Concussion: What Is It And How Can Physiotherapy Help?

Concussion: What Is It And How Can Physiotherapy Help?

Being medically defined as a “traumatically induced transient disturbance of brain function”, concussions are mild traumatic brain injuries that occur when an incident, ranging from as small as a bump against an object protruding through the wall while walking past it to as big as an impact from a car accident, causes your brain to shake or hit the inside of the skull. While the symptoms of a concussion can vary from person to person depending on the force of the trauma and the resulting disruptions to the brain, concussions should never be underestimated or ignored as they can have notable ongoing effects on a person’s quality of life - from their mental focus and concentration to physical factors like balance and coordination, and much more.

Concussion Symptoms

For many people with mild concussions, they may not necessarily feel too different after a concussion aside from some lightheadedness, a headache or feeling a little more tired than usual, so may not realise they have sustained a concussion. Common concussion symptoms include:
  • Headache and nausea
  • Dizziness, lightheadedness, fatigue and other neurological deficits
  • Loss of consciousness or amnesiaLight and noise sensitivity
  • Balance disturbance that affects a person’s walking, balance, coordination or otherwise leads to unsteadiness
  • Behavioural changes such as irritability, unstable mood and exaggerated expressions, getting upset or emotional more easily
  • Cognitive impairments including impaired focus, lack of concentration, confusion and poor reaction time
  • Poor sleep patterns or drowsiness

Concussions: Explained

While the symptoms and effects of a concussion may seem simple and straightforward, what actually happens within the brain when a concussion occurs is quite complex. As opposed to concussions being a physical injury to the brain and its structure, they instead cause functional disturbances which alter the way the brain functions. These changes caused by a series of “neurochemical and neurometabolic events”, which can lead to reduced blood flow to the brain tissues (the cerebral blood flow), impairments in the way the mitochondria work within the brain cells to produce energy (with energy being in great demand by the brain in daily life), and changes in the way glucose is metabolised, all contributing to the concussion symptoms we see. As your brain controls all aspects of your function, both physical and mental, this explains why concussions symptoms can be widespread throughout the body and can vary greatly from person to person.

While approximately 70% of concussion sufferers recover within 14 days and 95% recover within 6 weeks (all dependent on the severity of the initial impact), the most commonly seen complication of a concussion is called post-concussion syndrome, where concussion symptoms persist for weeks to months after the initial injury, with the average symptom duration found in one study was seven months.

The Dangers Of A Second Concussion Throughout Your Recovery

When discussing concussions, it’s vital to mention second impact syndrome, where the brain suffers further impact before it has recovered from the initial concussion. This causes usually rapid and severe brain swelling, the effects of which can be far more severe than the initial trauma, even to the point of being fatal. This is most often seen in high-impact sports like boxing and rugby, where players push through and continue even after suffering head trauma. It also highlights why it’s so important to have head injuries assessed and well managed, taking the right steps to protect yourself from a secondary injury.

Physiotherapy For Concussions

While rest and taking it easy are important in the initial stages after a concussion to help your brain recover, physiotherapy is a powerful tool to support you as you return to normal activity, return to exercise, help you manage or relieve some of the symptoms you’re experiencing, and help you manage any other injuries sustained when you had your head trauma.

With returning to exercise and increasing your daily mental load following a concussion, this is an area where great care must be taken. As brain function is typically reduced following a concussion, going too hard too fast and suddenly or significantly increasing the blood flow to the brain can actually aggravate concussion symptoms. This means that repetitively overloading the body and brain when it comes to physical activity may actually prolong your recovery and lead to the persistence of your symptoms. Likewise, mental exertion can aggravate symptoms after a concussion. Graded mental task and activity modification at home and work may be needed after a concussion. Physiotherapists can help with both and do physical activity testing to ascertain and give advice on a safe level of physical activity to return to.

With your vision and balance often affected in concussions, alongside how your vestibular system communicates, we can also offer targeted physiotherapy to retrain these areas and parts of the brain to best support your balance and coordination, reduce your risk of falls, and the like.

Additionally, for many concussion sufferers, they may have suffered a neck injury or whiplash at the same time as the trauma that caused their concussion. This can lead to ongoing neck pain and tension, which can cause a chain reaction to the shoulders when left unaddressed. Specialising in musculoskeletal pain and rehabilitation, this is where we use a range of therapies to decrease pain and discomfort, and promote cervical and thoracic spine mobility.

Depending on the length of your concussion recovery, this much-needed ‘time off’ can lead to reduced muscle strength and physical endurance. This will also be incorporated into your program to help you return to daily life (including sport) safely. Another big part of what we do is centred around education - equipping you with everything you need to know to have an optimal, safe and fast recovery while helping you avoid complications and other issues.


  • You don’t have to physically knock your head to have a concussion. If a hit to your body (such as from a tackle) is forceful enough to sufficiently accelerate the head, you can suffer a concussion too.
  • Concussions aren’t structural (physical) injuries that need repair like when muscles get damaged, but are functional and metabolic injuries that temporarily alter the way your brain works.
  • It is crucial to avoid secondary impact or trauma to the brain while recovering from a concussion to avoid second impact syndrome
  • Some people will develop post-concussion syndrome, leading them to experience concussion symptoms for many months. You should be assessed and take the right precautions if you fall into this category.
  • Attempting to return to sport or daily life too quickly following a concussion may aggravate your symptoms further. Always follow a controlled return to sport and activity program - including gradually increasing your mental load.