After a concussion, is rest the best?
Cocoon therapy has been a widespread recommendation for concussion recovery by clinicians hoping to help patients avoid the risk of a second mild traumatic brain injury. Cocooning shields the patient from all mental stimulation and physical activity, and recommends patients remain isolated in a dark room with very little sensory stimulation. Reading, texting, TV, video games and academics/work are all discouraged in order to reduce demands on the brain while it is vulnerable.
Is cocooning the right approach to treating a mild traumatic brain injury? Or is it a myth?
Recent studies have suggested that not only is cocoon therapy not helpful, it could actually delay recovery. Instead, the new recommendation for recovery from concussion is a cautious and gradual return to everyday life after a brief period of mental and physical rest. Physical activities such as sports, physical education and physical play at recess should cease until severe concussion symptoms resolve (a few hours to a few days).
When resuming activities, monitor the effects of:
- exposure to sensory stimulation
- resuming regular activities like sports, play, and academics
- attendance at school
- screen time
- social interaction
If symptoms don’t worsen with exposure, then the level of activity is OK. If symptoms return or worsen, cut back on the level of activity until it is better tolerated. By continuously monitoring and adjusting the level of exposure to activity, the brain is getting the right amount of stimulation.
A gradual return to normal life is necessary for emotional stability. But it’s also how the brain heals. That makes sense given what we know about the brain: that it grows – and heals – from input. That is, input about the environment from our eight senses. Those are the five commonly referred-to senses (sight, smell, hearing, touch and taste) and three others: the vestibular, proprioceptive, and interoceptive senses.
In late 2018, The Centers for Disease Control and Prevention (CDC) released new guidelines for concussion recovery. This was developed in coordination with the American Academy of Neurology and an extensive review of 25 years’ worth of scientific research. The resulting best practices for diagnosis, prognosis and management/treatment of pediatric mTBI can be found here. And the CDC has produced this summary for caring for your child’s concussion.
How iLs Addresses Concussion and mTBI:
At iLs, we have long recommended our Focus System to support healing from mTBI. Following are case studies of three very different presentations:
52-year-old man, “J”, who sustained mTBIs in two different car accidents – read here
13-year-old boy, “JN”, who experienced a brain injury as a 3 year-old – read here
60-year-old woman with brain stem injury who was able to return to social situations and improved her auditory processing – read here
Questions? Let’s get in touch! Connect with iLs at 303-741-4544 or [email protected].