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Concussion Recovery: Physical Therapy in Brooklyn for Headaches, Dizziness and Return to Play

By Dr. Jack Engelberg, PT, DPT · · 4 min read

A hit on the field, a fall on the playground, or a car accident on the Gowanus can all cause a concussion. In the days and weeks that follow, symptoms like headaches, dizziness, trouble concentrating and sensitivity to light can make school, work and daily life a struggle. Recovery approaches have changed in recent years: rather than weeks of resting in a dark room, today's guidance emphasizes a short period of relative rest followed by gradually increasing activity. Physical therapy helps guide that process safely.

What Is a Concussion?

A concussion is a mild traumatic brain injury caused by a blow to the head, or a blow to the body that makes the head move rapidly back and forth. The movement causes the brain to shift inside the skull, temporarily disrupting how brain cells function. You don't need to lose consciousness to have a concussion. In fact, most people don't.

Common Symptoms

Symptoms can appear right away or develop over hours to days:

  • Headache or pressure in the head
  • Dizziness or balance problems
  • Nausea
  • Sensitivity to light or noise
  • Blurred or double vision
  • Feeling foggy, slowed down or "not right"
  • Difficulty concentrating or remembering
  • Fatigue and sleep changes
  • Irritability, anxiety or sadness
  • Neck pain

Why Do Some Symptoms Last?

Many people recover within a few weeks, though recovery times vary, and children and teens may take longer. When symptoms linger, they often come from several systems that can each be treated:

  • The vestibular system — dizziness and imbalance (see vertigo and BPPV)
  • The visual system — trouble focusing, reading or tolerating busy environments
  • The neck — whiplash-type injury often accompanies a concussion and can cause headaches and dizziness (read about whiplash)
  • Exercise intolerance — symptoms flare with physical exertion
  • Sleep, mood and stress

How Physical Therapy Helps

Medical Evaluation First

Anyone with a suspected concussion should be evaluated by a physician, and athletes should be removed from play the same day and not return until medically cleared. Once serious injury is ruled out, physical therapy can help with recovery.

Physical Therapy Evaluation

Your therapist will review your injury and symptoms, then assess balance, eye movements, neck function, and how your symptoms respond to activity.

Treatment May Include

  • Sub-symptom aerobic exercise — guided, gradually increasing cardio at a level that doesn't significantly worsen symptoms, which research suggests can support recovery
  • Vestibular rehabilitation — gaze stabilization, habituation and balance exercises for dizziness
  • Cervical spine treatment — manual therapy and exercise for neck-related headaches and dizziness
  • Visual-motor exercises — for eye tracking and focus
  • Graduated return-to-sport progression — a step-by-step plan, coordinated with the athlete's physician and school or team
  • Return-to-learn and return-to-work guidance

What You Can Do at Home

  • Rest briefly, then gradually resume activity. A day or two of relative rest, then light activities like walking, as long as symptoms don't significantly worsen.
  • Limit screens early on if they make symptoms worse, then reintroduce them gradually.
  • Prioritize sleep with a consistent schedule.
  • Stay hydrated and eat regular meals.
  • Avoid alcohol during recovery.
  • Avoid activities with a risk of another head injury until cleared.
  • Pace yourself. Break schoolwork and tasks into smaller chunks.

When to See a Physical Therapist

Consider physical therapy if:

  • Symptoms last longer than a couple of weeks
  • You have ongoing dizziness, balance problems or neck pain
  • Exercise brings on symptoms
  • An athlete needs a structured return-to-play program

Go to the emergency room immediately for a headache that gets worse, repeated vomiting, seizures, slurred speech, weakness or numbness, increasing confusion, unusual drowsiness or difficulty waking, one pupil larger than the other, or loss of consciousness.

Frequently Asked Questions

Should I stay in a dark room until I feel better?

Prolonged complete rest is no longer recommended. After a brief rest period, gradually increasing activity tends to support recovery.

When can my child go back to sports?

Only after symptoms have resolved at rest and with school, a step-by-step return-to-play progression has been completed, and a physician has given clearance.

Can a concussion cause neck problems?

Yes. The same forces that cause a concussion can strain the neck, and neck problems can mimic or worsen concussion symptoms. Read more about neck pain.

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Schedule an evaluation by phone, or book online at refuahpt.com.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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