Concussion Rehabilitation Program
Specialized Physical Therapy for Concussion and Persistent Post-Concussion Symptoms
A concussion can affect far more than just headaches. After even a mild head injury, many people experience dizziness, brain fog, difficulty concentrating, visual symptoms, neck pain, balance problems, fatigue, motion sensitivity, or trouble returning to work, school, exercise, or daily life.
While some people recover within a few weeks, others continue to have symptoms for months. If you are still dealing with concussion symptoms, you do not have to wait it out alone.
Our concussion rehabilitation program is designed to identify the specific systems contributing to your symptoms and create a personalized plan to help you recover safely and efficiently. We monitor your progress with objective measures to help grade recovery.
What Is a Concussion?
A concussion is a mild traumatic brain injury that temporarily affects how the brain functions. You do not have to lose consciousness to have a concussion.
Common concussion symptoms include:
- Headache
- Dizziness or vertigo
- Brain fog
- Difficulty concentrating or remembering
- Light or noise sensitivity
- Nausea
- Fatigue
- Neck pain
- Balance problems
- Motion sensitivity
- Visual strain or difficulty focusing
- Anxiety or feeling “off”
Persistent Post-Concussion Symptoms
ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) is a complex neurologic and metabolic illness that causes profound fatigue, reduced function, sleep disturbance, cognitive symptoms, pain, and exercise intolerance.
The hallmark feature of ME/CFS is post-exertional malaise (PEM): a worsening of symptoms after physical, mental, emotional, or sensory activity. Unlike typical fatigue, PEM may not occur immediately. Symptoms often worsen 12–48 hours after activity and can last for days or even weeks.
Persistent symptoms may be related to:
- Vestibular dysfunction
- Problems with eye movements or visual processing
- Neck injury or whiplash
- Migraine
- Balance dysfunction
- Autonomic nervous system dysfunction
- Exercise intolerance
- Anxiety, stress, or nervous system sensitization
The good news is that these issues are often very treatable when they are identified correctly.
Our Treatment Philosophy
Every concussion is different.
Rather than using a generic approach, we perform a detailed evaluation to determine what is actually driving your symptoms. We then create an individualized treatment plan based on your specific findings.
Treatment is designed to help you:
- Reduce dizziness and headaches
- Improve balance and confidence
- Restore eye tracking and visual tolerance
- Address neck pain and stiffness
- Improve exercise tolerance
- Return to work, school, sports, and daily activities
- Reduce symptom flare-ups
We carefully progress treatment so that you are challenged—but not overwhelmed.
What Makes Our Concussion Program Different?
In addition to specialized physical therapy, we believe concussion recovery works best when there is close communication between providers.
We maintain strong relationships with many of the leading concussion specialists including neurologists, physiatrists, neuro-ophthalmologists, and speech language pathologists. When appropriate, we collaborate closely with your medical team to ensure you receive the right combination of care.
This collaborative approach can be especially helpful if you need:
- Additional medical evaluation
- Medication management
- Neuro-ophthalmology or vision care
- Headache or migraine treatment
- Specialist testing or imaging
- A coordinated return-to-work or return-to-sport plan
1. Detailed Vestibular and Oculomotor Evaluation
Many persistent concussion symptoms come from problems with the vestibular system and the way the eyes and brain work together.
We assess:
- Dizziness and vertigo
- Balance and gait
- Visual motion sensitivity
- Eye tracking
- Convergence
- Saccades and smooth pursuit
- Vestibulo-ocular reflex (VOR)
- Motion sensitivity
2. Cervical Spine and Whiplash Assessment
Neck injuries often occur along with concussion and can contribute to:
- Headaches
- Dizziness
- Brain fog
- Neck pain
- Feeling “off”
Treatment may include:
- Manual therapy
- Postural retraining
- Gentle strengthening
- Mobility exercises
- Deep neck flexor and cervical stability work
3. Gradual Return to Activity
We help guide a safe return to:
- Exercise
- Work
- School
- Sports
- Screens and visual activity
- Busy environments and travel
For many patients, this includes a carefully monitored aerobic exercise program designed to improve symptoms without causing a setback.
When appropriate, we utilize the Buffalo Concussion Treadmill Test (BCTT) or Buffalo Concussion Bike Test to identify your symptom threshold and guide a safe, individualized exercise program.
These protocols allow us to:
- Determine the heart rate and activity level that triggers symptoms
- Create a structured aerobic program below your symptom threshold
- Monitor progress over time
- Progress exercise safely and objectively
This approach is especially helpful for patients with persistent symptoms, exercise intolerance, autonomic dysfunction, or difficulty returning to activity.
4. Treatment for Persistent Dizziness and Motion Sensitivity
If you still feel dizzy, off-balance, motion-sensitive, or visually overwhelmed weeks or months after a concussion, vestibular rehabilitation may help.
Treatment may include:
- Vestibular exercises
- Habituation exercises
- Balance training
- Gaze stabilization
- Visual-vestibular integration
- Desensitization to motion and busy environments
Who This Program Is For
This program may be right for you if you:
- Recently had a concussion
- Still have symptoms weeks or months later
- Have dizziness, headaches, or balance problems
- Feel worse with screens, reading, driving, or busy environments
- Have neck pain after a concussion or whiplash injury
- Want help returning to exercise, work, or sports safely
- Have been told your imaging is normal, but you still do not feel normal
Frequently Asked Questions
How soon after a concussion should I start physical therapy?
Many people benefit from evaluation within the first 1–2 weeks if symptoms are not improving. You do not need to wait months to seek help.
What if my CT scan or MRI was normal?
That is very common. Standard imaging is often normal after a concussion, even when symptoms are significant.
Will treatment make my symptoms worse?
Some exercises may temporarily bring on mild symptoms, but treatment should not leave you significantly worse. We carefully dose treatment to stay within an appropriate level.
Can you help if I had my concussion months ago?
Yes. Many people improve even if symptoms have been present for months or longer.
