Concussion Do’s and Don’ts

Dr. Karl Ziermann of Orthopedic Associates of Dutchess County is board-certified in internal medicine with a sub-specialty in primary care sports medicine and concussion management.

A painful, burning sensation on the outer side of the thigh may mean that one of the large sensory nerves to your legs-the lateral femoral cutaneous nerve (LFCN)-is being compressed. This condition is known as meralgia paresthetica. The nerves in your body bring information to the brain about the environment (sensory nerves) and messages from the brain to activate muscles (motor nerves). To do this, nerves must pass over, under, around, and through your joints, bones, and muscles. Usually, there is enough room to permit easy passage. In meralgia paresthetica, swelling, trauma, or pressure can narrow these openings and squeeze the nerve. When this happens, pain, paralysis, or other dysfunction may result.

Symptoms

• Pain on the outer side of the thigh, occasionally extending to the outer side of the knee
• A burning sensation, tingling, or numbness in the same area
• Occasionally, aching in the groin area or pain spreading across the buttocks
• Usually only on one side of the body
• Usually more sensitive to light touch than to firm pressure

• Talk with your physician and employer about gradually returning to work/school.
• Talk to your physician and teacher/coach about school expectations and a safe return to play protocol.
• It’s important to get back to doing your normal activities slowly. Start by doing paced activity. As you begin to feel ok do a little more. Be sure to rest and give yourself extra time as you start to feel better.

After a concussion, your brain has less energy to spare. It is important to conserve physical and mental energy to allow your brain to fully recover. If symptoms return or new ones arise as you become more active, this may be a sign that you are pushing yourself too hard.

• Eating regular meals and snacks can help improve your mood, sleep and mental focus.
• Stay away from stimulants (coffee, caffeine, soda and energy drinks) and depressants (alcohol, sedatives) as they can add stress to the brain.
• Keep a regular schedule. Talk to your physician if you are having trouble getting a good night’s sleep

• Try doing activities that help you relax and feel calm. Stress, emotional distress and worry can make symptoms feel worse and prevent you from doing things that will help you get better.
• Talk about worries with your physician, family member or friend. Talking and letting others know how they can help tends to help you feel better.

Increased sleep need is normal and necessary in the acute stage.

It is no longer recommended to have complete rest after concussion. Light non intense, contact activity can be appropriate as long as it does not significantly exacerbate symptoms.

Multiple concussions may have serious long-term problems, including difficulty with concentration, memory, headache, and sometimes physical skills. (balance and coordination)

Sometimes the demands of school/work can trigger symptoms following a concussion. You may need to take time off to rest and recover; or reduced/modified responsibilities for a short period of time.

Don’t look at devices for an extended period of time. You may need to limit time on electronic devices.

Reaction time, vision, and thinking may be impaired by a concussion. Do not drive or operate machinery until cleared by your physician. You may need to limit driving, riding bikes, and operating heavy machinery.

Use of non-prescription drugs and alcohol may add to concussion symptoms and increase recovery time. Only take medication your physician has approved.