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Concussions and Physical Therapist Care

Concussions and Physical Therapist Care

Posted on August 11, 2014

ConcussionsBy Stephanie Penny, PT, DPT, OCS

Concussions have received a great deal of attention recently for the long-term problems associated with this injury. The Centers for Disease Control estimate that in sports alone, more than 3.8 million concussions occur each year. Recent scientific evidence highlights the need for proper care to prevent complications from concussion.

 A concussion, typically caused by a direct blow to the head, is a common sports injury in high-contact sports such as football, hockey, soccer and basketball. The injury can have severe short- and long-term effects, causing memory problems for up to a week and with multiple concussions, increasing the danger of developing dementia, Parkinson’s disease and depression. Children and younger athletes are particularly susceptible, taking up to twice as long to recover than older athletes.

If you think you might have a concussion:
• Seek medical care immediately
• Avoid any additional trauma to your head—don’t engage in any activity that carries a risk of head injury
• Limit activities of all kinds, including school and work.

How Can a Physical Therapist Help?
Physical therapists can evaluate and treat many problems related to concussion. Because no 2 concussions are the same, the physical therapist’s examination and individualized treatment program is essential.

Help Stop Dizziness and Improve Your Balance
If you have dizziness or difficulty with your balance following a concussion, working with a physical therapists who treats vestibular dysfunction may help. The vestibular system, which includes the inner ear and its connections with the brain, is responsible for sensing head movement, keeping your eyes focused when you move your head, and helping you keep your balance. Your physical therapist can provide specific exercises and training to reduce or stop dizziness and improve balance and stability.

Reduce Headaches
Your physical therapist will examine you for neck problems following a concussion for possible injuries to your spine. Neck injuries can cause headaches and contribute to some forms of dizziness.

As symptoms due to concussion improve, your physical therapist will help you resume physical activity gradually, to avoid overloading the brain and nervous system that have been compromised by concussion.

Return to sports and recreational activities:
When vestibular and headache symptoms pass, or if you quickly recover from cognitive symptoms, you may be allowed to participate in certain controlled physical activities.   Your physical therapist will access your muscle strength, range of motion, balance and coordination. These measurements will allow your therapist to:

  • Reintroduce the vestibular system to dynamic activity in a careful and deliberate way
  • Safely increase your heart rate through a variety of regimens, such as:
     Cardiovascular exercise
     Strength training
     Agility drills
  • Adjust the treatment regimen according to your progress
  • Tailor therapy to your particular sport


Alsalaheen BA, Mucha A, Morris LO, et al. Vestibular rehabilitation for dizziness and balance disorders after concussion. J Neurol Phys Ther. 2010;34:87–93. Article Summary on PubMed.
McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on Concussion in Sport 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Clin J Sport Med.2009;19:185–200. Article Summary on PubMed.