New Concussion Treatments Go Beyond Just Resting in a Dark Room

For years, the standard advice for concussion recovery was simple: rest in a dark, quiet room until symptoms resolve. While well-intentioned, this approach left many people isolated, anxious, and experiencing prolonged symptoms that seemed to have no end in sight.

Today, we know better. Modern concussion management has evolved dramatically, and research now shows that the old "cocoon therapy" approach may actually delay recovery for many patients.

Why Complete Rest Isn't the Answer

The brain is remarkably adaptable, but it needs appropriate stimulation to heal effectively. Complete sensory deprivation and strict rest can lead to:

• Deconditioning of the cardiovascular system
• Increased anxiety and depression
• Social isolation
• Prolonged symptom duration
• Development of fear-avoidance behaviors

While initial rest (24-48 hours) is still recommended immediately after a concussion, emerging research supports a more active, individualized approach to recovery.

Understanding the Modern Approach to Concussion Recovery

Current best practices recognize that concussions affect multiple systems in the body, not just the brain. Modern concussion treatment addresses six key areas:

1. Vestibular Rehabilitation

The vestibular system, which controls balance and spatial orientation, is commonly affected by concussions. Many patients experience dizziness, balance problems, and visual disturbances that don't resolve with rest alone.

Vestibular physiotherapy includes specific exercises that:

• Retrain the brain's balance system
• Reduce dizziness and vertigo
• Improve gaze stabilization (the ability to keep your vision stable while moving your head)
• Restore confidence in movement

These exercises are carefully progressed based on individual tolerance and symptoms, gradually challenging the system to adapt and recover.

2. Cervical Spine Treatment

Most concussions occur alongside neck injuries, yet the neck is often overlooked in concussion management. Research shows that cervical spine dysfunction can mimic or perpetuate concussion symptoms, including headaches, dizziness, and difficulty concentrating.

Cervical treatment may include:

• Manual therapy to restore normal joint mobility
• Soft tissue treatment for muscle tension
• Postural correction
• Specific exercises to stabilize the neck

Addressing neck dysfunction often leads to significant improvements in headaches and dizziness that patients assumed were purely "brain-related."

3. Vision and Oculomotor Rehabilitation

Vision problems are among the most common post-concussion symptoms. Patients frequently report difficulty reading, using screens, tracking moving objects, or tolerating busy visual environments.

Oculomotor exercises target:

• Eye tracking and coordination
• Convergence (ability of eyes to work together)
• Visual processing speed
• Tolerance to visual stimulation

These targeted exercises help retrain the visual system and can dramatically reduce symptoms like headaches, eye strain, and difficulty concentrating.

"The goal of modern concussion treatment isn't to eliminate all symptoms immediately, but to gradually increase your tolerance to activity while managing symptoms within safe limits."

4. Graded Aerobic Exercise

One of the most significant shifts in concussion management is the introduction of controlled aerobic exercise early in recovery. Research shows that sub-symptom threshold aerobic exercise—exercise performed at an intensity that doesn't significantly worsen symptoms—can:

• Improve cerebral blood flow
• Reduce time to recovery
• Decrease symptom severity
• Improve mood and reduce anxiety
• Restore autonomic nervous system function

This doesn't mean running a marathon. It means finding your individual exercise threshold—the level at which you can be active without triggering significant symptoms—and gradually building from there.

5. Cognitive Rehabilitation

For patients experiencing persistent difficulties with concentration, memory, or mental processing speed, targeted cognitive exercises can help restore function. This might include:

• Attention and concentration training
• Memory strategies
• Dual-task training (managing multiple tasks simultaneously)
• Gradual return to cognitively demanding activities

The key is progressive challenge—not avoiding cognitive activity, but engaging in it at appropriate levels and gradually increasing demands.

6. Psychological Support and Education

Anxiety, fear, and uncertainty about recovery can significantly impact concussion outcomes. Education about what to expect, reassurance that symptoms will improve, and strategies for managing the emotional aspects of recovery are critical components of treatment.

Many patients benefit from:

• Understanding their specific symptom profile
• Learning pacing strategies
• Developing coping skills for symptom flares
• Gradual re-engagement with social activities
• Setting realistic recovery expectations

The Importance of Individualized Treatment

No two concussions are identical. One person might primarily struggle with balance and dizziness, while another experiences mainly headaches and cognitive difficulties. Some recover quickly; others have symptoms that persist for months.

This is why individualized assessment is crucial. At Bedford Health Centre, our physiotherapists conduct comprehensive concussion evaluations that identify:

• Which systems are impaired (vestibular, cervical, visual, autonomic)
• Your individual symptom triggers
• Your baseline exercise tolerance
• Contributing factors that may slow recovery
• Your personal recovery goals

Based on this assessment, we develop a personalized treatment plan that addresses your specific impairments and progresses at a pace that's right for you.

When to Seek Treatment

You should seek professional concussion care if:

• You've sustained a head injury and are experiencing symptoms (headache, dizziness, nausea, sensitivity to light/sound, difficulty concentrating)
• Your symptoms aren't improving after 7-10 days
• You're experiencing persistent dizziness or balance problems
• You're having difficulty returning to work, school, or sport
• You're feeling anxious or overwhelmed about your recovery
• You've had multiple concussions in the past

Early intervention with appropriate treatment significantly improves outcomes and can prevent prolonged symptoms.

What to Expect During Concussion Physiotherapy

Your first appointment will involve a comprehensive assessment to identify which systems are affected and what's driving your symptoms. This typically includes:

• Detailed symptom and injury history
• Vestibular and balance testing
• Cervical spine examination
• Oculomotor (eye movement) assessment
• Cardiovascular tolerance testing
• Cognitive screening if needed

Based on the findings, your physiotherapist will develop a treatment plan that might include hands-on therapy, specific exercises, activity modification strategies, and education about pacing and symptom management.

Treatment is progressive. As your tolerance improves, exercises and activities are gradually advanced to continue challenging your recovery systems without overwhelming them.

The Role of Return-to-Activity Protocols

Modern concussion management includes structured return-to-activity protocols for work, school, and sport. These protocols ensure you're not returning too quickly (which can prolong symptoms) or too slowly (which can delay recovery and increase anxiety).

These protocols follow a stepwise progression, with each stage lasting a minimum of 24 hours. Symptoms should be monitored throughout, and progression only occurs when the current stage is well-tolerated.

Your physiotherapist will guide you through these protocols, adjusting the pace based on your individual response.

Moving Beyond the Dark Room

Recovery from concussion doesn't mean hiding from the world. It means strategically, progressively re-engaging with life while respecting your current limitations and systematically addressing the systems that need rehabilitation.

Modern concussion care is active, not passive. It's individualized, not one-size-fits-all. And it's collaborative—you and your healthcare team working together toward recovery.

If you or someone you know is struggling with concussion symptoms, know that effective treatment is available. You don't have to wait it out in isolation. With the right assessment, treatment plan, and support, recovery is possible.