To Rest or Not To Rest: Mental Rest in Concussion Treatment

Shake it off. Play through it. Tough it out.
This used to be what young athletes everywhere would hear after taking a blow to the body or hit to the head. Thankfully, that is slowly changing as we realize that this is dangerous advice to be giving. We’re all well versed now in the importance of physical rest as part of concussion treatment. However, when home and “resting” you may be unknowingly doing some damage by engaging in some boredom-busting activities that could prolong your concussion recovery or lead to permanent concussion symptoms.

What is "Mental Rest"? 

The importance of “mental rest” in addition to physical rest as a part of concussion treatment is starting to gain some momentum on the internet. “Mental rest” involves avoiding activities that stimulate the brain a lot such as doing homework, reading, texting, playing videogames, and watching TV. The logic behind this is that avoiding these things helps save your “brain energy” to use for healing from the concussion rather than being used up on these activities. Health care providers have been starting to add this recommendation to their repertoire of concussion advice; however, a recent study indicates that we may be recommending too much of a good thing.

Mental Rest is About Balance 

A study published this January in Pediatrics provided some of the first real evidence that “mental rest” is, in fact, helpful during concussion recovery, BUT we need to be careful about how much. The study showed that people doing mild and moderate levels of mental activity recovered just the same as those doing nothing. It was only those who engaged in their full schedule of activities with no restrictions that struggled to recovery as quickly and as fully. What this means is that doing absolutely nothing after a concussion isn’t going to make you heal any faster than if you thoughtfully re-engage in your normal activities – if anything, it will just make you fall farther behind in school and lead to increased boredom and restlessness at home.
So, when it comes to “mental rest” after a concussion, just remember this general rule of thumb: Do as much as you can without triggering or worsening your symptoms. Do as little physical and mental activity as possible for the first 3-5 days, but after that, gradually increase your level of activity as you can. Take advantage of academic accommodations at school like having a note-taker, extended deadlines for assignments, and alternatives to test-taking. If you’re unsure what accommodations you need or how to arrange them, a Speech-Language Pathologist can help liaise with your school to set those in place for you.

Melissa Kiley is a registered Speech-Language Pathologist with a special interest in concussion/acquired brain injury as well as literacy skills development. She has been working with clients for over 10 years and is highly skilled in developing functional and innovative treatments.