Accommodations

After a concussion, it is important to find a balance between being at rest and participating in activities. This balance is essential for the most successful recovery. Accommodations are strategies that support that balance. The good news is that most students and athletes will recover completely provided that everyone involved in the students’ care helps them balance rest and activity. It is also important to recognize that accommodations are expected to be temporary. Trying to keep up with high academic and sports standards too soon may bring about unwanted consequences. Keep in mind that rest, recover and return is the goal.

Important Take-Away Points

• After sustaining a concussion it is very important to avoid any activity that places the person at risk of sustaining another concussion;
• It is critical to balance rest and activity throughout recovery;
• A gradual return to activities will include increasing and/or decreasing participation in an activity based on how the recovery is progressing;
• Since most people will recover completely, accommodations for them will be temporary;
• Return to previous life activities are most successful in stages over time.
• There is no miracle cure or one-time intervention

Parents are in the best position to support a student’s recovery from concussion. They see their child interact in a variety of activities throughout the day and are able to modify or change those activities to allow for rest, while still balancing a gradual return to day-to-day activities. Modifying or changing activities may mean lessening the amount of time involved or the number of steps that are needed to complete the activity.

Teachers are also in an excellent position to support a student’s recovery from concussion. Teachers see their student interact in a variety of activities during the school day and are able to change those activities to gain their best performance. Teachers are trained in a variety of techniques to enhance the student’s learning.

As a student, what is the best way you can help yourself? You know that you feel different and that something has changed, but you may have trouble describing those changes. Speak up and tell your parents and teachers that you need their support. If you become frustrated or tired and need a break then let them know. If you feel you can do more then share that as well. Make sure you have a strong voice and speak up for yourself.

Follow-Up Care

After a concussion, there is no circumstance when somebody should return to an activity where suffering a new concussion is a significant risk. Although walking around the block can result in a fall and a concussion, there is not a high likelihood of that happening. In contrast, playing soccer, even in the park, is a much more significant risk and should be avoided while the student is still experiencing symptoms. Other things like riding a bike, skateboarding, or climbing trees are also activities to be avoided while still recovering. After seeing a healthcare professional additional care is rarely needed. However, if concussion symptoms do not begin to subside after 2-3 weeks, or they seem to worsen, then additional care should be considered. In most cases this involves education, monitoring and additional treatment.

Important Take-Away Points

• After sustaining a concussion it is very important to avoid any activity that places the student at risk of sustaining another concussion.
• The majority of concussions will resolve without requiring additional treatment beyond cognitive and physical rest.
• Some concussions may need additional treatment. Specialists can address specific symptoms and needs.
• 2-3 weeks is a good time frame to seek additional follow-up care if symptoms have not resolved. Your Primary Care Provider can provide direction on the most appropriate specialists to address your student’s needs.
• In a small percentage of students symptoms may persist beyond the usual 2-3 week period of recovery. In these cases a specialist should consider a diagnosis of post-concussion syndrome (PCS).

It is important that follow-up care be provided by healthcare professionals that have concussion training. If symptoms from concussion are not resolving after two or three weeks then a physician should consider identifying specialists to support ongoing recovery. Your primary care provider can direct you to the most appropriate specialist to address your needs.

Allied health professionals are also available to support recovery after concussion. These professionals include occupational therapists, physical therapists, speech and language pathologists, psychologists, and social workers. Allied health professions are selected by a physician based on their skills to address specific symptoms and problems. Each one needs to be trained to treat the symptoms of concussion. Additionally, there are a number of specialists who address a variety of specific symptoms that may be related to the concussion.