Modern Concussion Care: Moving Beyond Rest Toward Active Recovery
- Sasha Guay
- Dec 3, 2025
- 5 min read
Concussions are among the most misunderstood injuries in sport and daily life. Once treated with strict rest and a dark room, new research now shows that a guided, active approach leads to faster recovery and fewer long-term symptoms.
At Physical Edge Physiotherapy in Oakville, our concussion-rehabilitation programs combine the newest evidence from global experts with individualized physiotherapy care to help patients return safely to work, school, and sport.
What is a Concussion?
A concussion is a mild traumatic brain injury caused by rapid acceleration or deceleration of the brain inside the skull—often after a hit, fall, or whiplash-type movement.
Unlike other injuries, a concussion represents a temporary energy and communication problem within the brain—not bleeding or bruising. This functional disturbance affects how nerve cells process and share information, which explains why symptoms can vary so widely. The forces involved don’t cause visible damage, so brain scans such as MRI or CT are usually normal.
It’s estimated that around 10 % of contact-sport athletes will experience a concussion during their career.
Who Can Diagnose a Concussion?
Only physicians and nurse practitioners can formally diagnose a concussion. However, physiotherapists play a critical role in early assessment and rehabilitation.
Because no scan or blood test can confirm a concussion, it remains a clinical diagnosis of exclusion—other serious conditions (fracture, brain bleed, spinal injury) must be ruled out first.
A physiotherapist can help rule out more serious injury, guide the recovery process, identify contributing factors such as neck dysfunction or vision issues, and help restore normal function.
Recognizing the Symptoms
Concussion symptoms can appear immediately or evolve over several hours. Common signs include:
Headache, dizziness, or neck pain
Nausea, balance issues, or light sensitivity
Trouble concentrating or remembering
Fatigue, irritability, or anxiety
Sleep changes or mood swings
Most people recover within 1–3 weeks, but some develop Persistent Concussive Symptoms (PCS) lasting more than 30 days.
What Causes Concussion Symptoms?
Concussion symptoms come from a temporary disruption of energy regulation in the brain, not from structural damage. The brain’s demand for energy spikes while its supply briefly drops, creating a metabolic “energy crisis.”
Interestingly, the mechanics of whiplash can mimic concussion symptoms. Because the brain and neck move together during impact, physiotherapists treat both systems until it’s clear which structures are involved.
The brain typically restores normal energy function within 21–30 days, even if a few symptoms linger beyond that window.
What Is Post-Concussion Syndrome (PCS)?
When symptoms persist beyond 30 days, they’re often driven by problems in other body systems, not continued brain injury. Common contributors include:
Impaired blood-flow regulation during exertion
Vestibular or ocular-motor (eye and balance) dysfunction
Cervical spine (neck) issues
Hormonal, metabolic, or inflammatory changes
Psychological factors, such as stress or anxiety
Modern physiotherapy aims to identify and address each of these contributors to fully resolve PCS.
The Purpose of the Initial Assessment
Your first visit at Physical Edge focuses on:
Ruling out red flags that might require medical referral (fracture, neurological deficit, spinal injury).
Education on early symptom management—research shows this is most important within the first 7 days of injury
Guidance on recovery habits, including screen-time limits, blue-light filters, and sleep optimization.
Baseline testing to direct individualized care.
Early education and reassurance alone have been shown to improve outcomes and reduce anxiety about recovery.
Evidence for Active Recovery: What the Research Shows
For decades, strict rest was the standard advice. Yet new high-quality research has proven that light activity within days of injury is safe—and beneficial.
A 2023 meta-analysis by Dr John Leddy and colleagues reviewed 46 studies on rest, exercise, and recovery after sport-related concussion. Key findings include:
Strict rest is not effective. Adolescents told to rest completely had slower recovery and more symptoms than those encouraged to resume gentle activity.
Light physical activity within 48 hours (for example, walking) speeds recovery and reduces the risk of prolonged symptoms.
Structured aerobic exercise prescribed 2–14 days after injury shortened recovery by an average of 4–6 days and cut the likelihood of post-concussion syndrome almost in half.
Sleep quality matters. Disturbed sleep early after injury delays recovery.
Screen-time reduction for the first 48 hours helps symptoms resolve faster.
These findings echo the 6th International Consensus on Concussion in Sport (Amsterdam, 2022), which now officially recommends a short rest period followed by graded, subsymptom-threshold exercise—a major shift from earlier “total rest” guidelines.
Our Evidence-Based Concussion Program
Your individualized plan at Physical Edge includes progressive testing and treatment:
Buffalo Concussion Treadmill Test (BCTT):
Measures your heart-rate threshold for symptom onset and determines safe exercise intensity.
Vestibular / Ocular-Motor Screening (VOMS):
Identifies dizziness, blurred vision, or imbalance from eye-movement or reflex issues.
Neck and Cervical Screening:
Evaluates range of motion, muscle tone, and joint mobility to detect whiplash-related contributors.
Graduated Aerobic Exercise Program:
Builds tolerance using treadmill, bike, or walking sessions below your symptom threshold.
Return-to-Sport Testing:
When appropriate, concussion-specific return-to-sport testing ensures your cardiovascular and neuromuscular systems are ready for contact play.
This combination of assessments targets every major factor known to delay recovery—blood flow, balance, vision, and neck function—while following internationally accepted safety protocols.
Sleep and Screen-Time: The Unsung Recovery Tools
Sleep is the brain’s repair time. Studies in college and adolescent athletes show that poor sleep quality during the first week predicts longer symptom duration.
Tips for optimal recovery:
Keep a consistent bedtime and wake-time.
Avoid screens 1 hour before bed.
Use dark-mode or blue-light filters when screens are necessary.
Similarly, limiting screen use for the first 48 hours after injury—phones, computers, and television—can cut recovery time nearly in half compared to unrestricted use.
How Physiotherapy Supports Every Stage of Recovery
At Physical Edge Physiotherapy, concussion care doesn’t end when your headache improves. We help you rebuild confidence, coordination, and stamina through:
Education & reassurance: understanding that mild symptom flare-ups during activity (up to 2 points on a 0–10 scale) do not delay recovery.
Manual therapy: gentle hands-on techniques for the neck and upper spine to improve mobility and decrease dizziness.
Balance and coordination training: retraining vestibular and visual systems.
Graded exercise progression: safe cardiovascular loading under supervision.
Cognitive-physical integration: preparing you for real-world, multitask situations such as work or sport.
Why Early, Supervised Exercise Works
The latest evidence explains that early aerobic exercise improves cerebral blood-flow regulation, stabilizes the autonomic nervous system, and helps normalize the brain’s metabolic balance.
In other words, carefully dosed activity helps the brain “reset” faster.
Athletes who begin subsymptom aerobic training within the first week typically return to play about five days sooner than those told to wait until all symptoms disappear. Even individuals with persistent symptoms show faster improvement when following a structured exercise program.
Takeaway: Rest Smart, Move Safely
Modern concussion science is clear: complete rest is outdated.
Active, individualized rehabilitation—supported by qualified physiotherapists—offers the safest and most effective path to full recovery.
Whether you’re a student, weekend warrior, or competitive athlete, Physical Edge Physiotherapy provides evidence-based concussion care to help you move better, think clearer, and get back to doing what you love.
Click below to book your initial concussion assessment!
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