Concussion Management is Simple, Effective, and Critical for Recovery

Managing a concussion effectively should result in a successful recovery within about four weeks, says Dr. Joel Brenner with Children’s Hospital of the Kings Daughters in Norfolk. It’s important to manage each phase effectively.

Phase one is the acute phase, when the concussion happens. It might be managed in this phase by a physician, coach or athletic trainer. The key is to recognize that the injury could be a concussion, pull the athlete out of play, protect them from a second impact and then get them evaluated by a licensed healthcare provider, preferably one knowledgeable in concussion, diagnosis and treatment.

“This cannot be emphasized enough: protect the brain, remove the injured athlete from the field of play, get them evaluated as soon as possible,” Dr. Brenner says.

The next phase follows the evaluation and diagnosis of concussion. At this point, “we want to limit the physical activities, but not put them to bed. We got to a point around 10 years ago where people were sending kids with a concussion to recovery in a dark room, doing nothing, keeping them out of school. And we found out that this slows down the healing process and can actually lead to depression and anxiety.

“From a physical activity standpoint, we have them rest from sports, but when they’re feeling up to it, they can be walking with their family. And we don’t want them to be just laying around in bed. What I tell people is sleep’s the most important medicine. They need to be getting at least nine or 10 hours of good sleep at night, to help the brain heal, without napping during the day.

“We want them going back to school after a few days, but with different academic accommodations. The point is to make modifications while keeping life as normal as possible. That’s important from both a physical and a mental standpoint.”

Up to 75 percent of students get better within around four weeks using this basic concussion management protocol, says Dr. Brenner. For the other 25 percent, other interventions need to be considered, depending on where the student is experiencing lingering problems. Formal physical therapy, balance and coordination work, even weaning them off of medications they might have been overusing for headaches, might be indicated. “Which is why it’s important to limit medications from the onset, and work on good sleep habits, modified physical activity, and modifying academic activities during the recovery phase,” says Dr. Brenner.

For more information on traumatic brain injuries, including concussions, contact the Virginia Department of Health at or the Virginia Concussion Initiative at