If you’re reading this, then you or someone you care for is still dealing with symptoms after a concussion. You’ve been through doctor visits, maybe scans, and yet the headaches, dizziness, blurry vision, or fatigue just won’t quit.
The good news is that a clear concussion physical therapy protocol exists and must be tailored for the patient. Luckily, these protocols exist, especially for those who feel dismissed by conventional care. This guide lays it out simply and compassionately, so you can feel empowered again to find the solutions you’re looking for.
Why a Concussion Physical Therapy Protocol Matters
When a head injury happens, it’s not just a bump to the head. A concussion can affect your brain, inner ear, eyes, neck, and autonomic (heart/blood‐flow) systems all at once. Traditional advice like “rest and wait” can leave you stuck. Modern guidelines show that a structured concussion physical therapy protocol speeds recovery and addresses the hidden issues.
For example, the 2020 clinical practice guideline for physical therapists emphasized screening for neck, balance, vision, and exertion problems.
As you can see, concussion physical therapy protocols aren’t passive. It’s active, targeted, and paced.
The Core Phases of a Post-Concussion Protocol
Your concussion physical therapy protocol will typically follow these broad phases. Timing varies by symptom severity, but the structure helps guide treatment.
Phase A – Early “Relative” Rest (≈ 0‑72 hours)
After the initial injury, you’ll need a period of rest, but not complete isolation like many have been led to believe. Light aerobic activity (walking, non‑stressful tasks) is often okay, provided symptoms don’t spike.
The goal of these early movement stages is to calm irritated neural systems, avoid overload, and prevent deconditioning.
Phase B – Sub‑Symptom Aerobic Exercise Reactivation
Once you’re no longer heading backwards on symptoms, the protocol shifts. A properly trained functional neurologist or physical therapist will often introduce low‑intensity aerobic work (walking, stationary biking) below the symptom threshold.
Why? Research shows early movement helps reduce the risk of prolonged symptoms.
Phase C – Targeted Rehab Interventions
Targeted rehabilitation is the heart of any concussion physical therapy protocol. Your therapist will address:
- Neck/cervical spine mobility
- Vestibular/ocular (balance & vision) system retraining
- Autonomic/exertion tolerance (heart rate, blood flow)
- Return‑to‑life activities (work, school, sport)
Much of this stems from the 2020 guidelines, which were recently established and published, making them a relatively new thing to follow.
Phase D – Gradual Return to Full Activity
Once you’ve improved baseline symptoms, interventions shift toward tolerance of full daily life and gradual introduction of sport/recreation. The step‑wise progression is based on your symptom report and objective testing.
Each phase flows into the next only when you’re structurally and neurologically ready.
Key Elements Your Provider Must Include in Your Concussion Treatment Plan
A well‑designed concussion physical therapy protocol should include these major components:
- Individualized assessment: Your provider should test your neck mobility, balance, vision tracking, aerobic tolerance, and symptom triggers.
- Education & pacing: You’ll learn to monitor your symptoms, use pacing strategies (to avoid sudden flare‑ups), and know when to ease off.
- Aerobic exercise prescription: Start gently, then ramp up as tolerated. Multiple studies found better outcomes when therapy included aerobic work.
- Vestibular/oculomotor training: Because many people after a concussion have dizziness or vision issues, your treatment protocol must be personalized and target these systems.
- Neck/spine mobility and strength: Many concussions co‑occur with neck strain or whiplash, so treating the neck may reduce headaches and dizziness.
- Return‑to‑activity guidance: For school, work, driving, sport, or daily life, establishing step‑by‑step criteria is essential to safely resume your everyday life without setbacks.
What You, The Patient or Caregiver, Can Do
Here’s what you can contribute to make the concussion physical therapy protocol really work:
- Keep a symptom diary each day: note headaches, dizziness, vision changes, fatigue, sleep quality, and mood.
- Immediately communicate changes: If a task makes you feel worse for hours, tell your therapist. Flare‑ups signal your threshold.
- Follow your pacing and rest schedule: Resist the impulse to “push through” just because you feel a little better.
- Stay consistent: Even small sessions (10‑15 min) of rehab or aerobic work every day matter.
- Use your therapist’s home program: The outpatient sessions are essential, but the real progress happens between visits and via at-home exercises.
Things to Watch Out For (and When to Seek Help)
While most people recover with a solid concussion physical therapy protocol, you’ll want to alert your clinician if you notice:
- Gradual worsening of symptoms instead of improvement
- New neurological signs (weakness, numbness, seizures)
- Severe balance loss, double vision, or persistent vomiting
- Stuck at the same level for several weeks without progress
These may signal the need for a more specialized evaluation or a multidisciplinary team. The guidelines stress timely referral when recovery stalls.
Realistic Healing Timelines for Concussion Physical Therapy Protocols to Work
It’s natural to want a “quick fix.” But a true concussion physical therapy protocol honors the fact that brain and nervous‑system healing takes time. It’s important to be realistic about a concussion protocol timeline to set expectations for both patients and caretakers.
- Many people make meaningful progress in 2-4 weeks if therapy begins early.
- About 15‑20 % of people develop symptoms past 3 weeks (sometimes called post‑concussion syndrome).
- The pace depends on your previous health, number of past concussions, neck/vision issues, and symptom triggers.
So if you’ve already tried “everything” and still feel stuck, know this: a targeted protocol may be what makes the difference.
Why Personalized Protocols Matter for Concussion Care
You’re here because traditional care didn’t quite resolve your symptoms. Maybe you were told “just rest more” or “you’ll be fine in a week.” But with persistent symptoms, you most likely need more than that.
A well‑structured concussion physical therapy protocol gives you:
- A roadmap, not just “you’ll feel better someday”
- A therapist who understands your brain‑body symptoms, not just your neck or dizziness in isolation
- Tools you use every day to drive your recovery, not passive waiting
If you’ve felt frustrated, dismissed, or stuck following a concussion, this protocol provides clarity and hope.
Quick Concussion Physical Therapy Rehab Protocol Checklists
What your first few rehab sessions should address:
- Symptom review and baseline tracking
- Neck mobility assessment and gentle stretches
- Heart rate/exertion tolerance measurement (light aerobic test)
- Balance and vision screening (vestibular/oculomotor)
- Education on pacing and activity modifications
What you should expect in mid‑phase rehab:
- Gradual aerobic increase (e.g., 5‑10 extra minutes, mild incline)
- Targeted balance/vision exercises (head turns, eye tracking)
- Neck strength and mobility progress
- Return to light work/school tasks with symptom monitoring
- Clear criteria to move toward full activity
Your Personalized Concussion Physical Therapy Protocol is Within Arm’s Reach
If you’re ready to move beyond feeling stuck, our providers at The Neural Connection offer a specialized concussion recovery plan based on the proven concussion physical therapy protocols outlined here.
Contact us to schedule a detailed assessment so we can build your personalized roadmap to recovery and get you back to the life you want to live, without the lingering symptoms holding you back.
Check out our 120+ 5-Star Google Reviews ⭐️⭐️⭐️⭐️⭐️ to see what our patients say about us!
Consultation Link
*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients should consult their medical provider or primary care physician before trying any home remedies or therapies.
Frequently Asked Questions (FAQ)
How soon should I start the concussion physical therapy protocol?
Almost as soon as your medical provider clears you. After 24‑72 hours of relative rest, early aerobic and targeted rehab can begin. Starting early often leads to faster improvement.
What if I still feel foggy, dizzy, or have headaches after several weeks?
Then you may need a tailored concussion physical therapy protocol that addresses deeper issues (neck, vision, balance, exertion tolerance). It’s not uncommon and does not mean you’re “broken.” You just need the right roadmap.
Will I know exactly how long recovery will take?
Every person is different. Some recover in a few weeks, others take months. The protocol helps you track your progress, set realistic goals, and regain control of your recovery timeline.
