Athletes should avoid total rest after mild concussion, say experts

Athletes who have experienced a mild concussion should avoid total rest and resume light physical and mental activities to aid their recovery, according to a consensus statement issued by more than 100 international researchers and clinicians.

The statement, which took more than five years to complete and was informed by 10 systematic reviews of concussion-related evidence, updates previous guidance to avoid all physical activity until symptoms are completely resolved. It contradicts recent UK guidance to avoid contact sport for 21 days after sustaining a concussion and avoid any form of training for 14 days.

A concussion is a type of traumatic brain injury caused by a bump, blow or jolt to the head, resulting in symptoms such as disorientation, dizziness, headache, amnesia or sensitivity to light and sound, which may last for several weeks.

To help shape concussion policy across elite and grassroots sport, the Concussion in Sport Group (CISG) hosts a conference every four years and subsequently issues a consensus statement aimed at optimising the care of athletes who have or are at risk of brain injury. Its latest statement, published in the British Journal of Sports Medicine, is based on the outcomes of a meeting held in Amsterdam in October 2022.

A key recommendation is that individuals can return to light-intensity physical activity, such as walking or stationary cycling, 24–48 hours after a concussion, and systematically increase their exercise intensity after this. However, they should stop if they experience a significant increase in the intensity of concussion symptoms – defined as a greater than two-point increase on a scale of 0 to 10, where 0 represents no symptoms and 10 represents the worst symptoms