Concussion Treatment

for post-concussion symptoms after a brain injury

Concussion Rehab

is a comprehensive treatment approach to address the wide range of symptoms associated with a concussion or brain injury, including headaches, dizziness, vertigo, blurred vision, visual motion sensitivity, cognitive and emotional symptoms, and exercise intolerance.

Evidence-based physiotherapy assessment and treatment for post-concussion symptoms are provided to individuals (18+ years) who need education and management for a recent concussion injury or for those experiencing a concussion injury with persistent symptoms (also known as post-concussion syndrome).

Every concussion is unique, so my treatment approach is specially designed to meet the needs of each individual and their specific symptoms.

Physiotherapy for Acute Concussions

If you can seek treatment within the first couple of weeks or months after a concussion, you can recover quicker from your concussion injury, lower the chance of symptoms returning, and return to work, school, sports, or other activities as soon as possible.

Physiotherapy for Post-Concussion Syndrome

If you have been experiencing concussion symptoms for many months or years after your injury, you can still get treatment and improve your post-concussion symptoms. Treatment involves figuring out the specific areas that are still affected, which can include the cervical spine (neck pain or stiffness related to a whiplash injury), visual and vestibular systems (including blurred vision, difficulties reading, dizziness, vertigo, and balance issues), physiological and autonomic nervous system (affecting blood pressure, heart rate, and exercise tolerance), psychological and emotional symptoms (which may benefit from a referral to the appropriate therapist), and cognitive issues (related to thinking and memory, which may also benefit from a referral to the appropriate provider).

Physiotherapy for Sports Concussions

If your concussion was sustained during sports, exercise, or play, greater clinical skills and an understanding of when and how you can safely return to activity are crucial. Collaboration with your coach and team is vital to facilitating your return to play.

forward and backward movement of the head to depict a whiplash injury toronto ontario — What is a concussion?

A **concussion** is a traumatic brain injury caused by forces that can result in various symptoms and functional issues. It may not involve a loss of consciousness.
A concussion can occur in any of these situations:
A direct impact of the head against a stationary object, such as a fall resulting in the head hitting the ground
A direct impact of an object on the head, such as from a ball during a sport
Quick acceleration and deceleration of the head, such as during a whiplash injury in a car accident

a younger man rubbing his eyes to depict headaches in Toronto Ontario — Post-Concussion Symptoms

A concussion can result in a wide range of symptoms that can be present for several weeks, months, or years. These symptoms can include:

COGNITIVE (THINKING/ REMEMBERING)

Difficulty thinking clearly
Difficulty making decisions
Slowed thinking
Poor focus and concentration
Easily distracted
Forgetfulness and difficulty remembering new information

EMOTIONAL (MOOD)

Irritability and easily annoyed
Feeling depressed or sad
Poor frustration and easily overwhelmed
Feeling anxious or tense

PHYSICAL

Headaches
Vision problems, blurring, trouble seeing
Nausea
Dizziness
Light and/or noise sensitivity
Balance and coordination problems
Fatigue and having low energy

SLEEP

Sleeping more than usual
Sleeping less than usual
Trouble falling and/or staying asleep

Following a concussion, a brief period of rest is recommended for the first 24-48 hours, and then it is encouraged to become gradually active without significantly triggering your symptoms (this involves staying below cognitive and physical symptom exacerbation thresholds). Speak to a healthcare professional to determine your symptom exacerbation thresholds.

If your symptoms last longer than the natural recovery period of the first 14 days, then treatment for persistent post-concussion symptoms can be helpful. Depending on which symptoms you are still experiencing, you can benefit from one or many of the following concussion treatment techniques.

Post-Concussion Treatment

Rest and education

is a crucial aspect of concussion recovery. An extended period of rest is no longer recommended. A brief period of rest for the first 24-48 hours, followed by a gradual return to physical and cognitive activity (while keeping symptoms at a low level) is most appropriate.
Sub-threshold cardiovascular exercise

is safe and can help post-concussion recovery. Incorporating early cardiovascular exercise after a concussion has many benefits, including improved mood, cognition, sleep, and brain healing. Cardiovascular exercise can involve going for walks, going on a stationary bike, walking on a treadmill, or doing low-impact home exercises.
Manual therapy

consists of hands-on treatment that may be helpful if you are experiencing headaches, neck stiffness and tightness. Concussions usually involve a whiplash injury, so assessing and treating neck issues after a concussion can help with many post-concussion symptoms.
Balance training exercises

are used to improve steadiness so that it can feel easier to do your daily activities. Balance exercises involve integrating inputs from your visual, vestibular, and proprioceptive systems to work better together and allow you to feel more stable and in equilibrium.
Fundamental lifestyle education

is provided to promote brain health recovery by reducing overall inflammation. Education can be provided about sleep hygiene, headache and symptom management, basic nutrition and lifestyle changes, stress management, and other lifestyle areas that can impact brain health.
Cervical spine (neck) rehabilitation

involves treatment for the cervical spine (a.k.a. neck). A whiplash injury typically accompanies a concussion, so symptoms of headaches and dizziness can come from the neck. Treatment can consist of hands-on therapy and neck strengthening and stabilization exercises. Integrating them with visual and vestibular exercises is essential so that the sensory systems work in coordination.
Exercise prescription

of an individualized exercise program can be helpful to address any areas of concern and will be modified as concussion recovery progresses. These areas can be related to strength, flexibility, posture, and going back to specific hobbies and sports.
Recommendations for academic or employment accommodations

can be provided in coordination with academic or employment personnel to ensure a graduated return to school or work plan conducive to concussion recovery.
Cognitive training

combines physical and cognitive skills, such as reaction time, agility, strength, decision-making, and focus, to simulate real-life situations involving multi-tasking.
Visual and vestibular rehabilitation

addresses symptoms related to the visual and vestibular systems, which can often occur following a concussion. Symptoms can include vertigo, dizziness, blurred vision, double vision, balance issues, and oscillopsia (bouncing vision).
Referral for additional forms of care if appropriate (i.e. neuro-optometry, psychological)

may be recommended for certain areas of concern to ensure that the multiple aspects of a concussion are appropriately addressed.