You’ve had a concussion. Maybe a fall, a hit at hockey, a car accident. You went to the ER, got checked for anything serious, and got sent home with a page of instructions: rest, follow up with your doctor, take it easy, maybe something for the headaches.
That’s often where the guidance stops. It shouldn’t.
The old advice
Rest completely. Avoid light, screens, noise, and physical activity. Sit in a dark room until the symptoms go away on their own.
A lot of people still get told some version of this. It’s outdated, and for a good chunk of people, it actually slows recovery down and impacts their life in many ways.
What actually helps
At The Physio Hub we have Physiotherapists with concussion training and our management of concussions is up to date with current recommendations on what actually works. We see patients from the first week through to long-term, persistent symptoms, and none of it looks like waiting it out for everything to feel better.
Understanding what’s actually happening matters first.
If you’ve been told your brain is “bruised,” that’s the wrong mental model, and it tends to make people more anxious and more cautious than they need to be. A concussion is a functional injury: a temporary disruption in how brain cells communicate and use energy. Scans like a CT or MRI usually come back normal here, which is a normal, expected finding for this kind of injury.
Cardiovascular exercise, done early, is one of the strongest tools we have.
This can start as early as the first week for a lot of people. We use something called the Buffalo Concussion Test to find a safe heart rate zone, then get people on a bike at that intensity.
Controlled activity beats total avoidance.
Some modification to work, school, or sport makes sense early on, especially for safety in contact sports. The current approach favors gradual, symptom-guided reintroduction of activity and stimulation over rest.
The neck is often part of the picture.
A lot of persistent head and neck symptoms after a concussion trace back to the cervical spine. Manual therapy, dry needling, and specific neck strengthening (especially coordination work for the deep neck muscles) can meaningfully improve symptoms and lower the odds of them dragging on. All concussion incidents will involve a whiplash associated disorder as well. This needs to be looked after.
Vision and vestibular function need a proper look.
Dizziness, visual strain, and balance issues after a concussion often trace back to the vestibular system, sometimes to BPPV specifically. There are specific tests and exercises for this, and when it’s beyond what we can manage in clinic, we work with neuro-optometry and vision therapy specialists if necessary.
Sleep and pacing matter as much as the physical side.
Planning when to work, when to rest, and rebuilding sleep hygiene affects how fast everything else improves.
What to do this week
Get seen by a physiotherapist with concussion-specific training, ideally in the first week or 2, not after symptoms have already dragged on for months. But if that is where you are already at then we will get you on the right track!
Ask what a graded return to light activity should look like for you specifically, rather than defaulting to a dark room and total rest.
If headaches, neck stiffness, or dizziness are part of your symptom picture, mention it. Those often respond well to targeted treatment and get missed if nobody asks.
Whether this is your first concussion, your third, or you’re dealing with symptoms that have hung around longer than expected, the team at The Physio Hub in Collingwood has advanced training in concussion management. Reach out and we’ll help you build an actual plan.
Contact us now to Book an Appointment