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Post-Concussion Syndrome - Treatment

Updated: Aug 15, 2019

After an athlete sustains a concussion, they must follow the ten Recovery Stages. Each stage must be separated by at least 24 hours. If symptoms occur at any stage, the athlete must return to the previous stage. The 10 stages include:

  1. Stage 1- Symptom-limited activity. Engage in typical daily activities that do not increase or provoke symptoms. (ex: reading, texting, computer, walking)

  2. Stage 2- Light cognitive activity. Try a brief period of homework, reading a novel, or watching TV.

  3. Stage 3- Half-day of school or work, with or without modifications. (ex: No gym class, no band, no recess)

  4. Stage 4- Full day of school or work, with or without modifications.

  5. Stage 5- Return to physical activity à Graded Exercise Test (Buffalo Treadmill Test)

  6. Stage 6- Light non-contact practice or Sport-specific activity. You are allowed to return to the playing surface for a very light practice involving absolutely no contact. Individual drills including light jogging, skating, passing, and shooting are appropriate.

  7. Stage 7- Heavy non-contact practice. The intensity can increase and team-based drills that do not involve the risk of contact are appropriate.

  8. Stage 8- Medical clearance à Physical Exertion Test (Blackhawk’s Test) and Baseline Re-test

  9. Stage 9- Full-contact practice

  10. Stage 10- Game play


The following treatment options can help to support concussion management and improve recovery:

1. Exercise Therapy- Following symptom limited activity, exercise therapy can help to resolve symptoms and improve blood flow

2. Manual Therapy- Headaches, balance and visual issues, dizziness, and blood flow abnormalities are symptoms of both concussion and neck injuries (whiplash), which can be treated with manual therapy. Manual therapy involves treatment of the neck joints and muscles.

3. Diet and Nutritional Intervention- Avoiding pro-inflammatory foods (ex: red meat, refined sugars) and replacing them with nutritious options (ex: fruit and vegetables) may help to offset inflammation and reduce symptoms.

4. Vestibular and Visual Rehabilitation- An individualized balance and visual rehabilitation program may help to reduce symptoms such as dizziness, visual abnormalities, concentration issues, and memory loss.

5. Education and Reassurance- People with a history of depression or anxiety tend to have prolonged symptoms. Education and reassurance is an important part of concussion care.

Most of the treatment options are available at a Complete Concussion Management Certified clinic.

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