Gone are the days of laying in a dark room and waiting for a concussion to “just get better.” While rest is important, we now know that doing too little can slow recovery just as much as doing too much.

Concussions can present with a wide variety of symptoms and severities. Some people experience headaches, dizziness, trouble focusing, fatigue, neck pain, or sensitivity to light and sound for days, weeks or even months. Two people can have the same injury but very different symptoms.

Often, the difference in how quickly someone recovers comes down to how the concussion is managed in the first few days and weeks.

Why Every Concussion Is Different

Concussions do not all look the same, so they should not all be treated the same.

When evaluating a concussion, we break symptoms down into five different subtypes to better understand what is driving the symptoms:

• Vestibular system (balance and dizziness)
• Vision
• Cervical Pain and Headaches
• Exercise tolerance
• Mood-related factors

Most people have a combination of these factors, but identifying the main contributors allows us to build a treatment plan that is much more targeted and effective.

A More Effective Treatment Model

Once we know what is contributing to symptoms, treatment becomes much more specific. Depending on the individual, treatment may include:

• Gradual return to exercise
• Balance and dizziness re-training
• Vision-based exercises to work on coordination and retraining of eye muscles
• Neck treatment including manual to help with headaches and movement restrictions
• Guidance for returning to work, school, or sport

The goal is not to avoid all symptoms. Instead, we help patients work to a controlled level of symptoms and then rest until they return to their baseline. This is the same process as strength training and over time, this gradually builds tolerance and helps the brain recover.

For example, if a short walk or a few minutes of computer work causes a mild increase in symptoms, that may be appropriate. The key is stopping before symptoms become severe, or linger for over an hour, and allowing the body to recover before trying again.

What To Do at Home

The best approach is to avoid the “all or nothing” mindset.

Avoid Doing Nothing — But Don’t Overdo It

Use your symptoms as a guide. Complete activities that cause a mild increase in symptoms, but avoid pushing to the point that symptoms become significantly worse or last for hours. Increased symptoms that go away within an hour is a good guideline to start with.

Keep a Consistent Sleep Schedule

Quality sleep allows the brain to heal and recover more efficiently. Try to go to bed and wake up at the same time each day.

Ease Back Into Work, School, and Daily Life

It is normal to have some symptoms when returning to work or everyday activities. You do not need to wait until you are completely symptom-free to begin easing back in.

However, there is a difference between working into symptoms and pushing through them. Mild symptoms are okay. If symptoms continue to build, take a break and allow yourself to recover.

Build Tolerance Gradually

Recovery is a process. Small increases in activity over time are much more effective than trying to do everything at once.

Key Takeaways

• Concussions do not all look the same and require an individualized approach.
• Physical therapy can help speed recovery by targeting the specific systems involved.
• Gradually exercising or returning to activity to a controlled symptom level helps build tolerance.
• Avoid the “all or nothing” approach.
• Ease back into work, school, sport, and daily life gradually.

The sooner a concussion is evaluated and treated appropriately, the sooner recovery can begin.