Concussion Care Matters: What to Do After a Concussion
After a concussion, many people are told to "rest and wait it out."
While a short period of relative rest can be appropriate immediately after an injury, concussion recovery is not simply a matter of staying in a dark room until symptoms disappear.
Some people recover relatively quickly. Others continue to experience headaches, dizziness, brain fog, fatigue, visual problems, sleep disruption, or other symptoms that interfere with school, work, exercise, and everyday life.
If you're not feeling like yourself after a concussion, you don't necessarily have to wait and hope things improve on their own.
Understanding what a concussion is, recognizing your symptoms, and getting the right support can be an important part of recovery.
What Is a Concussion?
A concussion is commonly used interchangeably with the clinical term mild traumatic brain injury (mTBI). It is a traumatically induced disruption in normal brain function.
The American Congress of Rehabilitation Medicine defines mild traumatic brain injury as a traumatically induced physiological disruption of brain function, manifested by at least one of the following:
Any period of loss of consciousness.
Any loss of memory for events immediately before or after the accident.
Any alteration in mental state at the time of the accident, such as feeling dazed, disoriented, or confused.
Focal neurological deficits that may or may not be transient.
For an injury to meet the definition of mild traumatic brain injury, the severity does not exceed:
Loss of consciousness of approximately 30 minutes or less
An initial Glasgow Coma Scale (GCS) score of 13–15 after 30 minutes
Post-traumatic amnesia (PTA) of no more than 24 hours
What Does That Mean in Everyday Language?
In everyday terms, a concussion can happen when an injury causes the brain to function differently than it normally does.
You do not have to lose consciousness to have a concussion.
You also do not have to hit your head directly. A forceful impact to the body can cause the head and brain to move rapidly enough to produce a concussion.
Someone may describe feeling:
"Out of it"
Dazed
Confused
Foggy
Not quite like themselves
And symptoms may not always be immediately obvious.
What Are the Signs and Symptoms of a Concussion?
Concussion symptoms can affect multiple areas of functioning. Some people experience primarily physical symptoms, while others notice changes in thinking, mood, sleep, or several areas at once.
Physical Symptoms
Headache
Dizziness
Balance problems
Neck pain
Nausea
Light sensitivity
Noise sensitivity
Visual problems
Fatigue
Cognitive Symptoms
Feeling foggy or "out of it"
Difficulty concentrating
Trouble with memory
Difficulty finding words
Feeling mentally slowed down
Difficulty processing information
Emotional Symptoms
Irritability or becoming easily angered
Feeling more emotional than usual
Crying more easily
Anxiety
Changes in mood
Increased frustration
Sleep Symptoms
Sleeping more than usual
Sleeping less than usual
Difficulty falling asleep
Difficulty staying asleep
Changes in sleep quality
Symptoms can change throughout the day and may become more noticeable as you return to normal activities.
Does Everyone Recover From a Concussion in the Same Amount of Time?
No.
Some people recover relatively quickly, while others experience symptoms for longer.
There is no single recovery timeline that applies to every person with a concussion. Recovery can be influenced by many factors, including:
The individual's symptoms
Previous concussion history
Sleep
Physical activity tolerance
Visual or vestibular dysfunction
Cervical or neck dysfunction
Cognitive demands
Emotional health
Other medical factors
This is one reason concussion recovery should be individualized rather than based solely on a predetermined number of days.
Do I Need Complete Rest After a Concussion?
A short period of relative rest is generally recommended immediately following a concussion.
However, prolonged complete inactivity is not usually the goal of recovery.
Current concussion management generally emphasizes gradually returning to everyday activities and physical activity as tolerated, while avoiding activities that create significant symptom exacerbation or put the person at risk for another injury.
This may include gradually returning to:
Normal daily activities
School
Work
Walking and other light physical activity
Exercise
Social activities
The appropriate level of activity will depend on the individual.
Why Can Too Much Activity Be a Problem?
Although prolonged inactivity may not be helpful, pushing through significant symptoms isn't necessarily the answer either.
Some people find that physical or cognitive activity causes symptoms to increase. Others may tolerate one type of activity but struggle with another.
For example, you may be able to walk comfortably but become symptomatic after working on a computer. Or you may tolerate reading but develop dizziness when exercising.
The goal is to find an appropriate level of activity and gradually build tolerance over time.
If an activity consistently causes significant symptoms, your healthcare provider can help determine whether the intensity, duration, or type of activity needs to be modified.
When Should I Seek Additional Care?
Not everyone needs extensive concussion rehabilitation.
However, if symptoms are not improving, are interfering with your normal activities, or are making it difficult to return to school, work, exercise, or other important parts of your life, it may be appropriate to seek additional evaluation.
You may benefit from a more comprehensive assessment if you are experiencing persistent:
Headaches
Dizziness or balance problems
Visual symptoms
Brain fog
Memory or concentration problems
Fatigue
Sleep problems
Exercise intolerance
Neck pain
Emotional changes
A concussion specialist can help determine what may be contributing to your symptoms and whether rehabilitation is appropriate.
What Does Concussion Rehabilitation Look Like?
There is no single treatment that works for every concussion.
Because concussion can affect multiple systems, rehabilitation should be based on the individual's symptoms and clinical findings.
For example:
Dizziness or Balance Problems
A patient experiencing dizziness, imbalance, or motion sensitivity may benefit from vestibular rehabilitation.
Visual Symptoms
Blurry vision, difficulty focusing, eye fatigue, or difficulty tolerating visual stimulation may require assessment of the visual and oculomotor systems and, when appropriate, referral to a vision specialist.
Neck Pain or Headaches
Cervical dysfunction can contribute to headaches, dizziness, and other symptoms following concussion. Physical therapy may be appropriate when the cervical spine is contributing to symptoms.
Cognitive Difficulties
Someone struggling with memory, concentration, organization, or mental fatigue may benefit from cognitive rehabilitation with an appropriately trained speech-language pathologist or other rehabilitation professional.
Exercise Intolerance
If physical activity consistently triggers symptoms, a clinician can evaluate exercise tolerance and develop an individualized approach to gradually increasing activity.
Multiple Symptoms
Many patients experience symptoms across several systems. In these cases, a multidisciplinary approach may be appropriate.
Why Early Evaluation Can Matter
One of the biggest challenges with concussion is knowing when symptoms are part of a normal recovery process and when additional support may be helpful.
You don't necessarily need to wait until symptoms become severe before seeking guidance.
Early evaluation can help identify the factors contributing to symptoms and provide a clearer path forward.
That doesn't mean every person with a concussion needs immediate intensive rehabilitation.
It means that if you're struggling, you don't have to simply "wait and see" indefinitely.
Be Thoughtful About Who You Choose for Concussion Care
Concussion rehabilitation is a specialized area of healthcare.
Different symptoms may require different types of evaluation and treatment, so it's important to work with providers who have appropriate training and experience in concussion management.
Depending on your needs, your care team may include:
Physicians
Physical therapists
Athletic trainers
Speech-language pathologists
Neuro-optometrists
Psychologists or other mental health professionals
Neurologists
Other rehabilitation specialists
Ask questions about your provider's experience treating concussion and the specific symptoms you are experiencing.
A good concussion care plan should be based on your individual presentation and informed by current evidence—not a one-size-fits-all treatment approach.
You Don't Have to Navigate Recovery Alone
A concussion can be frustrating, particularly when you're doing everything you can to recover but still don't feel like yourself.
If symptoms are interfering with your daily life, there may be more that can be done than simply waiting for them to go away.
A comprehensive evaluation can help identify which systems may be contributing to your symptoms and whether targeted rehabilitation could be appropriate.
The goal isn't to rush recovery.
The goal is to understand what's happening, develop an individualized plan, and help you safely return to the activities that matter to you.
Need Help With Persistent Concussion Symptoms?
Colorado Concussion Clinic provides comprehensive concussion evaluation and rehabilitation for patients experiencing a range of symptoms following concussion.