A junior athlete dribbles a basketball. (Photo by Marine Lance Cpl. Paul E. Wyatt)

In a society that never likes to take a break, studies show that young athletes must be sidelined for their own good after sustaining a concussion. An expert with the Safe Concussion Outcome, Recovery and Education (SCORE) Program at Children’s National Medical Center discussed a number of strategies to help youth recover from TBI during last week’s DCoE webinar.

First, the parent, teacher, athlete or doctor needs to understand what full recovery means, said the expert, Gerard A. Gioia, SCORE Pediatric Neuropsychology director.

“We look to see if, functionally, things are back to normal,” Gioia said. “We’d ask, ‘Are you performing at school and at work like you normally do?’”

“Normal” means most symptoms should be gone, including headaches, fatigue, sensitivity to light, trouble with balance and dizziness.

Determining how long athletes should rest after a concussion — and what kind of rest — can be crucial to recovery, he said.

“Rest may be useful at a certain stage of recovery,” Gioia said. “But, we are starting to evolve in our process of management. We are very much a proponent of active rehabilitation.”

To prevent further injury during an “active” recovery, Gioia said to follow these simple rules:

• Avoid additional trauma — the brain is more vulnerable during recovery
• Rest the brain — limit unnecessary mental stimulation during the first few days of the injury and make sure to get good sleep throughout recovery
• Have a plan — introduce a moderated, monitored plan to gradually increase the amount of activity, based on what the individual can tolerate, while reducing the amount of rest

Not every patient recovers at the same rate, Gioia said.

“We want to find that sweet spot,” he said. “We want to know how much activity [a patient] can handle so it does not significantly worsen symptoms.”

He calls his approach the “not too much, not too little” principle: don’t do so much that symptoms get worse, and don’t do so little as to get bored.

For more information on concussions in youth, download a copy of Returning Your Child to School after a Concussion from the Defense and Veterans Brain Injury Center. Providers can also download clinical guidelines for symptoms such as dizziness as well as posters about how to recognize, treat and recover from concussions.