Like most physicians who treat concussion, Dr. Hawryluk recommends six steps for concussion recovery.
After a concussion is diagnosed, the first step is to rest. The patient needs to rest both physically and mentally for at least one day until symptoms subside. "This is one of the rare times we will counsel young patients not to do homework or even things like video games that we think can be too taxing for the recovering brain," says Hawryluk.
Once the symptoms have abated, it's time to get moving again—but slowly. Light activities like walking or riding a stationary bike are perfect. Do not overdo it. Once you push your body a little bit, it can cause a return of the symptoms," says Hawryluk. "The goal of step two is to do some light physical activity and see if symptoms return."
Athletes can return to their sport once they are symptom-free with light exertion. However, they are not ready to play—yet. Instead they are advised to try out activities involved in their sport. "If you're a hockey player, we would say you can go back and skate at this point," says Hawryluk. "At each of the steps, if we see a return of symptoms, we need to back up."
If all goes well the next step involves participating in practice drills but avoiding body contact. Next is participating in body contact in practice. If all goes well at this point, a physician may clear the player for return to full-contact gameplay. The fastest a player can progress through these steps is one week. Once again, it is key that none of these steps are rushed. If not, the results could be fatal, particularly in the young. "Players who return to a sport while they're still symptomatic are at risk for something called second impact syndrome, which causes dramatic and fatal brain swelling," says Hawryluk.
While athletes are given specific steps for concussion recovery, Hawryluk says a similar course should be followed by those who suffer a concussion in other ways. "The principles of rest and graded return to normal activity has really been associated with the most efficient recovery," he says.