Concussion and TBI

What is a concussion?

A concussion (mild traumatic brain injury, mTBI) is a brain/neurometabolic injury commonly caused by a blow or jolt to the head or body. Typical acute symptoms include headache, dizziness/imbalance, neck pain, light/noise sensitivity, cognitive slowing, and visual/oculomotor difficulties. Most people improve in days to weeks, but 10–30% can have persistent symptoms that benefit from targeted rehabilitation.

Why see a chiropractor for concussion-related symptoms?

Chiropractors commonly evaluate and treat many concussion-related issues that are musculoskeletal or sensorimotor in origin (cervical pain, cervicogenic headache, balance dysfunction, oculomotor problems). When concussion care is delivered as part of a multimodal, guideline-concordant rehabilitation plan (not as a replacement for medical evaluation when red flags exist), chiropractic clinicians can provide manual therapy to the cervical spine, vestibular and balance rehabilitation, oculomotor/vision-related retraining, graded exercise prescription, and coordinate care/referrals with physicians, neurologists, and physical therapists. Several narrative reviews and clinical reports support the role of multimodal, cervicovestibular rehabilitation in improving concussion-related symptoms. PubMed+1

Typical concussion symptoms we treat

• Headache (including cervicogenic and tension-type)
• Neck pain and stiffness
• Dizziness, vertigo, imbalance, or spatial disorientation
• Visual strain, blurred vision, difficulty tracking or focusing (oculomotor dysfunction)
• Exercise intolerance or early fatigue with activity
• Persistent symptoms after initial recovery (PPCS — persistent post-concussive symptoms)

Evidence-based approaches we use at Creekside

1. Comprehensive evaluation & red-flag screening

We screen for urgent signs (worsening neurological deficits, severe vomiting, progressive drowsiness, focal weakness, seizure, loss of consciousness > brief, or other red flags). Patients with red flags are referred immediately for emergency/medical evaluation.

2. Cervical (neck) assessment and graded manual therapy

Cervical dysfunction is common after concussion and may drive headaches, neck pain, and some balance/oculomotor complaints. Graded manual therapy and targeted cervical rehabilitation have been associated with faster symptom resolution and earlier medical clearance in several studies. Treating cervicogenic components is often an important part of recovery. PubMed+1

3. Vestibular and balance rehabilitation

Vestibular problems (dizziness, balance impairments, motion sensitivity) are a frequent cause of prolonged symptoms. Vestibular rehabilitation exercises tailored to the patient’s deficits (gaze stabilization, habituation, balance retraining, and gaze-stability progressions) have demonstrated benefit in reducing dizziness and improving function after concussion. Early initiation—once medically appropriate—can speed recovery for vestibular complaints. pmc.ncbi.nlm.nih.gov+1

4. Oculomotor/visual symptom management

Difficulties with tracking, convergence, and visual tolerance are common. Specific oculomotor retraining and integration with vestibular/cervical therapy can reduce visual symptoms and improve reading/focus tolerance. Recent chiropractic-led interventions suggest positive changes in oculomotor/cognitive symptoms when included in a multimodal program. PubMed

5. Graded aerobic exercise & return-to-activity planning

Controlled subthreshold aerobic exercise (carefully dosed to symptom tolerance) is an evidence-supported tool to improve recovery and reduce prolonged symptoms in many concussion patients. We provide individualized exercise prescriptions and progression plans consistent with current research and return-to-play/return-to-learn guidelines. ChiroUp+1

6. Multimodal coordinated care

Best outcomes are often achieved when cervical/manual therapy, vestibular/oculomotor rehab, and graded aerobic training are integrated into a sequenced plan and when chiropractic care coordinates with medical providers, physical therapists, and neuro-ophthalmology as needed. Case series and narrative reviews support a multimodal approach delivered by clinicians experienced in concussion rehabilitation. pmc.ncbi.nlm.nih.gov+1

What to expect during care at Creekside

1. Initial visit (60 min): Comprehensive history (injury mechanism, symptom timeline), concussion symptom scales, neck/cervical exam, vestibular/oculomotor screening (gaze stability, smooth pursuit, saccades, convergence), balance tests, and baseline exertion tolerance.
2. Individualized plan: We’ll explain findings, set recovery goals, and design a multimodal program (manual therapy, corrective exercises, graded aerobic program, home exercises).
3. Frequency & duration: Early phase typically 1–3 visits/week depending on severity; many patients see measurable improvement in 4–8 weeks, though individual recovery varies. We reassess regularly and coordinate referrals when specialized testing or medical management is indicated.
4. Coordination: We communicate with your primary care, sports medicine physician, or school/work teams as requested/authorized.

Safety & when to get immediate medical care

Chiropractic concussion care is not a substitute for emergency medical evaluation. Seek immediate care or call 911 for: increasing confusion, repeated vomiting, worsening or new neurological signs (slurred speech, limb weakness, severe balance loss), seizures, or prolonged loss of consciousness. We will refer for imaging or physician evaluation if our screening indicates need.

Frequently asked questions (FAQ)

Q: Can chiropractic adjustments “fix” a concussion?
A: No — concussion is a brain injury; there’s no single “fix.” However, manual therapy and targeted rehabilitation can treat neck-related pain and sensorimotor dysfunction that commonly prolong symptoms, and these interventions are part of an evidence-based, multimodal recovery plan. PubMed+1

Q: When should vestibular or vision therapy begin?
A: Once medical red flags are excluded and symptoms are stable, initiating vestibular/oculomotor rehab as early as 10–14 days post-injury (or earlier under clinician guidance) can be appropriate and is supported by research. pmc.ncbi.nlm.nih.gov+1

Q: Will insurance cover concussion rehab?
A: Coverage varies. Our office staff will verify benefits and discuss out-of-pocket costs. We coordinate with medical providers and provide documentation to support medical necessity.

Why choose Creekside for concussion care?

• We use guideline-informed, multimodal plans that address the cervical spine, vestibular system, and oculomotor function — the three commonly overlapping contributors to persistent concussion symptoms. PubMed+1
• We prioritize safety and partner with medical specialists when needed (neurology, sports medicine, neuro-ophthalmology). pmc.ncbi.nlm.nih.gov
• We track progress with objective measures and individualized return-to-activity plans.

References & suggested reading (key studies & reviews)

1. Galeno E, et al. Effectiveness of Vestibular Rehabilitation after Concussion. 2022. pmc.ncbi.nlm.nih.gov
2. Cheever K, et al. The Role of Cervical Symptoms in Post-concussion... 2021 — graded cervical manual therapy reduces time to symptom resolution. PubMed
3. Wong CK, et al. Sequencing and Integration of Cervical Manual Therapy and ... 2021 — clinical outcomes from combined rehab protocols. pmc.ncbi.nlm.nih.gov
4. Germann D, et al. Multi-modal management of sport and non-sport related... 2020 — case series supporting multimodal chiropractic plans. pmc.ncbi.nlm.nih.gov
5. Cade AE, et al. Effect of Chiropractic Intervention on Oculomotor and ... 2024 — chiropractic interventions and oculomotor/cognitive symptom outcomes. PubMed

Additional reading & resources: ChiroUp research summaries and clinical roundups on concussion-related topics. ChiroUp+1

Ready to get evaluated?

If you or a loved one has ongoing symptoms after a concussion (headache, neck pain, dizziness, visual problems, or difficulty returning to activity), call Creekside Chiropractic & Performance Center to schedule a thorough concussion rehabilitation evaluation.

Phone: (920) 459-9090

Legal & clinical disclaimer: This page provides educational information and is not a substitution for individualized medical advice. If you are experiencing urgent or severe symptoms, seek emergency care immediately.