Concussion Management and Rehabilitation

Concussion refers to a mild traumatic injury to the brain that may occur with or without loss of consciousness.

While concussions can occur from direct impact, many occur without any contact to the head. A sudden abrupt stop, such as a fall to the ground or two players running directly into one another without hitting heads, can cause a concussion.


  • Twenty percent of the estimated 1.7 million head injuries that occur in the United States each year are sports-related
  • In high school athletes, more than 50 percent have reported a history of concussion and more than 33 percent of collegiate athletes have reported a history of multiple concussions
  • Approximately 10 percent of sport-related injuries require hospitalization
  • Those who have had a head injury are two to four times more likely to have another head injury 
  • The majority of concussion patients recover quickly with rest, but as many as 33 percent may have continued symptoms

Post-concussion Syndrome (PCS)

Post-concussion syndrome (PCS) can develop after a single injury event. The symptoms of PCS include prolonged fatigue, headache, dizziness, irritability, insomnia, and difficulty with concentration or memory, as well as intolerance to cardiovascular exercise.

Traditionally, treatment for PCS has been to rest, both from physical and cognitive activity, until symptoms are resolved. But recent research shows rehabilitation as an effective way to address the symptoms of a concussion and get you back to your sports or activities faster.

Rehabilitation Evaluations

Evaluations may be performed 14 days or later following the injury and include a thorough assessment of the whole athlete, with special consideration given to aerobic exercise tolerance, whiplash-like cervical spine dysfunction and problems with vision and balance. Graded exercise testing combined with a thorough examination is performed.

Treating Post-concussion Syndrome

Our therapists have advanced training in concussion management and use evidence-based programs that are currently used in the NFL, NHL and other professional sports.

Treatment is specific to each patient but often includes elements of closely monitored sub-symptom aerobic exercise, manual therapy and therapeutic exercise for conditioning, spinal dysfunction and balance impairments. Progressive aerobic exercise has been shown to be safe and effective in improving function in patients with PCS.

Most patients are prescribed an exercise program to be performed five to six days per week, with close monitoring of exercise intensity using a heart rate monitor. Exercise intensity is determined during the evaluation, and maintained at sub-symptom levels. Cervical range-of-motion, eye movement and balance exercises may be prescribed, as well.

As patients make progress, exercise tolerance is re-evaluated and rehabilitation programs are fine-tuned to meet the demands of returning to full function and sport. Additionally, elements of injury prevention, such as movement pattern training and strengthening exercises, are incorporated as individuals return to pre-injury activities.

Please call (603)733-5921 with any questions or to schedule your evaluation.

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