The 2-Point Rule for Managing Concussion Symptoms after the Injury

These instructions are for Children's Hospital of Philadelphia (CHOP) Minds Matter Concussion Program patients who have been diagnosed with a concussion and are returning to activity (physical or cognitive/thinking activity).

Important information about the 2-point rule:

• Finding the right balance between activity and managing concussion symptoms is helpful for your recovery.

• Follow the instructions below to guide you on how to gradually increase activity following your concussion. These will help you resume your regular activities as quickly as possible!

Instructions for managing symptoms using the 2-point rule:

Follow this 2-point scale as a guide for measuring your symptoms and when to take a break.

• Before any activity: Imagine your concussion symptoms on a 10-point scale, where 0 means you feel great (no symptoms) and 10 is the worst symptoms you have ever experienced.

• It is ok for your symptoms to go 2 points above your starting number when you do any activity. See graphic for details.

  • This can be used for any activity: Schoolwork, reading, watching TV, using a phone or tablet, exercising.

• If your symptoms reach more than 2 points higher than your starting number, take a break to let your concussion symptoms come back down. You may then return to the activity. An example:

  • If your headache starts at a 2 out of 10, you can do any activity until it gets to a 4 out of 10 before taking a break.

  • Try to avoid going from a 2 out of 10 to a 7 out of 10. If you do, it may take longer for concussion symptoms to come back down.

Recovery

• It should take no longer than 20 to 30 minutes (1 hour maximum) to recover from any activity.

  • This can be used for any activity: Schoolwork, reading, watching TV, using a phone or tablet, exercising.

• If it takes hours to recover, you probably did a little too much before taking a break.

Contact your healthcare team with questions, concerns or if you develop symptoms with an activity that do not improve within 24 hours.

Minds Matter Concussion Program

Monday to Friday from 8:00 am to 4:30
215-590-6919

Reviewed on August 25, 2023, by Christina Master, MD