21 Jan Phone Use Right After Concussion – A Good or Bad Call?
Just had a concussion and want to recover quickly?
Some would argue that you’d better avoid all screens (including phones) for the first 2 days.
Source: https://www.sciencenewsforstudents.org/article/concussion-patients-recovery-avoid-screen-time
Is this true?
Let’s take a deeper look.
A high school athlete suffers a concussion during a game.
The player and family come into the office to visit with me the next day.
Now, we will talk about important things (at least to me) like headache management, impact on school, and risk of future injury.
However, no one in the room will leave satisfied until I address one of the burning questions in the mind of child and parents.
What about using the phone?
In the past, there was a heavy focus on immediate either full or at least partial rest from any activity that placed a stress on the healing brain. That often would mean recommending no use of phones.
The benefits of no phone use include a reduction in visual and cognitive/thinking load on the recently injured brain. Some activities also play loud sounds, which ups the stimulation load even more.
The risks of no phone include potential anxiety due to limited stimulation with being disconnected from friends, cute dog videos, and the rest of the outside world. This sense of isolation could complicate recovery from a concussion.
Now, the overall post-concussion treatment pendulum is swinging more toward an active approach to recovery. Yes, we don’t want to overwhelm the healing brain, but an absolute shutdown may also slow recovery. As I tell my patients, we often try to find the sweet spot between too little and too much activity.
So, how do we best answer that burning questions about phone use?
The process of finding that sweet spot answer usually involves making patient-specific decisions and frankly a bit of trial and error.
Enter a study from JAMA Pediatrics on The Effects of Screen Use in Concussion Recovery that got a whole bunch of attention with their reported results trying to clarify the whole phone use issue.
Concussed patients were randomized into either a group permitted to engage in screen time, or the group asked to abstain from screen time for 48 hours after injury. Outcome measures included a resolution of symptoms on a post-concussion symptom scale.
Many media accounts of this study (like the one above) trumpeted the finding that those who abstained from screens had a statistically superior recovery. This was indeed stated in the article.
Parents now have evidence-based permission to pry phones (and other screens) from the clenched hands of recently concussed athletes.
Or do they?
Reading deeper into the statistics of the study results, the screen abstinent group was, well, not fully abstinent from their screen use. Just like the rest of us, concussed kids couldn’t completely stay away.
The screen abstinent group spent a range of 16-105 minutes of phone time (average of 55 minutes) a day for the first two days after concussion. They were better at avoiding TV, computer, and video game screen use, but still had an average of 130 minutes (just over 2 hours) of total screen time in those first 2 days. This contrasted with the screen permitted group averaging 260 minutes a day of phone use and 630 total daily screen minutes (which is exactly the average screen time found by a 2019 survey of US teens).
So, what is my more accurate and likely more realistic interpretation of the data?
Rather than requiring absolute screen abstinence, there is now preliminary evidence supporting clinical recommendations to limit screen time in the acute period after concussion. This is also stated in the article.
There was no analysis of what was done while using the phone (texting, TikTok videos, crypto trading), so I cannot give the particulars on risks of activities or app use.
I’d also add in professional recommendations to limit any form of immediate post-concussion phone/screen to 10-15-minute time blocks to reduce risk of acute sound and visual overload.
No doubt that if any symptoms are worsened by screen use, immediately take a break.
So, in the 2-days immediately after a concussion, a range of 60-90 minutes per day of phone use is a sensible call.
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The above information is not intended to diagnose or treat any concussion or other medical condition. It is designed for general awareness and education and is not a substitute for a comprehensive evaluation or professional treatment recommendations from a medical provider. Please contact your personal medical provider for any health concerns or to manage any known or potential concussion injury.