Is Concussion Rehab Really as Complex as It Seems?
By: By: Maggie Bergeron, MSc(PT)∙ Estimated reading time: 3 minutes

Introduction

Physiotherapy management of concussion can feel overwhelming — and many physiotherapists have shared this concern. Concussion rehab involves multiple systems, persistent symptoms, and a great deal of variation between patients. But while the challenges are real, so are the rewards. Supporting patients with concussion can be incredibly meaningful and impactful.

To help clinicians feel more confident, Meaghan Adams has summarized the most common challenges physios face in private practice, along with practical strategies to overcome them.

Challenge #1: “Concussions are Complex. I’m Not Sure I Have the Skills to Help These Patients.”

Concussions are complex — but most conditions we treat are. Even so-called “simple” MSK injuries are often complicated by a patient’s individual health, psychological state, and life circumstances.

It’s true that acute concussions should be managed differently from prolonged post-concussion symptoms, and recognizing that is already the first step toward competency. Importantly:

• Most individuals recover from concussion within a few weeks.

• These short-term cases often don’t end up in physiotherapy clinics.

• The patients who do present are typically those with persistent symptoms — and these cases resemble chronic pain in complexity and in their impact on a patient’s life.

The good news?
You already have the foundational skills.

A biopsychosocial approach — the same model used for chronic pain — applies beautifully to concussion rehab. The so-called “soft” clinical skills you use every day (communication, education, pacing, reassurance, problem-solving) make an enormous difference for these patients.

Challenge #2: “Advice Keeps Changing. I Don’t Know What to Tell People.”

Or:

“I didn’t learn much about concussion in school. There’s so much conflicting information — rest, exercise, wake them every hour — I don’t know what to recommend.”

This is a common concern, and it makes sense. Concussion knowledge has evolved rapidly, which means outdated advice still circulates. Current evidence shows:

• We do not wake patients every hour overnight.

• We do not prescribe strict rest in a dark room for days.

Even if concussion rehab was not covered in your original PT training, you do have strong clinical reasoning skills. Concussion rehab uses the same reasoning framework you use with all patients:

• Assess for impairments

• Provide treatment addressing those impairments

• Reassess and adjust

The difference is simply what you look for.
Instead of range of motion or strength deficits, you may be assessing:

• Vestibular dysfunction

• Exercise intolerance

• Sensory integration issues

Getting educated on how to assess concussion-specific impairments gives you everything you need to get started. And, as Meaghan emphasizes, concussion education isn’t “one and done.” Research evolves, and updating your approach periodically is part of best practice.

Challenge #3: “Some Patients Require Expertise I Don’t Have.”

This is absolutely true. Many patients with persistent post-concussion symptoms will present with multiple impairments. For example:

• Someone may have vestibular dysfunction and significant anxiety around symptom flare-ups.

• You may treat their vestibular issues, while a mental health professional helps address psychological distress.

Staying within your scope of practice is essential. Concussion patients commonly need a team-based approach, involving:

• Physicians

• Occupational therapists

• Optometrists

• Psychologists

• Speech-language pathologists

• Teachers/coaches

• Social workers

• Case managers

You don’t need to be all of these roles — you just need relationships with those who can help.

And if there’s no existing team?
You may be the one to help build it.

Many clinicians start by identifying a single professional (e.g., OT, psychologist) who takes these cases, and gradually building a trusted referral network. Over time, you become a go-to resource for patients and providers

Why Consider Including Concussion Rehab in Your Practice?

Concussion rehab is a growing and underserved area of care. With the right knowledge and referral relationships, you can make a profound difference for patients struggling with persistent symptoms.

Becoming skilled in concussion management isn’t necessarily easy — but it’s absolutely worth it. Need a couple ideas to get started? Check out some of these exercises below:

Click Here to Explore Concussion Exercises in
Embodia's Home Exercise Program Library

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Date published: 11 December 2025
Last update: 11 December 2025