“Folks who get good information … typically have a faster recovery.”
Traumatic brain injuries (TBIs) are fairly common: They affect about 2.5 million people in the United States every year, according to UpToDate from Wolters Kluwer. Over 75 percent of these are mild, commonly referred to as concussions. Despite this, there’s actually a lot of confusion about what a concussion is—and how to recover from them.
“Folks who get good information about concussion at the time of their injury typically have a faster recovery,” says Steven Flanagan, MD, chair of the Department of Rehabilitation Medicine at NYU Langone Health. “Seeking out good care and getting answers to your questions early is actually a good way to help speed up the recovery.”
It’s recommended that anyone with a TBI—even if mild—should consult a healthcare provider, such as at an urgent care facility or emergency department. A trained medical professional can perform a neurologic assessment and possibly perform imaging (such as a CT scan) to check for TBI complications.
The other thing a healthcare provider can provide is reassurance. A concussion can stir up a lot of anxiety for the patient and their loved ones, and consulting a medical professional can help you understand what happened, what to do next, and what red flags to look out for—so don’t be afraid to ask questions.
“The first thing I would say to anybody who's seeking care from a healthcare provider is that the only bad question is the one you don't ask,” says Dr. Flanagan. “If you have a question, you ask it.
Other good questions to ask after a concussion include:
What’s the typical course of recovery?
What should I do (or not do) during recovery?
What are the possible complications of a concussion?
What post-concussion symptoms are normal, and what’s a sign of something going wrong?
When can I return to work/school/hobbies?
How do I know if I’m overdoing it during recovery?
What medications, if any, should I avoid during recovery?
What medications can I take to help with my symptoms during recovery?
You might also be tempted to ask, “Am I allowed to sleep?” It’s a myth that it’s dangerous to sleep after a concussion (as commonly repeated in movies and TV shows). In fact, historically, rest and avoiding activity has been the main recommendation for treatment, although that is changing.
“In the old days, [treatment for a concussion] used to be rest, rest, rest, rest, rest. Now we're really getting away from that, and beginning to think [that] prolonged periods of rest … actually prolongs symptoms," says Dr. Flanagan.
Today’s recommended route of recovery uses incremental or "graded" return to normal activity, where you start with light physical and cognitive activity and gradually increase to moderate activity and eventually normal activity. Learn more about steps to recovery after a concussion here.
“We have a saying: 'If you've seen one concussion, you've seen one concussion,'” says Dr. Flanagan. In other words, every TBI is a little bit different, and the recovery process will likewise vary for each patient. That’s why it’s a good idea to see a physician to get unique care for your unique situation, and to get out all your questions.
Dr. Flanagan is the chair of the Department of Rehabilitation Medicine at NYU Langone Health. He specializes in brain injury rehabilitation.
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What we have learned actually is that
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folks who get good information about concussion
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at the time of their injury typically have a faster recovery.
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There's a lot of confusion about concussion,
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a lot of misunderstanding about concussion
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and how people recover, so seeking out good care
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and getting answers to your questions early
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is actually a good way to help speed up the recovery.
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(mellow guitar music)
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The first thing I would say to anybody who's seeking care
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from a healthcare provider is that the only bad question
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is the one you don't ask.
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If you have a question, you ask it.
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Concussion, when you read about it or hear about it in the media,
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it's confusing, so I expect my patients and their loved ones
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to come in with questions because they don't understand.
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Or it's hard for them to really sort of get all this information
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and really have a good understanding of what's happening.
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So any question that you have, you should ask.
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That's number one.
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I think it's reasonable to ask what to expect,
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what's the typical course of recovery,
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but then it's also important to realize that not every concussion
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is gonna follow a prescribed path towards recovery.
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There could be different factors that may speed up
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or slow down recovery.
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A lot of questions are generally geared towards,
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well, what should someone do after a concussion?
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In the old days, it used to be rest, rest, rest, rest, rest.
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Now we're really getting away from that,
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and beginning to think that, well, actually,
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prolonged periods of rest, or what some people actually refer to
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as cocoon therapy, where you just put somebody into a dark room
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and turn the lights off and there's no stimulation.
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We're actually thinking that actually prolongs symptoms.
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We're recognizing now that some physical activity,
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below a threshold that worsens your symptoms,
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some cognitive or thinking activities, again below a threshold
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that exacerbates your symptoms, they actually speed up recovery.
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We have a saying: 'If you've seen one concussion,
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you've seen one concussion,' so everyone's recovery pattern's
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gonna be a little bit different, so it is okay to see your physician,
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particularly if you're getting treatment, so that we can see
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how those treatments are coming along,
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and alter them if necessary.
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Management of acute moderate and severe traumatic brain injury. Waltham, MA: UpToDate, 2020. (Accessed on March 7, 2020 at https://www.uptodate.com/contents/management-of-acute-moderate-and-severe-traumatic-brain-injury.)
Recovery from concussion. Atlanta, GA: Centers for Disease Control and Prevention, 2019. (Accessed on March 7, 2020 at https://www.cdc.gov/headsup/basics/concussion_recovery.html.)
Traumatic brain injury: epidemiology, classification, and pathophysiology. Waltham, MA: UpToDate, 2020. (Accessed on March 7, 2020 at https://www.uptodate.com/contents/traumatic-brain-injury-epidemiology-classification-and-pathophysiology.)