You've heard it. It will be 4-6 weeks of healing time for your prognosis and before you can return to activity. This is a blanket statement and the truth it's hard to put a time frame on any injury without considering a whole multitude of factors. Although certain time frames may be common amongst distinct classes of injuries, it is important to consider that when dealing with the body many dysfunctions are multifactoral.
Why is it so hard? The reason it is difficult to estimate healing timeframes or return to activity time frame is that they are highly subjective to genetic factors, lifestyle, previous injury, compliance to care, amongst a whole host of other factors. The "same" injury is not the SAME for everyone. The best course of action is to start with an action plan or care plan and reassess after 2-4 weeks to see what if any progress has been made.
Often the absence of pain is used as an indicator for when someone has fully recovered or reached maximum potential benefit from therapeutic activities. This is a poor indication of healing because we know that many of these dysfunctions are multifaceted and healing extends beyond the absence of pain.
This excerpt from NCAA concussion study points this out:
Studies in basic neuroscience have demonstrated that mild traumatic brain injury (concussion) is followed by a complex cascade of ionic, metabolic, and physiological events that can adversely affect cerebral function for several days to weeks.1,2 Concussive brain injuries trigger a pathophysiological sequence characterized earliest by an indiscriminate release of excitatory amino acids, massive ionic flux, and a brief period of hyperglycolysis, followed by persistent metabolic instability, mitochondrial dysfunction, diminished cerebral glucose metabolism, reduced cerebral blood flow, and altered neurotransmission. These events culminate in axonal injury and neuronal dysfunction.2-5 Clinically, concussion eventuates in neurological deficits, cognitive impairment, and somatic symptoms.6 -JAMA. 2003;290(19):2556–2563.
Basically, we may think of a concussion as just a hard to hit to the head but in fact, it affects many systems of the body. These include both mental and physical symptoms.
The study further goes on to say this:
Despite a growing body of sport-related concussion research, little evidence-based guidance is available on how long it takes for an athlete to recover after concussion and when it is safe to return to competition. A review of the literature reflects estimates of symptom and cognitive recovery ranging anywhere from several hours to several weeks after sport-related concussion.15,18,19,21-24,26-36 Computerized and clinical tests have detected postural stability deficits at least 3 days after concussion,37-41 but the course of longer-term recovery in balance functioning has not been extensively studied. It also remains unclear whether all domains affected by concussion (eg, symptoms, cognition, balance) follow the same or different recovery patterns. --JAMA. 2003;290(19):2556–2563.
This further illustrates the point that little is known about the exact time frame injuries take to heal and that individualized care is of the utmost importance when determining the appropriate steps for care.
All of this might seem common knowledge and the purpose of this is to encourage and remind patients who may become frustrated with their recovery journey, that healing is not linear. We all experience ups and downs on the path to better health. Reassess and adjust if necessary. Find a practitioner that understands your needs. Keep going!
Dr. David Satterfield, Chiropractor