What Is a Concussion?
A concussion is a mild traumatic brain injury caused by a direct or indirect force to the head — a collision in sport, a fall, a car accident, or any impact that causes the brain to move within the skull. You don't need to lose consciousness to have a concussion, and many concussions go unrecognized because the symptoms can be subtle or delayed.
Symptoms include headache, dizziness, brain fog, sensitivity to light or noise, difficulty concentrating, sleep changes, fatigue, and mood disturbance. Most concussions recover fully with appropriate management — but "appropriate management" has changed significantly in recent years. Complete rest is no longer the standard of care.
The Modern Approach to Concussion Recovery
Current evidence strongly supports early, graded, sub-symptom activity rather than prolonged rest. Strict rest beyond 48 hours is associated with worse outcomes, including higher rates of prolonged symptoms and post-concussion syndrome. The brain recovers better with carefully controlled movement and light cognitive activity.
Physiotherapy-guided concussion rehabilitation involves monitoring your symptoms, introducing activity at a level that doesn't worsen them, and progressing systematically through a return-to-activity protocol. We also assess and treat the cervical spine and vestibular system — two areas that frequently contribute to persistent concussion symptoms and are often overlooked.
What We Assess and Treat
- Concussion symptom monitoring and progression
- Cervicogenic headaches — headaches originating from the neck, which are common after concussion
- Vestibular rehabilitation for dizziness and balance problems
- Visual tracking and oculomotor dysfunction
- Graded aerobic exercise progression
- Return-to-sport protocols (following the Concussion in Sport Group guidelines)
- Return-to-school and return-to-work protocols
- Post-concussion syndrome management
Return-to-Sport Protocol
Returning to sport before a concussion has fully resolved carries a serious risk — a second concussion while the brain is still healing can result in much more severe injury. Our return-to-sport protocol follows the internationally recognized Concussion in Sport Group (CISG) stepwise progression:
- Symptom-free at rest before beginning any progression
- Light aerobic exercise (no resistance, no risk of contact)
- Sport-specific exercise
- Non-contact training drills
- Full-contact practice (following medical clearance)
- Return to competition
Each stage must be completed without symptom recurrence before advancing. We document the progression and provide clearance letters as required by schools, sports organizations, or employers.
Concussions from MVA or workplace incidents are covered by your auto insurance (MVA) or WSIB claim respectively. We provide the clinical documentation required by insurers and case managers throughout the rehabilitation process.
Post-Concussion Syndrome
When symptoms persist beyond four weeks, it's called post-concussion syndrome (PCS). PCS is more common when the initial concussion wasn't managed properly — particularly when complete rest was prescribed, or when cervical and vestibular involvement wasn't identified and treated. If you're dealing with lingering symptoms from a concussion weeks or months ago, physiotherapy can still help — and often significantly.
Frequently Asked Questions
Should I rest completely after a concussion?
Only for the first 24–48 hours. After that, complete rest actually slows recovery. Current evidence supports early, graded, sub-symptom activity under physiotherapy guidance. This produces faster recovery and lower rates of prolonged symptoms than strict rest.
How long does a concussion take to heal?
Most concussions resolve within 2–4 weeks with appropriate management. A minority develop post-concussion syndrome with symptoms lasting longer. Early physiotherapy guidance significantly improves the odds of a full and timely recovery.
When can I return to sport?
You must be symptom-free at rest before beginning the return-to-sport progression. The graded protocol takes a minimum of one week once symptom-free. Your physiotherapist will guide and document every step, and provide a clearance letter for your coach or team when appropriate.
My concussion was months ago and I still have headaches — can physiotherapy help?
Yes. Many cases of persistent post-concussion headaches are cervicogenic — driven by the neck rather than the brain. Physiotherapy assessment and treatment of the cervical spine is highly effective for this presentation. We also assess vestibular function, which is another common driver of lingering symptoms.
Is concussion rehabilitation covered by insurance?
Yes — physiotherapy for concussion is covered by extended health benefits, MVA insurance (for car accident-related concussions), WSIB (for workplace incidents), and Veterans Affairs Canada. We provide all necessary clinical documentation.
Kingston's Concussion Rehabilitation Clinic
Located at 1479 John Counter Boulevard, Unit 201, Kingston, Ontario. Call 613-384-2664 or contact us online to book a concussion assessment.