Concussions can impact different areas of your well-being, ranging from cognitive abilities to physical symptoms. Nursing back from a concussion can take time depending on its severity, and there are a few things to consider when considering returning to work after a head injury. 

This article will cover some advice on what things to consider before returning to work and advice for while at work.

What’s a concussion? 

A concussion is the result of a traumatic head injury that causes a disturbance in brain function.¹ Four different areas of function that are affected by concussions: 

1. Cognitive symptoms include forgetfulness, confusion, difficulty concentrating, and mental fog
2. Emotional symptoms include irritability and mood swings 
3. Sleep is highly affected, patients may feel drowsy, sleep more or less than usual, and may experience more sleep disturbance than usual 
4. Physical symptoms include headaches, weakness, bleeding from the nose or ears, dizziness, ringing in the ears, poor balance and visual changes 

Concussions are often associated with a loss of consciousness upon injury to the head.²  Symptoms may not show immediately and may develop within hours of the injury, in either case, medical care should be sought upon notice to avoid deterioration of wellbeing.¹ 

Recovery 

Patients usually recover from symptoms within a week or two of the injury. Children and teenagers may take longer to recover.³ Athletes with sport-related concussions may require a longer downtime, lasting one to several months.⁴ 

Acute symptoms such as sensitivity to light and noise, headaches, nausea and confusion are still common within the first 1-3 days of the injury. At this point in time, physical and cognitive rest is recommended, so avoid reading, screens, or other similar activities that require concentration or attention. The majority of people will experience a significant improvement in symptoms within 7 to 10 days of the injury, at this point, with the advice of a medical professional, it is encouraged to make a gradual return to work. However, there is no definitive amount of downtime recommended. If symptoms do not improve by this time, it is advisable to seek further medical care.^5,6 

A small percentage between 10-20% of people experience Post Concussion Symptoms (PCS). This means patients experience symptoms for a longer period of time which can be up to three months; occasionally it can last for a year or more. PCS requires a longer period of downtime and patients may want to consider a sabbatical or a short career break, if circumstances allow.⁷ In these cases, patients may need rehabilitation including physical, occupational, and speech therapy, and counselling to support patients through emotional and psychological distress caused by the prolonged recovery.^8,9 

When to return to work? 

Before returning to work, it is essential to consult a healthcare professional to discuss readiness to return. 

Before considering a return to work to ensure that overall well-being is improving, monitoring progress closely can help notice subsiding or worsening symptoms. Monitoring symptoms and activities through a digital or physical diary can help you ensure that basic activities are not aggravating the condition. A return to work is only recommended once cognitive and physical endurance can be maintained over the day. Most people are capable of returning to work and regular activities within one to two weeks of the incident.

Strategies for return

Some professionals may recommend a gradual return to work, starting with reduced hours and increased and reduced responsibilities. It is recommended to avoid highly demanding tasks that may strain mentally or physically. At this point, it is still important to manage and track symptoms, ensuring that the environment is low-stress and quiet can minimise the chance of headaches and dizziness – if possible, consider wearing earplugs to tune out excessive noise. Taking regular breaks throughout the day can prevent fatigue and manage other symptoms. 

Throughout this process, it is important to communicate with employers the nature of the injury, the extent of its impact on your health regarding your work, and the trajectory of recovery. Support and reassurance are also important management strategies during the recovery process and can facilitate return to work, feeling supported at work goes beyond its social role.¹⁰ It is common to assume that once the physical symptoms have significantly improved, cognitive and emotional symptoms will improve.  This often leads to overestimating the ability to return to work. Some workplaces have policies to support employees and schedule a flexible temporary schedule upon return from medical leave.¹¹ 

Accessing occupational health and employee assistance programmes can be a helpful addition. These resources can help you build and review a return-to-work plan, they can accommodate different provisions or materials, such as tape recorders or calendars, that may support you through the adjustment period.¹⁰ 

Remaining realistic with your ability and educating yourself about the repercussions and recovery from a concussion is extremely important. It may be difficult for some to manage their expectations for returning to work and pushing their health, unrealistic expectations can lead to disappointment and loss of self-esteem. Research has shown that realistic awareness, insight, willingness to accept and act on feedback, and strategizing to help overcome problems are influential factors in making a positive return to work.¹⁰ 

Summary 

Returning to work after a concussion is a difficult and complex process which may require a lot of careful consideration, planning, and adjusting depending on the severity of the head injury. Understanding the nature of a concussion and tracking its impact on cognitive, emotional, physical, and sleep functions is crucial for a successful recovery and a successful return to work. 

Most individuals recover within one to two weeks, however, a gradual return to work is still recommended to not inhibit the recovery process and prevent worsening of symptoms due to fatigue. A small percentage of people may experience symptoms for a prolonged period of time, requiring additional medical support and rehabilitation.

It is important to assess readiness to return to work with a healthcare professional and develop a structured plan that includes reduced hours, modified duties, and frequent breaks. Communication with employers about the injury and its impact on work capabilities is essential. Utilising occupational health services and employee assistance programs can provide additional support.

Remaining realistic about one's abilities and avoiding unrealistic expectations is key to a positive return-to-work experience. By following these strategies and maintaining open communication, individuals can successfully reintegrate into their work environment while continuing their path to recovery.