Concussion Recovery Protocol

Return to Operations

Week 1: Acute Recovery Phase

Days 1-7 | Phase 1 of 4

Current Phase

Phase 1: Initial Rest & Stabilization

Relative rest, symptom stabilization, and establishing baseline recovery protocols

Medical Clearance Required

This protocol is for mild concussion recovery only. If you experience severe symptoms (repeated vomiting, seizures, loss of consciousness, worsening headache, slurred speech, unequal pupils), seek immediate medical attention. Always consult a healthcare provider before beginning. Progression is symptom-guided—if symptoms worsen, step back or rest.

Week 1 Overview

Focus

Cognitive and physical rest with gentle movement

Physical RPE

1-2 (Very Light)

Screen Time

30-minute blocks maximum

Sleep Target

8-10 hours nightly

"Your brain is in an energy crisis. The goal this week is NOT training—it's creating the optimal environment for neurological healing."

DAY 1 Monday

Acute Rest

Morning Symptom Assessment

Physical Protocol

A)Gentle Walking

5-10 MIN

Indoor, flat surface preferred
RPE 1-2 (barely any effort)
Stop immediately if symptoms increase

This is NOT exercise—it's gentle movement to prevent deconditioning. If any symptom increases by 2+ points, return to rest.

B)Gentle Neck Mobility

3-5 MIN

Slow chin tucks × 10 (2-second hold each)
Gentle neck rotations × 5 each direction
Shoulder shrugs × 10

Many concussions involve neck strain. Keep movements slow and controlled.

Mindfulness Protocol

Box Breathing — Morning (5 min)

Position: Seated or lying down, dim lighting
• Inhale through nose: 4 seconds
• Hold: 4 seconds
• Exhale through mouth: 4 seconds
• Hold empty: 4 seconds
Repeat for ~12-15 cycles

Box Breathing — Evening (5 min)

Timing: 1 hour before bed
Environment: Dark/dim room, no screens, quiet
Same 4-4-4-4 pattern

Body Scan — Pre-Sleep (5-10 min)

Lie flat, eyes closed. Take 3 deep breaths.
Focus on top of head—notice sensations without judgment.
Slowly move attention: forehead → eyes → jaw (release tension) → neck → shoulders → arms → chest → abdomen → hips → legs → feet.
End with 3 breaths and drift to sleep.

Nutrition & Hydration

Hydration: 80+ oz water throughout day
Omega-3: 2000-2500mg fish oil (DHA/EPA)
Magnesium: 300-400mg evening (supports sleep)
Avoid: Alcohol, caffeine, high sugar
Meals: Small, frequent—nausea is common

Your brain uses 20-40% of daily calories during healing. Anti-inflammatory foods: fatty fish, berries, leafy greens, turmeric.

Cognitive Protocol

Screen time: Essential only, 30-min blocks max
Reading: 15-20 min light reading if tolerated
Avoid: Video games, intense TV, work emails, social media
Environment: Reduce bright lights, loud noises

Evening Wind-Down

No screens 1 hour before bed
Body scan meditation
Dark, cool room for sleep
Target: 8-10 hours

DAY 2 Tuesday

Acute Rest

Morning Symptom Assessment

Compare to Day 1 baseline. Improved, same, or worse?
If worse: Complete rest. Contact provider if significantly worse.
If same/improved: Proceed with today's protocol.

Physical Protocol

A)Gentle Walking

10 MIN

Indoor or outdoor (sunglasses if needed)
Flat terrain, easy pace
RPE 1-2

B)Gentle Stretching

5-8 MIN

Neck circles: 5 each direction (slow)
Shoulder rolls: 10 forward, 10 backward
Seated forward fold: 30 seconds
Supine knee-to-chest: 30 seconds each
Supine spinal twist: 30 seconds each side

Keep head above heart. Avoid positions that increase head pressure.

Mindfulness Protocol

Morning: Box Breathing (5 min)

4-4-4-4 breathing pattern

Midday: 5-4-3-2-1 Grounding (5 min)

Close eyes, breathe naturally. Notice:
• 5 things you can hear
• 4 sensations in your body
• 3 things you can smell
• 2 things you can feel with hands
• 1 thing you're grateful for

Evening: Body Scan (5-10 min)

Full body scan before bed

Nutrition & Hydration

Continue Day 1 protocol
Add: Creatine 5g (supports brain ATP production)
Focus foods: Salmon, blueberries, spinach

Cognitive Protocol

Reading: 20 minutes (physical book preferred)
Puzzle: 10-15 min crossword/sudoku if tolerated
Social: Light conversation is beneficial
Journaling: 5 minutes—write how you're feeling

Evening Protocol

Magnesium with dinner
No screens after 8 PM
Body scan meditation
Consider melatonin 0.5-1mg if sleep disrupted

DAY 3 Wednesday

Active Recovery

Morning Symptom Assessment

Log symptoms. Compare to Days 1-2.
Progression criteria: Symptoms same or lower than baseline.

Physical Protocol

A)Walking

10-15 MIN

Outdoor if tolerated (sunglasses recommended)
Flat to gentle terrain
RPE 2

B)Mobility Flow

8-10 MIN

Cat-cow: 10 reps (slow, controlled)
Thread the needle: 5 each side
Hip circles (hands and knees): 5 each direction, each leg
Prone press-up: 5 reps, 2-sec hold
Child's pose: 60 seconds

C)Balance Introduction

3 MIN

Tandem stance (heel to toe): 30 seconds
Single leg stance (wall support): 20 seconds each
Weight shifts side to side: 10 reps

Balance is often impaired post-concussion. Use wall support as needed.

Mindfulness Protocol

Morning: Box Breathing (6 min)

Extending duration by 1 minute

Post-Walk: Mindful Standing (3 min)

After walking, stand still. Close eyes.
Feel feet grounded. Notice breath. Notice body sensations.

Evening: Extended Body Scan (10 min)

Full body scan + 2 minutes focusing on breath at belly

Nutrition & Hydration

Continue base protocol + creatine
Focus: Adequate protein (0.8-1g per lb bodyweight)
Meal idea: Grilled salmon, roasted broccoli, sweet potato, olive oil

Cognitive Protocol

Reading: 25-30 minutes in blocks
Memory: Read paragraph, close book, write key points
Dual-task: Walk slowly while counting backward from 100 by 7s

Dual-task may be challenging. Go slow. Stop if symptoms increase.

Evening Protocol

Consistent sleep schedule
Supplements: Magnesium, Vitamin D 2000IU
Body scan meditation

DAY 4 Thursday

Light Movement

Morning Symptom Assessment

If Day 3 caused symptom increase, repeat Day 3.
Green light: Symptoms stable or improving.

Warm-up

Dynamic Prep

3 MIN

Walking in place: 1 minute
Arm circles: 10 each direction
Hip circles: 5 each direction
Ankle circles: 5 each direction

Main Work

A)Walking

15 MIN

Outdoor preferred (nature benefits recovery)
Gentle inclines if tolerated
RPE 2

B)Mobility & Activation

10 MIN

Cat-cow: 10 reps
Bird-dog: 6 each side (2-sec hold)
Glute bridge: 10 reps (2-sec hold top)
Dead bug: 6 each side (slow)
Prone Y-T-W raises: 5 each position

Activation, not strength work. Focus on control and body awareness.

C)Balance Progression

5 MIN

Single leg stance (no support): 30 sec each
Single leg stance eyes closed: 15 sec each
Tandem walk: 20 steps forward, 20 backward

Mindfulness Protocol

Morning: Box Breathing (7 min)

Try 5-5-5-5 pattern if 4-4-4-4 feels easy

Midday: Mindful Walking (5 min)

During walk, slow deliberate pace
Focus on: heel strike → weight transfer → toe push-off

Evening: Gratitude + Body Scan (10 min)

Begin with 3 things you're grateful for
Then full body scan

Nutrition & Hydration

Continue base protocol
Add: B-Complex vitamin
Check: Urine should be pale yellow

Cognitive Protocol

Reading: 30 minutes
Listening: 20-min podcast (low stimulation)
Work: 1-2 hours if needed (30-min breaks)

Cool-down

Gentle stretching: 5 minutes
Quad stretch: 30 sec each
Hip flexor stretch: 30 sec each
Child's pose: 60 seconds

DAY 5 Friday

Light Movement

Morning Symptom Assessment

Log symptoms. Should see improvement by now.
If unchanged/worse after 5 days: Contact healthcare provider.

Warm-up

Dynamic Prep

4 MIN

Walking: 1 minute
Arm circles: 10 each direction
Leg swings (front/back): 8 each
Leg swings (side/side): 8 each
Hip circles: 5 each direction

Main Work

A)Walking

15-20 MIN

Varied terrain (gentle hills) if tolerated
Can increase pace slightly if no symptoms
RPE 2-3

B)Movement Flow

12 MIN

Round 1 (3 min): Cat-cow × 8, Bird-dog × 6 each, Child's pose 30s
Round 2 (4 min): Glute bridge × 12, Dead bug × 8 each, Prone Y-T-W × 6 each
Round 3 (5 min): Bodyweight squat × 10, Wall push-up × 10, Hip circles × 8 each

First squat and push-up introduction. Keep RPE 2-3. Stop if head pressure.

C)Balance & Vestibular

5 MIN

Single leg stance eyes closed: 20 sec each
Tandem walk forward/backward: 20 steps each
Gaze stabilization: Thumb at arm's length, move head side-to-side keeping eyes on thumb × 20
Head turns with fixed gaze: 10 each direction

Gaze stabilization retrains vestibular-ocular reflex. Reduce range if dizzy.

Mindfulness Protocol

Morning: Breath Awareness (8 min)

Natural breathing (no counting)
Observe without controlling—notice where you feel breath most

Afternoon: Progressive Muscle Relaxation (10 min)

Lie down. Starting with feet:
• Tense muscles 5 seconds
• Release and notice relaxation 10 seconds
Progress: calves → thighs → glutes → abdomen → hands → arms → shoulders → face
Skip neck tensing—just relax

Evening: Body Scan (10 min)

Standard body scan protocol

Cognitive Protocol

Reading: 30-40 minutes
Work: Up to 3 hours (45-min breaks)
Social: Light activity (dinner with family/friends)
Dual-task: Walk while listening to podcast

Cool-down & Evening

Gentle stretching: 5 min
Plan low-key weekend
Body scan meditation
Check: How does today compare to Day 1?

DAY 6 Saturday

Active Recovery

Morning Symptom Assessment

Log symptoms. Compare to beginning of week.

Main Work

A)Extended Walk

20-25 MIN

Nature walk preferred (park, trail)
Varied terrain okay
RPE 2-3
Practice mindful walking for 5-min portion

B)Mobility Focus

15 MIN

Hip (5 min): 90/90 stretch 60s each, Pigeon 60s each, Hip flexor 60s each
Spine (5 min): Cat-cow × 10, Thoracic rotations × 8 each, Thread needle × 6 each
Shoulder (5 min): Wall slides × 10, Doorway pec stretch 45s each, Prone I-Y-T × 8 each

C)Gentle Core

5 MIN

Dead bug: 10 each side
Bird-dog: 8 each side
Plank hold: 20 sec × 2 (breathe normally)
Side plank (from knees): 15 sec each side

First plank introduction. Stop if any head pressure.

Mindfulness Protocol

Extended Morning Practice (12-15 min)

• 3 min: Box breathing (settling)
• 5 min: Natural breath awareness
• 5 min: Open awareness (sounds, sensations, thoughts without attachment)
• 2 min: Set intention for the day

Evening: Gratitude Journaling + Body Scan

Write 5 things you're grateful for this week
Write 3 things your body did well
Write 1 intention for next week
Then body scan (10 min total)

Nutrition Focus

Meal prep: Prepare brain-healthy meals for Week 2
Stock up: Fatty fish, berries, leafy greens, nuts, olive oil

Cool-down & Evening

Extended stretching: 10 min
Light social activity if desired
Avoid alcohol (still acute phase)
Extended sleep—no alarm tomorrow if possible

DAY 7 Sunday

Rest & Assessment

Week 1 Complete: Assessment Day

◆ Morning Assessment

Complete full symptom assessment (same as Day 1)
Compare scores: Day 7 vs Day 1

Progression criteria for Week 2:
• Total symptom score reduced by 50%+ OR
• All symptoms rated 3 or below OR
• Completed Week 1 without symptom increase

If NOT meeting criteria: Repeat Week 1

◆ Physical Activity (Optional)

Gentle walking: 15-20 minutes
Light stretching: 10-15 minutes
No structured exercise—rest and assessment only

◆ Mindfulness

Morning: 10-min meditation of your choice
Evening: Reflection journaling + body scan

◆ Week 1 Reflection Questions

What symptoms improved most?
What activities were most challenging?
How is your sleep quality?
What mindfulness practice resonated most?
Are you ready to progress?

◆ Week 1 Complete ◆

Acute phase complete. If symptoms allow, proceed to Week 2: Light Aerobic Introduction.