School Nurse: I've had a lot of training over the past year in concussion management. Can you review why cognitive rest immediately after a concussion is so important?

Matthew Grady, MD: So the idea of cognitive-physical rest early in the process really means that we're trying to divert all of our resources into healing.

Christina L. Master, MD: Your brain really needs to use the energy and the fuel that it's getting right after the injury to heal and not to exercise and think and do other things. So resting is a really important part of getting better.

Matthew Grady, MD: If we think of it in simple terms, after the brain is injured, the body needs fuel to heal the brain cells. If we divert fuel to other activities, such as schoolwork or running around, we take away fuel, potentially, from those healing cells. We know that early in the process there's a big demand for those cells to heal, and so we want to minimize the demands for other things and divert all our resources to those injured cells.

Parent : What is cognitive rest exactly, and what does it mean for my child's day-to-day routine?

Matthew Grady, MD: So the idea of cognitive physical rest early in the process really means that we're trying to divert all of our resources into healing and, in our athletes and young children, growing, as well. And so we're trying to minimize the demands on the brain during this critical time. Sometimes cognitive rest is misinterpreted as complete rest. I'm not asking individuals to do nothing. I'm asking them to minimize the activities that increase their symptoms. So I want individuals to remain social. They're able to interact with their friends. We do allow individuals to walk around. We do allow them to talk on a phone with their friends. We do allow them to do light activities, such as cooking. We prefer individuals not work out hard or do activities that would make them sweat. We also like to minimize activities that are not necessary, and so playing video games has a metabolic demand that is not necessary early in the course of recovery. So we do recommend minimizing video games, text messaging, and interactive computer.

Student athlete: Do I really need to do cognitive rest? What happens if I don't?

Alec: Unfortunately, I learned the benefits of cognitive rest the hard way. In the spring of my senior year, in the first lacrosse game of the season, I suffered a hit that left me stunned. And by the end of the game, my head was throbbing. I didn't tell anyone because I was afraid they wouldn't let me play. I tried to train through, and the symptoms just got worse and worse. Halfway through the season, I was forced to quit lacrosse permanently. This past summer I suffered another concussion, but luckily I knew what to do. I took the doctor's orders of cognitive and physical rest seriously, and in just a few weeks, I was feeling much better.