You have been diagnosed with a concussion. This plan is based on your symptoms and is designed to help speed your recovery and prevent further injury. All information provided by Mercy Personal Physicians.
There are three types of initial rest.
Brain Rest: Limit activities that require a lot of thinking or concentrating (including school work). Limit screen time (phone, computer). Avoid movies and TV for the first several days. Dim the brightness on your screens.
Physical Rest: You may be placed on Bed Rest for the first 24-72 hours after your concussion. Limit physical activity. Don’t begin any workouts, exercising, or physical training until we instruct you to.
Quality Sleep: Get lots of rest. Be sure to get enough sleep (typically 7-8 hours) at night. Keep the same bedtimes on weekdays and weekends. Take daytime naps or rest breaks when you feel tired or fatigued, but avoid excessive daytime naps (which interferes with quality night-time sleep).
Call 911 for off-base Emergency Department evaluation if you experience any of the following red flags:
Severe 10/10 Headaches
Can’t recognize people or faces
Weakness/Numbness in arms or legs
Other Emergent Symptoms
Please inform roommate, teammate, parent, or other responsible party of these Red Flag Symptoms.
Call or walk-in for an acute appointment with the Mercy Personal Physician’s Concussion Clinic for other worsening symptoms.
Return to Daily Activity
As symptoms decrease you may begin gradual return to your daily activities. If symptoms worsen or return, lessen your activities. Avoiding crowded or busy areas may help this transition.
Bright lights may worsen symptoms (wear sunglasses). Loud noises may worsen symptoms as well (use earplugs).
Drink lots of fluids and eat a balanced diet (including 3 meals a day) to maintain appropriate blood sugar levels.
You should not participate in any activities that risk a repeat concussion injury (sports, physical education classes, intramurals, etc.) if you are still experiencing symptoms.
Do not drink alcohol.
Minimize caffeine intake.
Sexual activity in first several days after injury will likely worsen symptoms and prolong recovery.
If you no longer have any symptoms and believe that your concentration and thinking are back to normal, talk with the Mercy clinic providers about the next steps in recovery before you resume athletics and full academic workload.
Return to Learn
The Mercy Concussion Clinic staff will inform you about the Return to Learn (RTL) protocol and insure you know what stage of the RTL you are currently on.
PACE YOURSELF! Use cognitive pacing with schoolwork. Perform easier work first and advance with more difficult material when able.
You will need to take breaks while doing schoolwork. For example, you may only be able to perform 15 to 30 minutes of homework before needing a break for 15 to 60 minutes. This will improve as you recover.
The Mercy team encourages you to contact your academic advisor and instructors to let them know about your condition and progress.
Returning to Physical Activity
Only return to physical activity when directed by your doctor.
Return to physical activity should be a gradual process. Only complete one stage, one time per day.
Pay careful attention to your symptoms at each stage of the “Return to Play” protocol. Only move to the next level of activity if you do not experience any symptoms at that given level.
If your symptoms return, stop the “Return to Play” protocol. Once you have not experienced symptoms for a minimum of 24 hours, start again at the stage previous to the one at which you had symptoms.
If you again have return of symptoms, stop all physical activity until you follow-up with a Concussion Clinic provider.
Do not exceed the given time limits and exertion level.
Return to Play (Exercise) Protocol
Stage 1 – Physical Rest
No physical activity.
Can attend classes when directed (See Return to Learn Protocol).
Stage 2 – Light Physical Activity
You will be directed when you can begin this stage. Provider may start you on this stage before complete symptom resolution.
15 minutes of low-level physical activity. THR: 30-40% of maximum exertion.
Examples: treadmill walking or stationary biking. Recommend quiet, uncrowded area of gym. No head impact.
Stage 3 – Moderate Aerobic Physical Activity
20 minutes of moderate level physical activity. THR: 40-60% of maximum exertion.
Examples: treadmill jogging, stationary biking, light weightlifting, light calisthenics. No head impact.
30 minutes of moderate level physical activity. THR: 60-80% of maximum exertion.
Examples: running/sprinting, high intensity stationary biking, regular weightlifting, non-contact sport specific drills. Outdoor or indoor. No head impact.
Stage 5 – Intensive Activity/Sports Practice (No Contact)
30-45 minutes of high-level physical activity. THR: 80% of maximum exertion. (Full exertion)
Examples: hard running, interval training, CrossFit, Olympic style weightlifting, sport skills practice without contact (no tackling, no headers, no scrimmaging, and no intramural sports). No head impact.
If you haven’t completed Stage 5 successfully, Mercy can’t clear you for unrestricted activity.
Stage 6 – Unrestricted Activity
You will be at this stage after your final concussion clinic visit with Mercy.
Initiate contact activities as appropriate to sport, including PE, intramurals, and competition.
Karvonen Formula (used to calculate Target Heart Rate)