Most concussions resolve within 2-4 weeks. When symptoms persist longer, we call it persistent post-concussion syndrome (PPCS). It affects roughly 15-30% of concussion patients and is highly treatable — but rarely with rest alone.
Typical persistent symptoms
- Headaches, often starting in the neck
- Dizziness, motion sensitivity, imbalance
- Brain fog, memory issues, difficulty concentrating
- Fatigue, reduced exercise tolerance
- Visual issues — trouble reading, screen sensitivity
- Mood changes, anxiety, sleep disturbance
Why it lingers
PPCS is almost never a single ongoing brain injury. It's usually a combination of unresolved cervical spine dysfunction, vestibular / balance system disruption, visual system dysfunction, autonomic dysregulation, and sometimes central sensitization. Each system needs its own targeted intervention.
Our approach
Cervical assessment and treatment — most PPCS headaches and dizziness have a neck component that gets missed in standard concussion care.
Sub-symptom threshold aerobic exercise — structured progressive activity that stays below symptom triggers. Strong evidence for accelerating recovery.
Coordinated referrals — vestibular therapy, neuro-optometry, and physician-managed medication for headache or mood as needed.
Manual therapy and acupuncture for pain modulation and autonomic regulation.
What NOT to do
Complete rest beyond the first few days makes PPCS worse. Excessive screen avoidance can perpetuate visual system dysfunction. Waiting for it to "just resolve" past 4-6 weeks rarely works — active care is the difference-maker.
If your concussion symptoms have persisted past a month, come in for an assessment. Recovery is possible, but the sooner we start structured multidisciplinary care, the shorter the road.