Concussion is a type of mild traumatic brain injury that can temporarily alter brain function. It can occur when the brain rapidly moves within the skull. Some common symptoms include headache, fatigue, nausea, imbalance, sensitivity to light and sound, cognitive difficulties, sleep disturbances and emotional changes. Symptoms may appear immediately or several days after an injury. Symptoms typically resolve within 4 weeks.

Sleep

• The brain needs rest to heal. Follow these 12 Tips for Improving Sleep to help
• Stick to a consistent sleep schedule. Napping a lot during the day might make it difficult to sleep at night
• Don’t wake up someone with a concussion if they’re sleeping fine during the first few days following their injury

Screen time and activities

• Minimize screen time for the first 2 days after your injury, including computers, TVs and phones
• Do things that help you relax. These could be things like painting, listening to quiet music, cooking, journaling or spending time with loved ones

Food and fluids

• Eat healthy meals every 3 to 4 hours and prioritize hydration, mostly water
• Avoid drinks with caffeine for the first few days because these can put added stress on your brain. However, know that you may get headaches if you are used to drinking caffeine regularly and you suddenly stop

Alcohol and drugs

• Avoid alcohol and recreational drugs. They can hide your symptoms and slow recovery
• Discuss other medication use with your health care provider

Driving

• Don’t drive until you can focus well and manage complex situations. Talk to a doctor or nurse practitioner before driving

Headache, nausea, dizziness

• If you have a headache, feel sick or dizzy: put something cold or warm on your head, stretch and massage your neck and shoulders. Take slow breaths. Go to a quiet place
• Pay attention to what triggers your headaches and, in general, try to avoid those things for the first one to 2 weeks. However, avoiding triggers for too long may make you more sensitive to them
• Practice gentle neck exercises, including stretches and muscle contractions
• Certain medications can mask concussion symptoms. Talk to your health care provider about when to use over-the-counter pain medication (such as acetaminophen or ibuprofen). Do not use opiates or narcotics that are not prescribed for you. Prolonged use and overuse of pain medications may lead to ongoing headaches after a concussion
• Daily supplements like magnesium, omega-3 fatty acids, coenzyme Q10 and riboflavin may decrease how often you get headaches and how painful they are

Mood, behaviour and social relationships

• Concussions can affect how you feel. You might feel tired, irritable, sad or anxious
• Being with family and friends can help make your mood better and more stable. Spend time with people you enjoy. Build fun into your day
• If you are sad, anxious, irritable, depressed, etc., consider asking your doctor: Could counselling help? Could seeing a psychiatrist help?

Adults 65+ years

• Ask your health care provider if they have any concerns about how your current medications might have an impact on your concussion recovery
• Work with your health care provider to adjust your return to activity plan, if needed
• Have someone accompany you to make sure you are safe when introducing activities back into your routine after concussion. For example, have someone join you for your aerobic walks in case you start to feel unsteady and need support

Cognitive tips

After a concussion, your brain might work slower. Conserve energy using the four Ps:

• Prioritize. Do the most important things first. Ask yourself: Is it urgent? Does it have to be done today? Can it wait until I am better?
• Pace. Take breaks
• Plan. Plan your day and week so that you’re doing work or chores when you have the most energy. Take turns between physical tasks like folding laundry and thinking tasks like using your computer for work. Make time for a hobby you enjoy
• Positions. Think about the things around you and how your posture can affect your energy level. Avoid standing too long and sitting hunched over. Avoid loud noises and bright lights. Find a quiet area where you can work. Listen to soothing music if that helps you. Consider a physical therapy plan to regain your postural strength and your awareness of your body’s position and movement

Returning to physical activity

• Aerobic activity like brisk walking has been shown to help concussion recovery
  • Calculate your maximum heart rate
    • Max heart rate = 220 – your age
  • Start with light aerobic activity (55% max heart rate) and then progress to moderate aerobic activity (70% max heart rate)
• Don’t rush it. Follow a Return to Activity or Return to Sport plan to slowly get back to your regular activities with help from health care providers or sport coaches
• Talk with your health care provider about moving on to greater exercise intensity and activities where there is a risk of re-injury

Returning to school and work

• You can go back to school or work within a few days if your symptoms are not worse. You might need to adjust your normal school or work schedule or duties for the first little while
• Talk to your teacher or employer and health care experts if you’re not feeling well while at school or work
• School: It’s important to follow a structured, graded approach and ensure accommodations have been arranged with your school, as needed. Work with school staff to make and follow a Return to Learn plan
• Work: Follow a Return to Work plan in consultation with medical professionals, occupational therapists and workplace representatives

When to get more help

• If you’re not feeling better, talk to a health care professional so that you can get help
• Learn more using the Concussion Awareness Training Tool. There are different modules for youth, parents and caregivers, school professionals, workers or workplaces, etc.
• Refer to Vancouver Coastal Health Authority’s MyGuide: Concussion or MyGuide: Concussion (Teen Edition) for more patient information