“Can a physiotherapist really help with a concussion—or is it something you just have to wait out?” That’s the question I asked myself after a close friend, a semi-pro rugby player, took a nasty hit during a game. His symptoms lingered for weeks—headaches, dizziness, even trouble focusing. The usual advice? “Rest and wait.” But that passive approach didn’t sit right with either of us. We dug deeper, and what we found changed everything: physiotherapy isn’t just useful for sprains and strains—it’s a powerful, evidence-backed tool in concussion recovery.

In this article, we’ll explore how physiotherapy can play a vital role in treating sports concussions, break down the different types of treatments used, and share personal insights and expert guidance to help athletes (and their families) make informed decisions.

What Is a Sports Concussion?

A sports concussion is a mild traumatic brain injury (mTBI) caused by a blow or jolt to the head—or even the body—that shakes the brain inside the skull. Symptoms can appear immediately or develop over hours or days, and they can range from mild dizziness to more serious cognitive issues like memory loss or difficulty concentrating.

“Concussions aren’t just about the brain hitting the skull—they involve complex changes in brain function and blood flow,” explains Dr Emily Carter, a neurologist at the University of Bristol.

While most people associate concussions with football or rugby, they can occur in almost any sport—from cycling to skiing to gymnastics.

Traditional Advice: Rest, Rest, and More Rest

For years, the go-to response to a concussion was strict rest—no screens, no exercise, and minimal stimulation. And yes, initial rest (24–48 hours) is still recommended. But now we know more. Recent studies suggest that extended rest may delay recovery and contribute to other issues like anxiety and depression.

This shift in thinking has opened the door for active rehabilitation approaches—like physiotherapy.

How Physiotherapy Helps with Concussion Recovery

1. Vestibular Rehabilitation

If you’ve ever had post-concussion dizziness or balance problems, that’s your vestibular system talking. Physiotherapists trained in vestibular rehab can assess how your inner ear, eyes, and brain work together—and fix what’s gone out of sync.

“We use targeted exercises to retrain the brain’s balance pathways,” says Jane Hollins, a specialist vestibular physiotherapist. “It can be life-changing for someone who’s been dizzy for weeks.”

2. Cervical (Neck) Treatment

Many concussions come with neck injuries—especially in contact sports. A stiff or misaligned neck can mimic or worsen concussion symptoms like headaches or visual disturbances. Manual therapy, mobilisation, and guided exercises can relieve pain and restore proper movement.

Personal Note: When my friend started neck mobilisation therapy alongside his vestibular exercises, his persistent headaches reduced within a few sessions. It wasn’t just coincidence.

3. Exercise Therapy and Graded Activity

Too much rest can actually prolong symptoms. Physiotherapists use controlled, progressive exercise plans to reintroduce cardiovascular activity without worsening symptoms.

A 2021 study in the British Journal of Sports Medicine found that sub-threshold aerobic exercise—exercise that stays below symptom thresholds—helped reduce recovery time in adolescents with concussions.

4. Visual-Motor Training

Some concussed athletes experience visual tracking issues, blurred vision, or trouble focusing. Physiotherapists may collaborate with neuro-optometrists or provide specific eye movement and coordination exercises to tackle this.

Beyond Physical Recovery: The Mental and Emotional Side

Concussions aren’t just physical. They mess with your mood, sleep, and sense of self—especially for competitive athletes. A physiotherapist isn’t a psychologist, but their consistent, supportive presence can anchor the recovery process.

“There’s a psychological benefit to feeling like you’re actively doing something to get better,” notes Dr Sarah Linley, a sports psychologist. “Physiotherapy provides that structure and progress tracking.”

Many clinics also work as part of a multidisciplinary team, referring patients to mental health professionals when needed.

Red Flags: When to See a Physiotherapist After a Concussion

You shouldn’t walk into a clinic the day after a major head injury. Initial rest is important. But if symptoms linger beyond a few days—or if you’re experiencing the following—it’s time to consider physiotherapy:

• Persistent dizziness or vertigo
• Headaches that don’t resolve
• Balance or coordination issues
• Neck stiffness or pain
• Sensitivity to light or sound
• Trouble focusing or blurry vision

Most physiotherapists will work alongside your GP or neurologist to tailor the right plan.

How to Choose the Right Physiotherapist

Not all physiotherapists are trained in concussion management. Look for someone with:

• Experience in vestibular and neurological rehab
• Familiarity with sports-related injuries
• A multidisciplinary team or referral network
• A clear, step-by-step recovery protocol

Asking questions upfront helps. If they mention the Buffalo Concussion Treadmill Test or VOMS (Vestibular Ocular Motor Screening), you’re likely in good hands.

FAQs: Quick Answers to Common Questions

Q: Can physiotherapy make a concussion worse?
A: Not when done correctly. Treatments are tailored to your symptoms and tolerance levels. A good therapist will stop any intervention that worsens your condition.

Q: How soon after a concussion should I start physiotherapy?
A: Usually after 48 hours of rest, but always get cleared by a medical professional first.

Q: Do I need a referral?
A: In the UK, you don’t always need a GP referral to see a private physiotherapist—but it’s wise to coordinate care.

Q: Is concussion physiotherapy covered by insurance?
A: That depends on your provider and policy. Many sports organisations do offer coverage.

Final Takeaways: What You Can Do Today

1. Don’t rely on rest alone—concussions often need active rehab.
2. Seek expert guidance from a physiotherapist trained in concussion management.
3. Track your symptoms and share them openly with your care team.
4. Advocate for yourself or your child—especially when symptoms linger.
5. Support recovery with good sleep, hydration, and mental rest.

Let’s Talk

Have you or someone you know recovered from a sports concussion? What made the biggest difference? Share your experience in the comments below—or reach out if you have questions. The more we talk about it, the more we help others find the support they need.

External Sources:

• British Journal of Sports Medicine – Sub-Threshold Exercise Study
• NHS – Concussion Overview
• Concussion Legacy Foundation – Treatment Resources

Written by a physiotherapy student with a passion for sports injury rehab and evidence-based care. Based on real-world experience and supported by current research.