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Concussion Rehab - How a Physiotherapist Can Help

Concussion Rehab - How a Physiotherapist Can Help

A concussion is a mild traumatic brain injury that is typically caused by a blow to the head. At PhysioWorks in Manotick, our physiotherapists offer concussion rehabilitation services to help you feel like yourself again.


What is a Concussion?

A concussion is a mild traumatic brain injury (mTBI) that is generally (but NOT necessarily) caused by a blow to the head. Following a concussion, there is a period of change in brain function that may last anywhere from 10-14 days or more, as suggested by recent Canadian research. A concussion cannot be seen on routine x-rays, CT scans, or MRIs. 

Concussions do not always include a loss of consciousness. Symptoms of a concussion often start to improve within 10-14 days. In some cases it can take weeks or months to heal. In addition, repeated concussions may take even longer.

How Can a Physiotherapist help with a concussion?

A physiotherapist can offer support and education to ensure the best possible outcome following a concussion. It is highly recommended that you seek physiotherapy treatment as soon as possible.  

What will the physiotherapist do at my first assessment? 

The physiotherapist will perform an initial assessment, including a full history of your injury/accident, any past medical history, and detailed questions about your current symptoms. 

The physiotherapist will then complete a physical evaluation of your neck and upper back in order to rule out any injuries to these areas.

If the physiotherapist feels you are at the proper stage of healing, she will begin an assessment of the visual and vestibular systems (your vision and balance). 

Canadian Stats on Concussions

  • 64% of visits to hospital emergency departments among 10-18 year-olds are related to participation in sports, physical activity and recreation.
  • Among children and youth (10-18 years) who visit an emergency department for a sports-related head injury, 39% were diagnosed with concussions, while a further 24% were possible concussions.
  • Football, soccer and hockey have all shown a greater than 40% increase in rates of reported head injury (relative to other injuries) between 2004 and 2014 for children and youth.
After the physiotherapist explains the findings you will receive clear instructions to ensure the best recovery. 

What kinds of treatments do physiotherapists do for concussions?

Physiotherapy treatments are geared to each individual’s specific needs based on the mechanism of injury, injury type, and assessment findings. They may include manual therapy to restore any joint problems in the neck, upper back and shoulder area, exercises to regain mobility, strength and balance, acupuncture, and visual motor and vestibular retraining exercises to restore normal brain function.

How long will it take to recover from my concussion?

Every individual is different. The therapist will support you throughout your recovery process and will progress your treatments as your condition allows.

What kind of training do your physiotherapists have?

We have physiotherapists on staff with specific experience and training in the management of concussions, manual therapy, acupuncture, dry needling, visual motor integration training and vestibular rehabilitation therapies.

Warning Signs & Symptoms of a Concussion

Symptoms of a concussion can appear immediately or a few days after the injury occurred. It is typical to experience one or more of the following symptoms:


  • Dizziness
  • Nausea
  • Vomiting
  • Headache
  • Pressure in the head
  • Imbalance
  • Sensitivity to light
  • Neck pain
  • Seizure
  • Blurred vision
  • Loss of consciousness


  • Noise sensitivity
  • Fatigue/low energy
  • Confusion
  • Drowsiness
  • Difficulty concentrating
  • Amnesia


  • Insomnia
  • Poor sleep quality
  • Sleeping too much


  • Irritable
  • Nervous/anxious
  • Sadness
  • Feeling of being “not right” or in a fog

Activities linked to Concussions

  • Fall or Fight
  • Playground injury
  • Car/bike accident
  • Sports-Related Injury

Tips for Those Suffering from a Concussion

Rest is extremely important after a concussion because it helps the brain to heal. If you have sustained a concussion, get plenty of sleep at night and rest during the day.

Avoid activities that are physically demanding or that require a lot of concentration, which can worsen your symptoms. Return to normal activities gradually, and check with your health care providers about when it is safe to drive a car, ride a bike, or operate equipment.

If you are working, consider speaking with your employer about a gradual return to work, and modifying your work activities if necessary. It is also important to avoid alcohol and only take drugs approved by your doctor. Avoid sustained computer or personal digital device use, which could cause headaches, dizziness, and other post-concussion symptoms.

Tips for Parents and Caregivers

If you suspect your child has sustained a concussion, remove the child from play immediately and watch for possible symptoms to evolve. If symptoms of a concussion are seen, take your child to a heath care professional.

Upon discharge from medical care follow the instructions of the professional. Rest is key, but not just physical rest or pacing of activities, but more importantly cognitive rest.  Activities that require concentration/attention may exacerbate post-concussion symptoms and delay recovery. 

Ensure that the child is free from symptoms for 24 hours before allowing a gradual return to school, sports, electronic device use, etc. One of the most common problems during recovery is returning to full activities too soon.

Consider setting up a meeting with the principal, your child's teacher(s), resource teachers and counsellors to discuss the best return to school plan for your child.  This may include rest breaks throughout the day; less homework or more time to complete tests/projects; reducing time writing or looking at a computer screen; and/or receiving help with completing schoolwork.

Once your child has successfully returned to a full day of school they may begin to focus on returning to sports.

Tips for Coaches

If you suspect a player has sustained a concussion, ensure that the player is continuously monitored until a parent or responsible adult is available to take them to a doctor. Watch for red flags and signs and symptoms of a concussion.

Do not give the player any medications unless directed by a doctor. There is evidence that some medications can worsen concussion symptoms and increase potential risks associated with brain injuries.

Concussed athletes need to be progressed properly and continually assessed for any symptoms that may arise with increased movement, activity, or exertion. The overall goal is to properly manage and progress the athlete towards return to his/her sport as safely as possible and to reduce risks of further and worse consequences.

Each athlete is different, as is each concussion. Treat the symptoms that the athlete presents with, and tailor the plan of care to their needs.  Athletes need to be challenged in ways the average person does not, so when appropriate you can challenge them to try to provoke symptoms, always erring on the side of caution.

An excellent concussion response tool can be found here.

Are you experiencing ongoing symptoms of concussion?

To book a consultation, contact our office today. Our physiotherapists are ready to help you feel more like yourself again!

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( | (Concussion in Sports – Mike Reinold) |

Ready to get started on the path to better mobility?

(613) 692-1847