RETURN TO SCHOOL AFTER CONCUSSION
People are getting the message about the need to rest after sustaining a serious concussion. They are also learning that students should not practice or appear in games until being symptom free and being cleared by their physician. The message is getting out. What I keep encountering is that students are struggling to maintain their academic focus after injury. This is frequently quite difficult and may actually prolong their recovery curve. How is that possible?
The primary issue after a student sustains a concussion is decreased mental and cognitive efficiency. The metabolic activity in the brain is changed during post-injury time. This takes one to two weeks to resume the normal cascade of cerebral perfusion and neurotransmission. This is the cause of the cognitive slowing that takes place and poor focus. The key to recovery is rest - physical and cognitive. That means that if a student is out of sports because of a head injury (concussion) he or she should not be studying 3 or more hours a day for mid-term exams. Every year I get calls from frantic students (and their parents) about whether they can take the SAT exam a week after they sustained a concussion. They should not OR if they do they can expect a significantly different score than they might otherwise have attained having not been concussed.
SCHOOL NURSES A SUPPORT
It is important that parents notify the school nurse once a student returns to school after injury. That is fairly intuitive if the student is using crutches or needs someone to carry his backpack. But concussionis often considered an invisible injury and some prefer not to say anything to nurses. I can tell you that school nurses are awesome to work with and I would not hesitate to use them for support. Most nurses I work with are well informed about concussion and the need for rest. They allow students to check-in when they need to decompress from the travails of class work sometimes permitting a 20 minute power nap when needed. Yes, inform the nurse.
Rest is invariably the key ingredient to healing. But in many cases students need not be kept home for days upon days. I recommend a partial day immediately following the injury with gradually longer times in class. Try not to miss the same class every day e.g. math or science because these require ongoing repetition and build from one topic to the next. However, parents and school counselors can be quite creative about the return to school schedule until the student athlete is fully healed.
MIDTERMS AND SAT TESTS
Students are expected to take standardized tests during their time in class. Bigger tests evoke bigger stress for athletes recovering form concussion. Whenever possible school administrators have allowed athletes to make up tests when they are ready. Most teachers are willing to modify an exam schedule for someone in need.
