CONDITION

Concussion Recovery

A Modern Approach to Post-Concussion Symptoms

Dr. Austin Van Poole
Written by Dr. Austin Van Poole, DC
Active Rehab Chiropractor
6 min read

A Modern Approach to Post-Concussion Symptoms

If you’ve recently hit your head either during sports, a fall, a car accident, or an everyday activity, you may be dealing with symptoms that feel confusing, frustrating, or slow to improve.

Headaches. Dizziness. Brain fog. Fatigue. Exercise intolerance.

Here’s the most important thing to know:

Recovery from a concussion isn’t about doing nothing. It’s about doing the right things at the right time.

At Radius Physical + Sports Rehab, I focus on evaluating and treating the systems commonly affected after a concussion to help patients recover safely and efficiently.

What Happens After a Concussion?

A concussion is not simply a bruise to the brain. It’s a temporary disruption in how the brain and nervous system function.

I often describe it this way:

It’s like a sudden electrical and chemical surge that temporarily throws your system out of balance.

After an injury, the body may experience changes in:

  • Blood flow regulation

  • Energy production

  • Nervous system control

  • Balance and coordination

  • Vision and eye tracking

  • Heart rate and exercise tolerance

  • Emotional regulation

Even when imaging is normal, these systems can remain disrupted — which is why symptoms may persist.

The Metabolic Mismatch: Why You Feel Worse With Activity

One of the key concepts in recovery is metabolic dysfunction.

After a concussion:

  • The brain’s energy demand increases
  • But its ability to produce energy decreases

This creates a temporary “energy crisis,” which explains:

  • Fatigue
  • Symptom flare-ups with exertion
  • Difficulty tolerating exercise
  • Feeling “drained” after mental or physical activity

The good news: this system responds very well to guided, progressive activity.

Common Post-Concussion Symptoms

Symptoms may appear immediately or develop within 24–72 hours.

Physical symptoms:

  • Headache
  • Dizziness or balance problems
  • Nausea
  • Light or noise sensitivity
  • Fatigue

Cognitive symptoms:

  • Brain fog
  • Difficulty concentrating
  • Slower processing

Emotional symptoms:

  • Irritability
  • Anxiety
  • Mood changes

If symptoms persist or worsen with activity, targeted evaluation can help identify what systems need support.

Why Early Evaluation Matters

Most concussions improve within weeks, but symptoms can linger when underlying issues are not addressed.

Early evaluation helps identify:

  • Exercise intolerance (autonomic dysfunction)
  • Vision or eye-tracking problems
  • Vestibular (balance) deficits
  • Cervical spine involvement
  • Nervous system dysregulation

At Radius, we don’t just tell you to rest — we determine what your system can tolerate and how to safely rebuild capacity.

How We Evaluate Post-Concussion Symptoms

Vestibular Ocular Motor Screening (VOMS)

This assessment looks at:

  • Eye tracking

  • Convergence (eye coordination)

  • Motion sensitivity

  • Symptom response to visual tasks

Because the vision and balance systems are commonly affected, this helps guide targeted treatment.

Buffalo Concussion Treadmill Test (BCTT)

This evidence-based test helps us:

  • Identify your symptom-limited heart rate threshold
  • Measure exercise tolerance
  • Assess autonomic nervous system function
  • Establish safe cardiovascular training levels

This allows us to prescribe movement as treatment, not avoidance.

Modern Concussion Care: Movement Matters

Old recommendations focused on weeks of dark-room rest.

Current research supports:

  • 24–48 hours of relative rest
  • Followed by gradual return to activity
  • Structured, symptom-guided exercise

Prolonged inactivity can actually slow recovery.

How We Treat Post-Concussion Symptoms

Treatment is individualized based on your evaluation.

Targeted Cardio (Primary Treatment)

Using your BCTT results, we prescribe:

  • 20–30 minutes of daily cardiovascular exercise
  • At a specific, symptom-limited heart rate

This helps:

  • Restore blood flow regulation
  • Improve energy tolerance
  • Reduce fatigue
  • Speed recovery

Vestibular & Visual Rehabilitation

If VOMS reveals deficits, we prescribe specific exercises to address:

  • Eye tracking
  • Convergence
  • Motion sensitivity
  • Dizziness

Cervical Spine Treatment

Neck dysfunction is a common and often overlooked contributor to symptoms.

We assess and treat:

  • Upper cervical mobility
  • Muscle tension
  • Cervicogenic headaches
  • Neck-related dizziness

Addressing the cervical spine frequently reduces headache and dizziness significantly.

Advanced Training in Concussion & Brain Injury Care

At Radius Physical + Sports Rehab, our concussion care approach is built on current research and hands-on clinical collaboration.

In November 2025, our TBI treatment team traveled to the University of Nevada, Reno to work directly with experts in the Neuromechanics Laboratory. During this immersive training, we received advanced clinical education and practical guidance from:

  • Nicholas Murray, PhD, CIC Director of the Neuromechanics Laboratory and Chair of the MS Kinesiology Program
  • Zoe Haddox, LAT, ATC University of Nevada, Reno School of Public Health

This experience focused on the latest evidence in:

  • Concussion and mild traumatic brain injury recovery
  • Autonomic nervous system dysfunction
  • Exercise tolerance testing and prescription
  • Return-to-sport and return-to-activity decision-making
  • Objective assessment of post-concussion symptoms

What this means for you:

Your care at Radius is guided by the same evidence-based principles being studied and applied in leading concussion research settings — not outdated rest-only approaches.

We use this advanced training to help patients recover safely, restore function, and return confidently to school, work, sport, and daily life.

What About Persistent Symptoms?

If symptoms last longer than expected, this is often referred to as post-concussion syndrome (PCS).

This does not mean permanent damage.

Persistent symptoms often reflect:

  • Autonomic dysregulation
  • Exercise intolerance
  • Vestibular dysfunction
  • Cervical spine involvement
  • Nervous system sensitivity

With targeted care, even long-standing symptoms can improve.

When Should You Schedule an Evaluation?

Consider an evaluation if:

  • You’ve had a recent head or neck injury
  • Symptoms last longer than a few days
  • Exercise worsens symptoms
  • Headaches, dizziness, or brain fog persist
  • Recovery feels stalled
  • You want guidance returning to sport, work, or activity

Early, active care typically leads to faster recovery.

Who We Help

Dr. Austin Van Poole provides focused evaluation and treatment for post-concussion symptoms at Radius Physical + Sports Rehab.

We work with:

  • Athletes
  • Active adults
  • Students
  • Motor vehicle accident patients
  • Anyone struggling with lingering symptoms after a head or neck injury

Don’t Just Wait It Out

Most people are told to rest and hope symptoms improve.

But recovery improves significantly when we:

  • Identify exercise thresholds
  • Restore nervous system regulation
  • Address vision and balance deficits
  • Treat cervical spine dysfunction
  • Reintroduce movement safely

The sooner the right systems are addressed, the smoother recovery tends to be.

Ready to Start Your Recovery?

If you’re experiencing ongoing symptoms after a head or neck injury, we can help guide your recovery.

Book online to see available appointments, if you don’t see a time that works for you, Call or text: (530) 955-0065 and let our front desk work their scheduling magic!

Dr. Austin Van Poole
About the author
Dr. Austin Van Poole, DC
Active Rehab Chiropractor

Dr. Austin Van Poole is a compassionate and results-driven chiropractor based in Nevada City, California, focused on musculoskeletal rehabilitation, soft tissue therapy, and active care for injury recovery and performance enhancement. Known for his empathetic approach and dedication to patient-centered care, Dr. Van Poole is passionate about helping individuals reduce pain, regain function, and reclaim the active lives they love. Whether treating acute injuries, chronic pain, or sports-related conditions, he delivers personalized care plans focused on movement optimization and long-term wellness.

More from Dr. Austin Van Poole →

Frequently Asked Questions

Common questions about concussion recovery.

What is a concussion?

A concussion is a traumatically induced transient disturbance of brain function. It is a form of mild traumatic brain injury (mTBI), and the two terms are often used interchangeably. It reflects a temporary change in how the brain works rather than a structural injury, which is why symptoms can occur even when imaging is normal.

What are the common symptoms of a concussion?

Concussion symptoms fall into several groups: physical (headache, dizziness, balance difficulty, nausea, visual changes, light or noise sensitivity, fatigue), cognitive (confusion, memory problems, mental fogginess, difficulty concentrating), emotional (irritability, mood changes), and sleep changes. Headache is the most common symptom. Symptoms may not appear right away — developing symptoms within hours to days after the injury can still indicate a concussion.

How long does it take to recover from a concussion?

Recovery timing varies and no test definitively predicts it. Approximately 90% of concussion symptoms are transient and typically resolve within about 10 to 14 days, and most injured athletes clinically recover within a month. When symptoms persist much longer — commonly beyond three months — this may be called post-concussion syndrome, which does not mean permanent damage; most people with it eventually recover, though how long varies.

Is rest or activity better after a concussion?

Current guidance favors a balance, not prolonged rest. A short period of relative (not strict) rest is recommended for roughly the first 24 to 48 hours, which includes reducing screen time; light activity such as walking is generally permitted as long as it does not provoke symptoms. There is no longer a role for extended strict rest, and recovery then proceeds with gradual, symptom-guided return to activity.

When can someone return to sport after a concussion?

Return to sport follows a graduated, stepwise strategy carried out alongside return to learn and supervised by a qualified healthcare professional. Published frameworks describe about six steps — from symptom-limited activity through light and moderate aerobic exercise, sport-specific training, non-contact and then contact practice, to competition. Each step typically takes at least 24 hours, medical clearance is required before contact steps, and an athlete should not return to play until cleared.

When should I seek urgent or emergency care after a head injury?

Seek emergency evaluation if a head injury is followed by warning signs of a more serious injury: severe or worsening headache, seizures, repeated vomiting, focal neurological deficits, loss of consciousness, or deteriorating or worsening mental status or symptoms. Any loss of consciousness, however brief, warrants prompt attention. When in doubt after a head injury, contact a healthcare provider, because some head injuries are more serious than a concussion.

How can physical therapy help concussion recovery?

Physical therapists help guide a safe, personalized recovery program and are part of a multidisciplinary concussion team. They can assess and treat balance and vestibular (dizziness) problems, examine the neck, which can occur alongside a concussion and contribute to headache and dizziness, and rebuild strength and exercise tolerance without worsening symptoms. Care increasingly emphasizes early, symptom-guided, paced progressive exercise and a gradual, safe return to activity.

Sources

The information on this website is general education about musculoskeletal and movement-related conditions. It is not medical advice or a diagnosis, and it cannot tell you what is causing your symptoms. Reading it is not a substitute for an in-person evaluation, and booking a visit does not confirm that your condition is right for our care until a provider has examined you. This information cannot identify every condition, and some urgent problems can feel like musculoskeletal pain. If your symptoms are severe or getting worse, or you are unsure how urgent they are, contact your physician, call 911, or go to the nearest emergency room. When in doubt, seek emergency care.

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