At a physiotherapy appointment after a concussion, expect to talk about quite ordinary things: reading, walking, sleeping and getting through work. How you manage those tasks helps the clinician understand what needs attention.
A headache is one piece of information. A headache that appears after ten minutes of reading, together with blurred vision, gives the assessment more direction. So does dizziness that happens when you roll over in bed but disappears when you keep still.
Physiotherapists use that detail, along with physical testing, to plan rehabilitation. They also recognize when symptoms need further medical investigation.
Before Rehabilitation, the Injury Needs Medical Assessment
A concussion is a brain injury caused by force to the head or body. Losing consciousness isn’t necessary, and symptoms aren’t always immediate.
If a concussion is suspected, arrange assessment by a doctor or nurse practitioner. They can establish the medical diagnosis and investigate other injuries. A physiotherapist contributes findings about movement, balance and function, working within their training and professional scope.
This distinction matters. A stiff neck after a collision may be part of the picture, but it shouldn’t distract from assessing the head injury itself. Nor does a normal CT scan rule out concussion. Routine imaging generally doesn’t show a concussion, although it can help investigate other concerns.
Emergency warning signs include repeated vomiting, a severe or worsening headache, a seizure, new weakness, increasing confusion or difficulty waking. Call 911 or seek emergency care if these develop after a head injury.
Once urgent concerns have been addressed, the next question is what is making daily life difficult and how rehabilitation can help.
The Examination Connects Symptoms With Treatment
The first appointment usually involves a history of the injury and symptoms since then. Mention earlier concussions, migraines, medications and changes in sleep. Bring any relevant medical reports, and be specific about activities you’ve stopped or cut short.
The physiotherapist may check how your neck moves, examine tender areas and assess muscle function. A collision can injure the neck and cause a concussion at the same time. Where neck problems contribute to pain or restricted movement, treatment may include appropriate mobility and strengthening exercises.
Balance and dizziness require a different set of checks. Depending on the findings, the clinician may examine standing balance, walking, eye movements and how well your eyes remain focused as your head moves. These tests help identify which functions are affected; no single result explains every symptom.
That is why concussion treatment can differ between people with the same diagnosis.
For vestibular difficulties, exercises may work on balance, keeping vision steady during movement and gradually tolerating movements that provoke symptoms. The vestibular system helps sense head movement and contributes to balance.
Brief spinning with a change in head position can sometimes be BPPV, or benign paroxysmal positional vertigo. If the appropriate tests confirm it, a trained clinician may perform a repositioning manoeuvre. That approach is different from general balance training.
Visual problems may need another professional’s input. Persistent difficulty focusing or complex visual symptoms can warrant referral to an optometrist or ophthalmologist. New double vision after a head injury needs urgent medical attention.
Working Out How Much Activity You Can Manage
You may have heard that concussion recovery means stopping everything until you feel normal. Current guidance recommends relative rest for the first 24 to 48 hours, then a gradual return to activity as tolerated. Light daily tasks can continue during relative rest, with reduced demands and breaks.
Knowing where to start can still be difficult. You might manage a quiet morning at home, then find a short outing unexpectedly tiring.
A physiotherapist can help set an activity level you can tolerate. Where appropriate, supervised exercise testing helps guide that decision. Walking or stationary cycling may form part of the plan, with effort and duration adjusted as you improve.
During early recovery, a mild, short-lived increase in symptoms can be acceptable. A larger increase, or symptoms that stay elevated, calls for changing the activity and reviewing your response. Ask for clear instructions about when to pause, how long to recover and when to contact the clinician. Those instructions should fit your assessment.
A written home plan is useful here. Knowing which exercises to do, how much to do and what response to watch for makes it easier to follow treatment between appointments.
Returning to Work, School or Sport
Recovery needs to be tested against the day you want to return to. A short walk and a full shift make very different demands.
Your care team may suggest temporary adjustments: shorter periods of computer work, breaks between tasks or a gradual increase in hours. Physiotherapy addresses physical problems, while other professionals may help with sleep, mood or concentration.
For sport, follow a staged return. Canadian guidance requires medical clearance before progressing to activities with a risk of contact or falling. Feeling comfortable during light exercise isn’t enough to establish readiness for those activities.
Symptoms continuing beyond about four weeks need review and may call for coordinated care. Seek help sooner if you’re getting worse or having difficulty managing daily life.
Before each follow-up, note a few specific changes. Perhaps you can read longer, turn your head more comfortably or walk without the same dizziness. Record setbacks too, including how long symptoms lasted. These details help your physiotherapist decide what to continue, what to change and whether another assessment is needed.
