Chris G. Koutures, MD, FAAP Pediatric and sports medicine specialist

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Comprehensive blend of general pediatric and sport medicine care with an individualized approach that enhances the health and knowledge of patients and their families



Proud physician:
USA Volleyball Mens/Womens National Teams
CS Fullerton Intercollegiate Athletics
Chapman University Dance Department
Orange Lutheran High School

Co-Author of Acclaimed Textbook

Pediatric Sports Medicine: Essentials for Office Evaluation

Orange County Physician Of Excellence, 2015 and 2016


Complete Rest After Concussion May Not Be Best Prescription

This report from the 2016 Pediatric Academic Societies meeting adds to a growing body of evidence suggesting that children who get low risk exercise even while still having post-concussion symptoms may actually have shorter recovery periods.

One may rightfully wonder if there is some selection bias in these results- kids who may have felt less burdened by concussion symptoms naturally tried to return to exercise sooner. Further study will have to explore this potential phenomenon.

Overall, I think these findings and the outcomes of similar studies provide support for a more active post-concussion recovery monitored by qualified health care providers and not just predicated on rest and watchful waiting.

The proper time to start such active recovery is not certain and likely will be an individual matter as well.

This does also bring up the fact that many current concussion return to sport policies recommend or even require that athletes must be symptom-free before being allowed to return to any form of exercise.

If continued study indeed adds support to the role of appropriately monitored and prescribed exercise to enhance recovery, then these policies, such as the California Interscholastic Federation return protocol, will need to be amended.

Rather than a "one size fits all" uniform pathway, allowing some measure of flexibility may also provide beneficial when determining starting points and type/amount of exercise.

Otherwise medical experts and school officials are possibly restricted in utilizing exercise to aid in recovery and this limitation may actually be slowing the improvement of concussed athletes.