Concussion Management

Young girl holding side of head

Concussion Conditions

  • Neck
  • Vestibular

Clarifying your concussion:

The diagnosis or suspicion of a concussion can build anxiety that extends beyond the injured individual. As a parent of a child with a concussion, there is often a feeling of helplessness and sense of non-direction. An athlete’s emotions can range from a “want” to be back in the game, to anxiety and stress over wondering what life may look like without sport or being able to catch up at school. An adult who is suffering from a concussion can experience the same fears and anxiety over their sport or academic life, but the stress is often compounded by responsibilities around work and parenting.

Concussions are now readily labelled as a type of brain injury. Concussions reduce brain activity which can result in many symptoms. Following a concussion, the brain remains in a vulnerable state where another insult can negatively impact long term. Most concussions resolve in 1-2 weeks and do not result in long term deficits – if treated appropriately.

What causes concussions?

  • A concussion incident from a direct impact to the head is easier to recognize. In sport this could be a fall, a baseball to a mask or a body check/contact to the head (heading in soccer). But events that involve a black eye and/or teeth displacement are often missed as direct blows to the head. In life direct blows also can come from events like falls or hitting your head on your trunk/car door.
  • Concussions can also come from an indirect force to the head. An awkward stumble that doesn’t actual result in a fall but jolts the neck, creates a “whiplash” force that moves the brain within the skull.

Concussion Signs & Symptoms

  • Headache/Sensitivity to Noise
  • Vision Changes/Sensitivity to Light
  • Dizziness and/or Nausea
  • Feeling in a fog or slowed down
  • Feeling of Unsteadiness or Balance Loss
  • Reduced Concentration/Reduced Memory
  • Neck Pain
  • Fatigue or Low energy
  • More emotional or irritable/sad
  • Increased Nervousness or Anxiety
  • Difficult Sleeping

Treatments and Prevention of a Concussion

Always look for a medical professional to assess any symptoms after a possible concussive incident. EPA’s unique process assesses individuals to determine what symptoms are contributing to their possible concussion. Research outlines that those individuals that seek out physiotherapy to assess and treat the various systems in your body that contribute to these concussion symptoms return to school/work and sport earlier compared to patients that just “rest”.

Our physiotherapists use their advanced manual therapy skills to treat symptoms coming from the neck and vestibular system. When appropriate we use balance and vision training exercises. Finally, we adhere to a rigorous cardiovascular conditioning and sport specific protocol prior to making recommendations to return to sport.

Most importantly, our physiotherapists advocate for patients and their support teams. We make ourselves available for the many questions and communicate with doctor; coach/trainer and employer. Concussion recovery varies among patients. Research clearly shows that concussions in patients under the age of 18 can often take longer to recover. Most concussion patients are cleared for return to school/work and sport within 2 weeks, but those with more severe symptoms may be in treatment longer.



The strength behind concussion prevention often relies on adhering to rules to avoid unnecessary and inappropriate head and body contact. While wearing safety equipment can reduce other injuries, no specific helmet or mouth guard has been shown to reduce concussive symptoms to date.

Discharge Review

To keep you on your Path to Improved Health, you will receive home exercises and tools to continue your exercises. We will also provide you with many concussion resources and ensure that we keep your Family Doctor aware of your progress to date.

Discharge Peak Review

We want to ensure you stay at your peak performance either in school, sport or work. We will follow up with you after you are discharged, and should you have a reoccurrence or another concern, we would invite you to return to the clinic.

Youth Minor Sports Organization Support

EPA, with our affiliation with the University of Guelph’s Health and Performance Centre are here to support our community athletes.  We welcome the opportunity to help ensure that your organization is meeting Rowans Law.

Our physiotherapists are available for both in person and zoom educational seminars with your executive, coaches, athletes and parents.  To book an educational seminar, please email: 

Rowan Law Resources for Concussion Awareness: 

Under 10 years of age:

Educational video:

Ages 11-14:

Educational video:

Ages 15+:

Educational video:

All students & athletes:


Concussion Baseline Testing:

Many youth and professional sporting organizations are opting into concussion baseline testing. Canadian research does identify several risk factors that can predispose athletes to concussions.

Concussion Baseline testing occurs before the athlete’s season begins. In addition to being aware of players at higher risk, baseline testing gives athletes the opportunity to have many body systems that can be injured by a concussion assessed when they are in a healthy state.

This baseline information gives medical professionals a comparative advantage when assessing athletes that have suffered a concussion. Eramosa Physiotherapy Associates (EPA) has adopted an extensive Concussion Baseline Testing Program which is available to individuals and sporting organizations. Our baseline testing includes a detailed assessment by a Registered Physiotherapist to include:

  • Medical history looking for high-risk factors
  • neck movement & strength
  • VOMS- Visual Ocular System
  • Balance, cognition, and memory testing through the administration of the SCAT5
  • ongoing communication with your doctor, parents, and athletes

Our experience has demonstrated that many athletes have “normal” positive findings in their healthy baseline state. Without the opportunity to have evaluated the athletes prior to an injury, these “normal positive findings” could be misinterpreted for positive concussion findings post-injury and could lead to poor recommendations with the return to school, work or sport.

Your physiotherapist will share any relevant findings, with permission, to coaches and your additional health care providers.

Return to Life After Concussion

Concussion Symposium with Hockey Hall of Fame goaltender Ken Dryden