Monthly Archives: November 2017

The Most Critical Reason to Wait for “Recovery and Return to Play” (RRTP) Clearance

The rule about waiting for all post-concussion symptoms to pass is well beyond advisable, it’s absolutely essential. Truly wise athletes will embrace this rule as law. Any questions, doubts, or exceptions to this are as risky as driving on an unlit mountain road at night with the headlights off.

The presence of concussion symptoms (recent or lingering) are indisputable evidence that the energetic, biochemical, and neurological stability within the brain remains disrupted and is currently inadequate to properly support normal brain function. This ongoing instability, overlooked, ignored, or allowed to remain unattended, is very likely an initiating component in the onset of progressive brain deterioration.

If an athlete’s wait for improvement and the eventual cessation of symptoms takes longer than expected, it can seem torturous. That’s all the more reason to summon additional patience and calmly wait out the storm. If you patiently, properly employ the Concussion Resolution Protocol RRTP rules, you’ll be taking the best possible path to achieve a full recovery.

The very first and most critical step in achieving a concussion recovery is to be quietly restful and at peace, in a peaceful environment, until all symptoms are gone (no matter how long it takes). Remember, it’s a law. And you can add this to the law: where concussion symptoms and anxious athletes are concerned, the word gone is strictly defined as “completely and totally absent.”

The majority of sport-induced concussion symptoms suffered by otherwise healthy, competitive athletes pass quickly (in a few days to a week) or reasonably quickly (within 2 weeks), especially if the Recovery and Return to Play Guidelines (RRTP) are clearly understood and honestly followed, particularly Step 1.

Strict adherence to RRTP Step 1 – waiting for all symptoms to pass – is critical. Be clear about that. No funny business, no “close enough” assumptions, no personally-established time-sensitive exemptions apply in Step 1. If your return to optimum health is the senior priority, there can be no exceptions.

The most overlooked and disregarded aspect of the very first step in following RRTP guidelines to achieve a full recovery is to eliminate all reading and electronic screen time. This means eliminating even the average use of one’s eyes during this time. We’re not talking about forever, but certainly a full day, maybe even two or three days. No books, magazines, cell phones, computing, or visual entertainment at all. Again, no exceptions.

In RRTP Step 1, texting, TV, computing, surfing, phone calls, social media, movies, and any form of reading material can all be considered bad medicine. You can turn them off and set them aside, but it’s far better to leave them all well out of reach. Being inactive may not be easy, but it is doable, and absolutely essential. It’s highly recommended that you give others a heads-up so they can support you with this requirement. Recovery begins by being calm, peacefully inactive, and at rest. 100% chill mode.

As days go by, if you’re not improving or you remain uncomfortable, you may be discouraged about your apparent lack of progress and your ability to recover from this particular injury. But the absence of improvement is all the more reason to make rest, peace and quiet, and the elimination of all stimulation (self-initiated or external) your top priority.

This is potentially the most unsettling part of the ride, and can be a substantial challenge. But the sooner you discipline yourself to truly lay low (nobody else is going to do it), the sooner you’ll be symptom-free and able to enjoy your customary good health.

Until then, it’s totally understandable to feel impatient, uncomfortable, frustrated, or even imprisoned. These are aspects of recovery that no one wants, but they’re often an inescapable part of the journey.

Remember, priority one is to recover from the injury. Completely. It’s the only priority at this stage. Returning to sports? That’s still a few steps away. That doesn’t happen safely without a full recovery.

Established sets of RTP guidelines following a concussion would be better amended to clearly emphasize the recovery component as the senior importance. An athlete’s subsequent Return to Play follows, but is clearly a secondary priority. See the Recovery and Return to Play (RRTP) Guidelines in the Author’s Notes section.

The Core Issue – The Real Reason RRTP Clearance is So Important

Be aware that resuming any activities now, while symptoms remain (even one symptom, like a headache), would be just as unwise (and reckless) as not reporting your initial injury symptoms and continuing to play. Equally unwise is any form of “gaming the system” and knowingly playing with symptoms even though someone may have formally cleared you or told you you’re good to go. All of the above alternatives are exceptionally risky, shortsighted, and literally rolling the dice against the future. Your future.

Let’s take a closer look at why it’s flat out self-destructive to play with symptoms. The CRP recovery perspective has been shaped and honed by years of experiences in observing, addressing, and successfully resolving sport-induced concussions. There is no guesswork in achieving a CRP-based recovery: what works and what doesn’t work is known.

Given this union of knowledge and experience, we strongly believe that returning to play prematurely, or continuing to engage in sporting activities while concussion symptoms remain, is very possibly how an ongoing, untreated concussion (most often a transient disturbance) actually morphs and escalates into a traumatic brain injury (TBI). The physically unobservable effect of which is an indeterminate accumulation of harm to the brain (actual but undetectable tissue damage), very likely the direct result of the sustained disturbance, ongoing interruption, or prolonged absence of the vital life force.

In other words, if the vital life force is absent from any part of the brain

  • in too severe a manner, as in one or more violent impacts (e.g., vehicle accidents)
  • too often (e.g., boxing)
  • or for too long (e.g., career collision or combat sports)

those significant and/or sustained absences may very likely result in physical harm and damage to brain tissue. An unwelcome, invisible result, no different than a material absence of blood supply to dependent body tissue.

Ignoring concussion symptoms is predominantly an “interior” decision, a judgment call, equivalent to knights going into battle without protective armor or gunfighters dodging bullets without Kevlar vests.

On the more common upside, if you’re noticeably and continually improving each day, it’s an excellent sign. As you become aware of reductions and absences of symptoms, confidence in your ability to improve is restored. The probability is high that your recovery is progressing in a timely manner. The internal and uplifting recognition that you are healing is real and reliable. You’re on the way back. This subjective perception contributes immeasurably to the mechanisms of natural recovery and represents a trustworthy benchmark in the journey back to pre-concussion wellness.

A concussion recovery in progress, regardless of how it is initiated, is a prime example of natural healing assisted solely by genetics, time and nature. But don’t forget that as long as any symptom(s) still remain, or fleetingly reoccur, it’s not yet time to break out the celebration gear. Stay with the RRTP guidelines, be at peace, continue to experience progressive improvement, and save the celebration until after all your symptoms are gone.

During the latter stages of recovery, when most symptoms have ceased and you’re clearly on the way back, be aware of the increase in outside influences, the reappearance of friends and associates, involvement with entertainment and most especially the quality of thoughts. Thoughts are things. They create realities. The wrong thoughts can easily knock you off the path to recovery. The mind is a great asset when it’s working on your behalf, but a formidable adversary when it works against you. Don’t embrace any line of thinking that does not support your full recovery.

As affirmed elsewhere, and integral to the CRP perspective, the time it takes for an athlete to recover from a concussion is the most important and potentially influential recovery factor of them all. Why? Because the details of a concussion recovery, including the amount of time a recovery takes, become encoded and carry the potential to partially influence or entirely govern similar future head trauma recoveries.

In other words, a slow concussion recovery in the present will likely predispose a slow recovery in the future. Likewise, a swift recovery from a concussion now will likely predispose a similarly swift future recovery. But a full recovery is essential, regardless of the amount of time it takes. no matter what the future holds.

So, fast, slow, or somewhere in between, patiently and honestly waiting for all post-concussion symptoms to pass before resuming any activities or play is an indispensable safeguard for your present and future health.

In the absence of a spontaneous or assisted recovery, the RRTP guidelines are your very best friend.