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Concussion and Post-Concussion Physiotherapy

A concussion is a brain injury and like any injury, it benefits from the right rehabilitation. While most concussions resolve within a few weeks with appropriate management, some people experience symptoms that linger for months: headaches, dizziness, brain fog, light sensitivity, sleep disruption, difficulty concentrating, and neck pain. That cluster is called post-concussion syndrome, and physiotherapy is a key part of how it's treated.

What Is a Concussion?

A concussion happens when a force from a fall, a collision, a car accident, or any blow to or near the head causes the brain to move inside the skull. This disrupts brain chemistry and function. You don't have to lose consciousness to have a concussion.

Common symptoms include:

  • Headache or a sensation of pressure in the head

  • Dizziness, nausea, or a feeling of being "foggy"

  • Sensitivity to light or noise

  • Difficulty concentrating or remembering

  • Sleep problems:  sleeping too much or too little

  • Emotional changes:  irritability, anxiety, or low mood

  • Blurred or double vision

  • Neck pain and stiffness

If symptoms persist beyond two to four weeks without improvement, a structured rehabilitation program can help identify what's driving them and address each component.

How Post-Concussion Syndrome Is Treated

Post-concussion physiotherapy is not a single treatment it's a multi-system assessment that identifies which components are keeping symptoms active, then targets each one directly. Prince's approach is evidence-based and individualized, drawing on current clinical guidelines for concussion rehabilitation.

Treatment may address:

  • Cervicogenic headache: headaches originating from the neck joints and muscles, which are commonly injured alongside a concussion and are a treatable driver of persistent symptoms

  • Vestibular dysfunction: dizziness, vertigo, and balance instability arising from the inner ear and brain's balance system, addressed through vestibular rehabilitation exercises

  • Visual-vestibular mismatch: difficulty with busy environments, scrolling screens, or moving visual fields, addressed through graded visual and gaze stability training

  • Autonomic dysregulation: heart rate and blood pressure dysregulation contributing to exercise intolerance, addressed through structured aerobic exercise protocols (Buffalo Concussion Protocol or similar)

  • Cervical manual therapy and exercise: for neck stiffness, muscle tension, and referred head pain

  • Gradual return-to-activity planning:  a staged, symptom-guided protocol for return to sport, school, work, or exercise

Sessions are paced to stay within your symptom tolerance. The goal is to progressively challenge the system in a controlled way not to push through symptoms.

When to See a Physiotherapist After a Concussion

You don't need to wait until you're feeling better, or worse. An early assessment can help establish a clear baseline and give you guidance on what to do and what to avoid in the first days and weeks. If you're weeks or months out from a concussion and still struggling with symptoms, that is equally a valid time to seek assessment post-concussion syndrome is treatable.

Physiotherapy is not a substitute for emergency care. If you or someone you know is experiencing worsening headache, repeated vomiting, seizures, increasing confusion, or weakness after a head injury, seek emergency medical attention immediately.

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