can affect one’s lifestyle. It might even affect your work life because it will prevent you from engaging in physically strenuous activities. It might also impair your focus and decision-making abilities. In this stage, it is crucial to have a support system of loving family and friends who can lend a hand with your housework, help you prepare meals, take care of your shopping and errands, and offer financial assistance if necessary. 

Stage 5: Therapy and rehabilitation

The best way to manage long-term concussion symptoms is to undergo brain injury rehab and therapy. While rest is necessary for the brain to heal, it is also crucial that patients do cognitive exercises to recover.

Studies show that participating in cognitive games like puzzles and word games after a concussion increases heart rate variability – a sign that the parasympathetic nervous system (PNS) is activated. 

One consequence of concussion is that it drives a person’s sympathetic nervous system (SNS), which stimulates the “fight or flight” response, into hyperdrive after the injury. PNS and SNS work harmoniously and activate at different times of the day depending on the circumstances (i.e., PNS is active during rest time while SNS is during high-tension moments at work or when driving during rush hour). A concussion disrupts their rhythm. Moreover, many patients seem to experience hyperactive SNS after their injury. 

Engaging in cognitive tasks will trigger the PNS into action and engage the parts of the brain that facilitate decision-making and critical thinking. 

How long before you can start doing physical therapy? Some researchers say patients can begin 48 hours after their injury. It should be gradual, starting with light activities like walking and slowly increasing the intensity or duration until the patient can perform them without experiencing any symptoms. If a headache forms and quickly intensifies, or other symptoms like severe nausea and dizziness occur, that’s a clear sign of stopping the activity. The patient must scale back and give themselves more time before scaling up again. 

The goal is to ease the brain and body into moving again without aggravating the TBI. Hence, it might be long before a patient can comfortably run, play sports, and do other physically demanding activities again. Moreover, symptoms sometimes appear hours after an activity. 

Patients must also constantly communicate with their doctors and therapists at this stage of concussion recovery. They should:

  • Assess how much physical activity the patient can safely engage in at present.
  • Decide which exercises and therapies a patient can safely explore (preferably under the supervision of licensed therapists).
  • Determine the right pace of physical therapy.
  • Identify the triggers of the patient’s worst symptoms.
  • Document how well or poorly the patient responds to therapy.

Depending on the symptoms and their frequency and severity, patients might receive other forms of therapy like interval training and neurofeedback therapy. They may also have to consult a psychologist and neuro optometrist. Some see improvements with yoga, changing their diets, and continuously doing cognitive exercises. 

Stage 6: Gradual return to normal activities

The final stage of recovery is transitioning to life before the injury. The brain can heal itself even years after a TBI, but the road to recovery will be difficult for some. A proper diagnosis and holistic therapy will be crucial to recovery and ensuring the patient’s quality of life won’t deteriorate drastically.

Seek Specialized Care and Rehabilitation From Experts

TBI Patients need highly specialized treatment and care that address their unique needs. For some, it takes a team of specialists, therapists, and trustworthy caregivers to help achieve a breakthrough and recover sufficiently, if not entirely, from TBI.

Moody Neurorehabilitation can provide more information about TBI, the recovery process, and what it entails for patients and their families. We are a leading rehabilitation institute specializing in brain injury treatment and patient care since 1982. We use techniques, strategies, and therapies from all over the world and provide the best care possible for brain injury patients and survivors. 

Our modern facilities utilize state-of-the-art technology such as the Hocoma Lokomat and Bionik InMotion Robotic Arm to facilitate our patients’ recovery journey

Moody Neurorehabilitation can help you or someone you love overcome the challenges of long-term concussion symptoms and power through recovery. Contact us to learn more about our programs, services, and facilities. 

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