Most people can begin a gradual return to school or work within a few days of a concussion, as soon as they can manage light mental activity without symptoms getting much worse. You do not need to be symptom-free first, and returning to learning comes before returning to unrestricted sport.
The return is done in stages. Your physician or nurse practitioner, and your school or employer, should be part of the plan.
The first 24 to 48 hours
Keep to quiet daily activities at home that do not make symptoms worse, and limit screen time. This short period of relative rest is followed by a gradual increase in activity.
A typical staged return
- Light thinking activity at home. Reading, easy schoolwork or email in short blocks with breaks.
- Part-time attendance. Shorter days or selected classes or tasks, with accommodations.
- Longer days, fewer accommodations. Build up time and workload as symptoms allow.
- Full days. Normal workload, including tests or demanding tasks.
If symptoms flare up more than mildly, step back to the previous stage and try again once they settle.
Accommodations that can help
- Rest breaks in a quiet space
- Reduced screen time, or printed materials
- Extra time for assignments and postponed tests
- Shorter shifts, modified duties or working from home
- No gym class, physical work or driving until you are advised it is safe
Students in Ontario
Ontario school boards are required to have concussion policies, including a return-to-school plan that supports a student’s gradual return to learning and to physical activity. Tell the school about the concussion and ask for their plan.
Workers
Talk to your employer about a graduated return. Jobs involving heights, machinery, driving or safety-critical decisions need extra caution, so get medical advice before going back to those duties.
When to get help
See your physician or nurse practitioner if you cannot increase your school or work time after one to two weeks. Go to emergency for a severe or worsening headache, repeated vomiting, a seizure or increasing confusion.
Our concussion management service can guide you through each stage.
Need help planning your return?