Navigating Concussions in Fall Sports: A Guide to Physical Therapy Management

Fall sports season is in full swing, and while athletes of all ages are eager to hit the field, court, or track, it’s essential to address a significant concern in sports – concussions.    In this blog post, we will provide insight into causes of concussions, and the crucial steps in managing and recovering from these injuries.

A concussion is a mild traumatic brain injury (TBI) that occurs when there is a sudden and forceful impact to the head or body, causing the brain to move rapidly within the skull. This movement can result in various neurologic changes and temporary dysfunction of brain processes. Concussions are often referred to as “mild” because they are typically not life-threatening, but they should be taken seriously due to their potential for short-term and long-term effects on cognitive, physical, and emotional well-being.  Concussions are not exclusive to contact sports like football; they can occur in soccer, field hockey, volleyball, and even cheerleading.

Recognizing the signs of a concussion allows for early identification and prompt medical evaluation. Early intervention is crucial because it can help prevent further injury and complications. Delayed diagnosis and treatment can lead to more severe symptoms and prolonged recovery.

Common characteristics and symptoms of a concussion may include:


Confusion: Individuals may feel disoriented, have difficulty concentrating, or experience memory problems.

Dizziness and Balance Issues

Nausea or Vomiting

Sensitivity to Light and Noise

Blurred Vision


Mood Changes: Mood swings, irritability, anxiety, or depression may occur.

Sleep Disturbances: Changes in sleep patterns, such as difficulty falling asleep or excessive drowsiness, can be present.

The Role of Physical Therapy in Concussion Management

Physical therapists work alongside other medical professionals to ensure a comprehensive approach to concussion management.  An examination is done to assess the extent of injury, monitor progress, and provide information to develop an appropriate treatment plan. The key components of a physical therapy examination for concussion include:

Patient History: The physical therapist will begin by gathering information about the patient’s medical history, including the details of the injury, any previous concussions, symptoms, and any relevant medical conditions.

Symptom Assessment: The therapist will ask the patient about their current symptoms, such as headache, dizziness, nausea, fatigue, memory problems, sensitivity to light or noise, and mood changes. The severity and frequency of these symptoms will be documented.

Neurologic Assessment: This includes assessing the patient’s reflexes, coordination, balance, and muscle strength. The therapist will look for any neurological deficits or abnormalities.

Vestibular Assessment: The vestibular system helps control balance and spatial orientation. The therapist may perform tests to assess vestibular function, including eye movements, head movements, and balance assessments.

Ocular-Motor Assessment: Eye movements and visual tracking are often affected by concussions. The therapist may assess the patient’s ability to follow objects with their eyes, focus on different distances, and perform smooth visual tracking.

Balance Assessment: Balance and postural control can be impaired after a concussion. Various balance tests, such as the Sensory Organization Test (SOT) or the Balance Error Scoring System (BESS), may be used to evaluate balance and identify deficits.

Functional Assessment: The patient’s ability to perform daily activities, such as walking, climbing stairs, and lifting objects, may be assessed to determine how the concussion has affected their functional abilities.

Postural Assessment: The therapist will evaluate the patient’s posture and movement patterns to identify any abnormalities or compensations.

Gait Assessment: Walking patterns may be analyzed to detect any abnormalities or signs of impaired balance.

Based on examination findings, the physical therapist will develop an individualized treatment plan that includes exercises to improve balance, coordination, and strength, as well as strategies to manage symptoms and gradually return to normal activities.  Examples of rehabilitation protocols are discussed below:

Early-Stage Rehabilitation

Rest is crucial in the early stages of concussion recovery, followed by a carefully managed, gradual return to normal activities.  Physical therapists can perform manual therapy techniques to alleviate common symptoms like headaches and neck pain as well as introduce gentle stretches and stabilization exercises.

Vestibular Therapy

Vestibular physical therapists can design treatment programs to improve balance and coordination, as well as address vision problems through specialized eye and head movement exercises. Patients are also educated on lifestyle modifications and strategies to manage symptoms in daily life.

Cognitive Rehabilitation

Brain fog and memory problems can be addressed through cognitive therapy.  Strategies to improve memory, attention, and processing speed are integrated into the rehabilitation process.

Gradual Return to Sports

A step-wise approach to reintroducing physical activity is crucial, with constant monitoring of symptoms.  Physical therapists help athletes safely regain their skills and fitness levels.

Long-Term Monitoring

Even after returning to sports, athletes should be monitored for any signs of post-concussion syndrome because early detection and intervention can prevent long-term complications.

Raising Awareness

Coaches, athletes, and parents should be educated about the importance of concussion management and the role of physical therapy.

It is crucial to remember that each concussion is unique, and the management approach may vary based on individual circumstances. Always consult with a healthcare professional for guidance and care. Returning to normal activities, especially contact sports, should only occur when the person is fully recovered and cleared by a healthcare provider. Otherwise, there is risk of second-impact syndrome or long-term cognitive issues.  Contact our concussion specialists at Lifeline Therapy if you or a loved one is having symptoms due to a concussion.

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