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Breathing & recovery

Light exercise after a concussion: the stage 3 session

This is stage 3, light exercise, of the UK concussion guidelines' graduated return. It's only for someone already through stages 1 and 2: 24 to 48 hours of relative rest, then normal daily activities such as short walks and simple chores without symptoms getting more than mildly worse. You should also have been assessed by a healthcare professional or through NHS 111, the National Health Service's urgent advice line. You don't need to be free of symptoms. Before you start, score your worst symptom from 0 (none) to 10 (the worst you can imagine). Keep going if it rises by no more than 2 points and settles within an hour of stopping; if it rises more, or a new symptom starts, stop, rest and try again the next day at an easier level. No weights, hard efforts or anything with a risk of a fall or a knock to the head.

20 minBeginner8 movesCardio machine · A bench or box · A wallQuads · Hip flexors · Glutes · Chest · Triceps · Calves
Follow along: a timer, a cue and the next move, one step at a time.

Check in

  1. Slow breathing (6 breaths a minute)1 min
    Beginner · 3D demoSit and score your worst symptom out of 10 before you start. Breathe gently, with no holdsEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)

Light cardio

  1. Stationary cycling10 to 15 min
    Beginner · Quads, Glutes, Hamstrings · 3D demoEasy enough to speak in short sentences. Or walk briskly for the same time, on the flat. Stop and rest if symptoms rise by more than 2 points or a new one startsHarder: Air bike intervals

Easy bodyweight moves (once round; twice when that feels easy)

  1. Standing march1 min
    Beginner · Hip flexors, Abs, Glutes · 3D demoHold a counter if you feel unsteadyHarder: Standing band hip flexion
  2. Sit to stand from a chair8 reps
    Beginner · Quads, Glutes, Hamstrings · 3D demoAt a steady pace, breathing out as you standHarder: Bodyweight squat
  3. Wall push-up8 to 10 reps
    Beginner · Chest, Triceps, Shoulders · 3D demoKeep your head in line with your bodyHarder: Push-up
  4. Glute bridge8 to 10 reps
    Beginner · Glutes, Hamstrings, Abs · 3D demoLower slowly. Afterwards, roll onto your side and sit up slowlyEasier: Pelvic tilt into bridgeHarder: Glute kickback (quadruped hip extension)
  5. Slow calf raise10 reps
    Beginner · Calves · 3D demoHolding a supportEasier: Seated bent-knee calf raise (soleus raise)Harder: Standing dumbbell calf raise

Cool down and check again

  1. Treadmill walking2 to 3 min
    Beginner · Quads, Calves, Glutes · 3D demoSlow, easy walking, or easy pedallingHarder: Treadmill jogging
  2. Slow breathing (6 breaths a minute)2 min
    Beginner · 3D demoSitting. Score your symptoms again now, and again an hour laterEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)

Tips

  • Do it once a day. If your symptoms rose by no more than 2 points and settled within an hour, add 5 minutes or a little more effort next time (our suggestion for building up); if they rose more, rest until tomorrow and go back to the last level that felt fine.
  • A mild rise in symptoms during exercise is common and usually settles within minutes to an hour or two; a mild, brief rise doesn't slow recovery. Strict rest doesn't help either.
  • If you use a heart rate monitor, the international consensus suggests staying under about 55% of your maximum heart rate (220 minus your age) at first, then building towards 70%.
  • Not yet: no added weights, hard intervals, contact, heading or anything with a risk of a fall, such as cycling on roads, skiing or climbing.
  • Once you're free of symptoms at rest, move on to stage 4: harder cardio, weights and training for your sport with no risk of a knock to the head. Training with a risk of a knock waits until you've had no symptoms at rest for 14 days, and competition until day 21 at the earliest.
  • Call NHS 111 if your symptoms are getting worse or haven't improved by 14 days, and see a GP if they last more than 28 days. Call 999 for a severe or worsening headache, repeated vomiting, getting drowsier, a fit, or new weakness, numbness or double vision.
  • Children and teenagers follow the same stages, with an adult nearby, and school comes before sport.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

Guides that recommend it

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Questions people ask

How long does the light exercise after a concussion: the stage 3 session take?

About 20 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: Cardio machine, A bench or box, A wall. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 3 of its 8 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.