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Young soccer player injured on the field

Physical Therapy for Concussions

By: Jessica Eisenberg DPT, MS, ATC


Concussions are a hot topic these days and one of the most common injuries in sports. The majority of young athletes who have suffered a concussion will recover within 3 to 4 weeks, but others may suffer ongoing symptoms known as post-concussion syndrome. Post-concussion symptoms include headaches, neck pain, dizziness, fatigue, difficulty with concentration and memory, and feeling irritable or emotional. Physical therapy can play an important role in the treatment of concussions and post-concussion syndrome, helping to ensure a safe return to play.

Currently, treatment for an athlete diagnosed with a concussion includes the immediate removal of the athlete from play, a period of physical and mental rest, followed by a gradual return to activity. Physical therapists and athletic trainers are medical providers who can safely guide and monitor athletes through a safe progression of returning to play. The five basic steps of this progression include:

  • Step 1: Light aerobic activity
  • Step 2: Moderate activity
  • Step 3: Heavy, non-contact activity
  • Step 4: Practice with full contact
  • Step 5: Return to competition

Each step is as least 24 hours with progress stopping if symptoms return. With a return of symptoms, the athlete will go back to the previous step after a period of rest and repeat that level until they remain symptom free. It’s important to remember that each athlete will recover at their own rate, making it impossible to provide a specific timeline for returning to play.

Physical therapy is also helpful to concussion recovery through vestibular rehabilitation. The vestibular system is the balance system of the body, providing sensory information about motion, equilibrium and spatial orientation. Symptoms that could indicate vestibular issues include dizziness or vertigo, motion sensitivity, tinnitus (ringing in the ears), lightheadedness, blurred or double vision, sensitivity to light, and a feeling of imbalance. Vestibular rehabilitation is an exercise-based therapy designed to improve these symptoms.

In addition, physical therapy can help to relieve neck pain, headaches and range of motion problems that an athlete may experience following a concussion. Manual therapy techniques are used to increase mobility, decrease pain and restore full active range of motion.

The CHKD sports concussion program is the only comprehensive, multi-disciplinary sports concussion program in the region designed specifically for children, adolescents and young adults. Our comprehensive, multi-disciplinary team includes pediatric and adolescent sports medicine physicians, pediatric neurologists, pediatric neurosurgeons, certified athletic trainers, sports physical therapists, neuropsychologists, and pediatric radiologists. If you suspect your child may have sustained a concussion, you can make an appointment with someone on our concussion team by calling 757-668-7529 (PLAY).

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About CHKD Sports Medicine

About CHKD Sports Medicine  CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.