What concussion actually is

A concussion is a functional brain injury caused by a biomechanical force — a direct blow to the head, or an impulsive force transmitted through the body. The brain’s normal energy use and neural signaling are temporarily disrupted. Standard structural imaging (CT, MRI) is typically normal — this is a functional injury, not a structural one in most cases.

Who I see

  • Athletes from local hockey, soccer, football, baseball, and rugby
  • Children and adolescents after a sport or recreational incident
  • Patients with persistent symptoms beyond the expected recovery window (14 days in adults, 4 weeks in youth)
  • People recovering from motor vehicle collisions with cervical and concussive symptoms

What the evidence says now

Care follows the Concussion in Sport Group Amsterdam consensus 2022 (Patricios et al., BJSM 2023):

  • Relative rest for the first 24–48 hours — not strict darkroom rest.
  • Sub-symptom-threshold aerobic exercise after 24–48 hours accelerates recovery (Leddy et al., Pediatrics 2019).
  • Graded return-to-learn and return-to-sport through stage-based progressions.
  • Sub-type-targeted rehabilitation for persistent symptoms — vestibular, ocular, cervical, exertional, migraine/headache, and mood subtypes each get specific treatment (Ellis sub-typing model).

Individual diagnoses managed here

How rehab works in practice

After a thorough assessment (including symptom checklist, vestibular/ocular screening, cervical assessment, and graded exertion testing where appropriate), the plan is built around the dominant sub-types driving your symptoms. Treatment may include cervical manual therapy and deep neck flexor training, vestibular rehabilitation, ocular-motor exercises, sub-symptom-threshold aerobic progression (often guided by the Buffalo Concussion Treadmill Test), sleep and load management, and graded return-to-learn / return-to-sport progressions.

When to seek emergency care

Any concussion presentation with worsening headache, repeated vomiting, seizure, loss of consciousness longer than 1 minute, increasing confusion or drowsiness, focal neurological signs, or significant deterioration requires immediate emergency department evaluation. Concussion is a clinical diagnosis — but red-flag signs need urgent medical workup to rule out more serious injury.