Post Concussion Treatment Exercises

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By Dr. Sender Deutsch
Published on September 24, 2014

Did you miss our previous blog post on Post Concussive Syndrome? Check it out first!

Post Concussion Exercises

Which Types of Exercises are Appropriate After Suffering From A Concussion?

Light exercises at a very easy conversational pace have been shown to help allow the brain to recover, as long as the symptoms aren’t worsening; five to twenty minutes of light walking, cycling or just movement is appropriate.

Current research has shown that when rehabilitating individuals with post-concussive syndrome, it is very important to treat patients similar to a whiplash disorder. Working to address the soft tissue around the head and neck is important as the muscles become tight and tense as a result of the trauma. The nerves that exit through these muscles can be entrapped and could be exacerbating the individual’s symptoms. The nerves of your upper neck (cervical spine) converge with nerves that innervate your head, face and scalp.  If these nerves become irritated, they can replicate the same symptoms as a concussion. Therefore; rehabilitating the upper neck by manual treatment and ensuring proper posture, alignment, range of motion and most importantly stability is the key to a full recovery.

Stability Exercise Training

Stability exercise training is a key component to help getting rid of the symptoms. The upper neck is responsible for helping to control blood pressure, heart rate, balance and proprioceptive awareness and therefore we work to retrain ones balance to ensure the head, neck and brain are working together with simple movements and then more coordinated complex movements.  We are working to retrain the brain!

Often patients need to go slow and steady in order to retrain movements such as: marching / tandem gait. This helps the brain coordinate opposite arms and legs for proper smooth movement fascial patterns. Focus on simple exercises, for example: opposite arm and leg movements, single leg balance, and progress to eyes closed and wobble/unstable surfaces exercises.

Just recently, I had two patients’ that had undergone physical therapy and rehabilitation at another facility. Their treatments were primarily focused on passive work and the therapist neglected to retrain the cervical-vestibular and proprioceptive system.  It wasn’t until we incorporated manual therapy with balance and proprioceptive re-training, that they were able to fully recover and get rid of their persistent headaches.  This type of treatment has been utilized for whiplash associated disorders and should be utilized with concussion patients, as we have found that there is a direct overlap between the two conditions and most of the time patient’s that have experienced a concussion have also experienced a whiplash disorder.

Post – Concussion Exercises 

Simply exercises such as: single leg balance can be initiated after the first couple weeks of resting.  Progressions will include: head rotations, ocular movements and a combination of the two progressing to various unstable surfaces along with eyes open and closed exercises.  Strength and conditioning techniques designed to rehabilitate the interscapular muscles and deep neck flexors will also be prescribed.

Treating post-concussive syndrome must be a holistic approach that includes complete rest from the onset to negate further damage.  As well, it is extremely important to shut down completely and not to return to sport before being evaluated by a qualified medical professional to avoid secondary impact syndrome which can cause further brain damage.