Concussion Rehabilitation

Dynamic Physiotherapy is is a proud clinic of the Complete Concussion Management Inc.ä (CCMI) Partnership Program.

From initial pre-season baseline testing to concussion treatment and rehabilitation, as partnered CCMI practitioners, we collaborate with primary care physicians, coaches and trainers and informed parents, patients and athletes to co-manage concussion symptoms and recovery, helping patients and athletes safely return to learn, work and play.

 What is a concussion?

A concussion is a brain injury caused by acceleration or deceleration of brain tissue. These forces create a shearing or stretching of nerve cells within the brain, which causes a biochemical imbalance within the brain cells, resulting in decreased blood flow and temporary energy deficits within the brain.

Symptoms may include loss of consciousness, headache, pressure in the head, neck pain, nausea or vomiting, dizziness, or balance problems


How do you treat a concussion?

We offer concussion treatment services & strategies including: 

Manual therapy 

  • 100% of concussion result in whiplash. It takes 70Gs of force to cause a concussion and 70Gs of force to cause whiplash, they also both cause the same symptoms. The injury can place strain on the tissues and joints of the head, neck and shoulders, which can lead to a lingering of symptoms. Manual therapy aims to reduce the strain, to reduce symptoms and promote recovery.  

Exercise therapy 

  • Rest is no longer best for concussion. In fact, prolonged rest can promote lingering of symptoms. 

  • Generally we see blood flow abnormalities from concussion. Having an athlete begin exercising and gradually increasing their HR over time is going to improve blood flow to the brain and promote recovery.

  • Exercise also provides many other benefits like improving depression and other pysch problems we can see with a concussion. 

We may also provide vestibular and visual therapies to help with balance, coordination or vision issues. 

If not treated promptly or correctly, an athlete can fall into post concussion syndrome (PCS), Which is 30+ days of symptoms. 

Why do we need to be careful about concussion recovery?

When you receive a concussion you generally lose about 20% of ATP (energy) in the brain. Within 2-4 weeks of recovery, your brain can go back to normal levels of energy, with no damage or long term effects. 

BUT.. if you go back to sport earlier (within a week to 10 days) and sustain another concussion, your ATP will drop further, your recovery will be much longer and harder. Anything below approx 60% brain energy levels can cause cell death. Meaning, you can lose functions in the brain that you will NEVER get back. 

The positive to this is, if you are fully recovered and sustain another concussion, your energy levels will drop minimally (approx 20%) and you are not at risk of long term complications. It doesn’t matter if you get 10 concussions over 5 years.. As long as you recover from each one!

How do I know I’m recovered from concussion?

Although athletes may feel better symptomatically within 7-10days, neurocognitive and functional testing will show they are not back to normal!

As CCMI trained clinicians, we assess via a battery of tests that includes balance, reaction time, cognitive ability, memory, visual processing and physical capacity.

As concussion is a multifaceted injury that can impact a number of functions of the body, It’s important to note that online neurocognitive testing alone isn’t sufficient. 

The challenge we, as clinicians have, is that we cannot truly determine if an athlete is fully recovered and safe to return to sport if we do not have a baseline of function. 

For example, if we test your reaction time and your scores are low.. Does this mean you are in a dysfunctional state, or is your reaction time always poor? 

There is no point running the battery of tests to determine if you are recovered, if we don’t know how you were before the injury! 

Baseline Testing

In clinic baseline testing takes approx 30min and needs to be completed yearly to remain valid.

  • Step 1.

    Prior to your in clinic baseline test, you will receive an email with a registration link. Once registered you will receive a code, bring this with you to your appointment.

    Step 2.

    In clinic we will ask you some questions regarding your medical history, concussion history and symptom score.

    We will then perform some tests on orientation, immediate memory recall, auditory concentration and visual tracking and processing.

    Step 3.

    We will then perform 2 different balance tests, including the use of sensors and a computer system measuring your postural sway.

    Step 4.

    We then move on to the final stations being reaction time, strength and delayed memory recall.

    Step 5.

    Is completed outside of clinic. This is the DANA test. It is an additional neurocognitive test that you can complete on your mobile via the concussion tracker app.

    For this, you will need 2 valid baseline tests on 2 separate days to have a complete baseline.

  • Unfortunately, no! In order to have a valid baseline, testing must include the full battery of tests and be completed yearly to remain valid.

    Without a baseline test, it is very difficult as clinicians to make a safe and accurate decision regarding safety to return to play.

Concussion Assessment and Treatment

  • We will ask you some questions regarding mechanism, signs and symptoms and injury history.

    Depending on the mechanism and whether you have a valid baseline, we may retest your baselines or perform some vestibular oculomotor motor testing.

    We will also assess your neck for any possible involvement.

    We will then treat your cervical spine if warranted and provide you with some exercises for home and some information regarding limiting work/study and exercise, and ensuring adequate sleep as well as nutrition.

  • Depending on your progress, we may continue to treat your cervical spine and incrementally upgrade your return to work, study and exercise and training plan.

    As you progress, you will be put through a gradual treadmill test. For athletes looking to return to sport, you will also then be put through a more intense physical exertion test and then a retest of your baseline (if valid) or a vestibular oculomotor motor screen.

  • These tests need to be done and passed before you can upgrade your capacity and return to sport. If not completed, we cannot accurately determine if you are safe to return to sport.

From seasoned athletes, to first timers,
we welcome the chance to serve you.

Contact us today and let us help you.