Post-Concussion Symptoms

Concussion recovery is not just about resting and waiting.

Post-concussion syndrome describes a cluster of symptoms that persist beyond the expected recovery window following a head injury. These include headache, cognitive fog, fatigue, dizziness, visual disturbance, sleep disruption, emotional dysregulation and sensitivity to light and sound. For most people, symptoms resolve within weeks. For a significant minority, they persist for months — sometimes years.

The management of persistent post-concussion symptoms has historically been limited to rest and symptom monitoring. There is now growing evidence that active, multi-modal treatment — addressing the cervical spine, the cranial structures and the nervous system — produces significantly better outcomes than a wait-and-see approach.

What's happening in the body

Concussion involves a complex neurometabolic cascade — a disruption to normal brain function at the cellular level that takes time to resolve. But persistent post-concussion symptoms are also driven by cervical spine injury (whiplash-type mechanisms frequently accompany concussion), cranial restrictions, vestibular dysfunction and autonomic nervous system dysregulation — all of which are addressable with appropriate manual therapy.

The cervical spine in particular is often overlooked in concussion management. The upper cervical joints and suboccipital musculature are almost always involved in the mechanism of injury, and cervicogenic headache, dizziness and cognitive symptoms frequently have a cervical component that responds well to targeted treatment.

How Dr Chase approaches it

Assessment covers the cervical spine, the cranial structures, the vestibular system and the autonomic nervous system. Understanding the relative contribution of each to the current symptom picture guides the treatment approach — because post-concussion presentations are highly individual and respond poorly to generic protocols.

Treatment draws from gentle cervical mobilisation, cranio-sacral therapy (which works with the fluid and membranous system surrounding the brain and spinal cord and is well-suited to post-concussion presentations), nervous system regulation work, and where relevant, NRT for associated nasal and sinus involvement. The pace of treatment is carefully calibrated to avoid symptom flare-up.

If post-concussion symptoms have been lingering, active assessment and treatment is a more effective path than continued rest. The sooner treatment begins, the better the outcomes tend to be.