Living with the lingering effects of a concussion can be a frustrating and isolating experience. Symptoms like persistent headaches, dizziness, and “brain fog” can disrupt your work, your hobbies, and your ability to enjoy life in Seattle. For years, the standard advice was simply to rest in a dark room, but modern, evidence-based care has shown that a proactive approach is the key to a faster and more complete recovery.¹
At Union Physical Therapy, we have moved beyond this outdated passive approach. We understand that after an initial rest period of 48-72 hours, a safe, active rehabilitation program is crucial for healing.¹ Our Doctors of Physical Therapy are experts in movement and function who can diagnose the root cause of your symptoms—whether they stem from your inner ear, your neck, or your visual system—and create a personalized, one-on-one treatment plan to guide you back to health.
When Should You See a Physical Therapist for a Concussion?
A concussion is more than just a bump on the head; it’s a complex injury that can affect multiple body systems, including your neck (cervical spine) and your balance (vestibular system).³ The forces involved are often similar to a whiplash injury, leading to symptoms that can overlap and be difficult to diagnose on your own.⁸
If symptoms like headaches, dizziness, neck pain, or balance issues persist for more than a week, it is highly recommended to seek a comprehensive evaluation from a physical therapist.⁵ Our expert assessment is designed to differentiate the source of your symptoms and build a treatment plan that addresses the true cause of your discomfort.⁷
Our Comprehensive Concussion Evaluation
Effective treatment starts with an accurate diagnosis. Your first 45-minute session at our Seattle clinic is spent entirely one-on-one with a Doctor of Physical Therapy. We perform a detailed, multi-system assessment to create a complete picture of your condition.
This evaluation may include:
- Cervical Spine Assessment: We thoroughly examine your neck and upper back for joint restrictions, muscle tightness, and weakness that can be a primary source of post-concussion headaches and dizziness.⁷ This helps us identify issues like cervicogenic headaches, which require a different treatment approach than those originating from the brain itself.
- Vestibular and Oculomotor Exam: We test how well your inner ear and eyes are communicating to control your balance and vision. Using specific tests, we assess your gaze stability (keeping focus while your head moves), visual tracking, and how your eyes work together to focus on objects.⁵ These systems are frequently impaired after a concussion and are a major cause of dizziness, nausea, and visual fatigue.
- Exertional Tolerance Testing: We safely monitor your heart rate and blood pressure as you perform light physical activity to determine your symptom threshold.⁷ This is a critical step in developing a safe and effective exercise program that promotes recovery without making your symptoms worse.²
The Union PT Approach: Your Personalized Concussion Recovery Plan
Once we have identified the specific systems affected by your injury, we develop a targeted, multimodal treatment plan. A combination of therapies has been shown to be most beneficial for a faster recovery.⁴ Your plan will be tailored to you and may include the following evidence-based treatments.
Vestibular Rehabilitation Therapy (VRT) for Dizziness and Balance
Dizziness is one of the most common and disruptive symptoms after a concussion, affecting up to 77% of individuals and often predicting a longer recovery.¹¹ VRT is an exercise-based approach proven to improve dizziness, gait, and balance function.¹² Your therapist will guide you through specific exercises designed to retrain your brain and inner ear, which may include:
- Gaze Stability Exercises: Improving your ability to keep your vision clear and focused while you move your head.¹⁴
- Habituation Exercises: Gradually desensitizing your system to movements and positions that provoke dizziness.⁵
- Balance Training: Progressively challenging your stability, starting on solid ground and moving to more complex surfaces and tasks to rebuild your confidence.¹³
Manual Therapy for Post-Concussion Neck Pain and Headaches
The neck is often a “silent partner” in a concussion. Dysfunction in the joints and muscles of the cervical spine is a major contributor to persistent headaches and dizziness.³ Our physical therapists use skilled, hands-on manual therapy techniques to:
- Reduce muscle tension and spasms.
- Improve the mobility of stiff neck joints.
- Alleviate cervicogenic headaches originating from the neck.¹⁰
This approach can provide significant pain relief, creating a window of opportunity to begin strengthening and stabilizing exercises for long-term resilience.
Vision and Oculomotor Therapy
If your evaluation reveals issues with eye tracking, focusing, or coordination, your therapist can prescribe specific drills to retrain the connection between your brain and visual system.¹⁷ These exercises are often simple but highly effective at reducing eye strain, blurred vision, and headaches associated with reading or screen time. Exercises may include:
- Pencil Push-Ups: To improve how your eyes converge on a near target.⁵
- Saccadic Eye Movements: Rapidly shifting your gaze between two points to improve visual tracking speed and accuracy.¹⁴
Graded Exercise and Return to Sport Progression
The final piece of your recovery is a safe, gradual return to the activities you love, whether that’s running at Green Lake, working a full day without fatigue, or competing in your sport. We design a sub-symptom graded exercise program that slowly increases in intensity, carefully monitoring your response to promote healing and rebuild your fitness.² This active approach is proven to be more effective than prolonged rest for a successful recovery.
Why Choose Union PT for Concussion Rehabilitation in Seattle?
Navigating a concussion can be confusing, but you don’t have to do it alone. At Union Physical Therapy, our treatment model is perfectly aligned with the best practices for concussion care.
- One-on-One Expert Care: Every 45-minute session is exclusively with your Doctor of Physical Therapy. This allows for the constant monitoring and adjustment necessary for a safe and effective concussion recovery.
- A Multimodal Approach: We don’t have a single “concussion program.” We have a team of experts with specialized skills in Vestibular Rehabilitation, Manual Therapy, and Sports Physical Therapy. We integrate these services to create a comprehensive plan that addresses your specific symptoms.
- Evidence-Based Practice: Our treatments are grounded in the latest clinical research to ensure you are receiving the most effective care possible to speed up your recovery and prevent long-term issues.
Begin Your Recovery in Seattle Today
You don’t have to wait for your symptoms to go away on their own. If you’re struggling after a concussion, our dedicated team at Union Physical Therapy is here to help you navigate your recovery with an active, evidence-based approach.
Frequently Asked Questions About Concussion PT
What are the main symptoms of a concussion a PT can treat?
Physical therapists are experts at treating the physical symptoms of a concussion, including headaches (especially those originating from the neck), dizziness, vertigo, balance problems, neck pain and stiffness, blurred vision or eye strain, and fatigue with physical activity.
How long does a concussion last?
Recovery time varies for everyone. Most people feel better within 2-4 weeks, but for some, symptoms can persist for months in what is known as Post-Concussion Syndrome. Seeking active rehabilitation with a physical therapist can significantly shorten this recovery timeline and help manage persistent symptoms.
Can physical therapy help with a concussion?
Absolutely. Physical therapy is a highly effective treatment for post-concussion syndrome. A trained physical therapist can identify if your symptoms are coming from your inner ear (vestibular system), your neck, or your visual system and provide specific therapies like VRT, manual therapy, and oculomotor exercises to resolve them.
What is concussion rehabilitation?
Concussion rehabilitation is a specialized form of physical therapy that actively treats the wide range of symptoms following a concussion. Instead of just rest, it uses targeted, evidence-based exercises and manual techniques to address the root causes of issues like dizziness, headaches, balance problems, and visual strain.
Testimonials
References
Choose PT. (2025, September 24). Physical Therapy Guide to Concussion. Retrieved from https://www.choosept.com/guide/physical-therapy-guide-concussion
Sparrow, A., & University of Massachusetts. (2020). Return to sport concussion protocol. Retrieved from https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/return-to-sport-concussion-protocol.pdf
MOSH Concussion Care Network. (n.d.). Concussion physical therapy. Retrieved from https://www.mymosh.com/orthopedics/concussion-physical-therapy/
Joseph, M. (n.d.). The effectiveness of physical therapy interventions for athletes post-concussion: A systematic review. Retrieved from https://pubmed.ncbi.nlm.nih.gov/36793559/
Hss.edu. (n.d.). Physical therapy for concussion. Retrieved from https://www.hss.edu/health-library/move-better/physical-therapy-for-concussion
Concussion Alliance. (n.d.). Physical therapy. Retrieved from https://www.concussionalliance.org/physical-therapy
Quatman-Yates, C., & The Academy of Neurologic Physical Therapy. (2020). Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health. Retrieved from https://www.jospt.org/doi/10.2519/jospt.2020.0301
Treleaven, J., et al. (2024). Cervical spine sensorimotor deficits persist in people post-concussion despite minimal symptoms. Annals of Medicine, 56(1). https://doi.org/10.1080/07853890.2024.2422048
Cheever, K., et al. (2016). Cervical Injury Assessments for Concussion Evaluation: A Review. Sports Health, 9(1), 74-79. https://doi.org/10.1177/1941738116678678
Shapiro, A., & Chiroup. (n.d.). 5 effective cervicogenic headache treatments. Retrieved from https://chiroup.com/blog/5-effective-cervicogenic-headache-treatments
Iverson, G. L. (2019). Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion in Athletes. Journal of Sport Rehabilitation, 28(7), 764-776. https://doi.org/10.1123/jsr.2018-0284
U.S. Department of Veterans Affairs. (n.d.). The Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review. Retrieved from https://ijspt.scholasticahq.com/article/128282-effectiveness-of-vestibular-rehabilitation-in-children-post-concussion-a-systematic-review
Physiopedia. (n.d.). Post-Concussion Syndrome. Retrieved from https://www.physio-pedia.com/Post-Concussion_Syndrome
Neural Effects. (n.d.). Concussion therapy exercises. Retrieved from https://neuraleffects.com/blog/concussion-therapy-exercises/
Womack, A., & Peds Concussion. (2014). Virtual concussion exam manual. Retrieved from https://pedsconcussion.com/wp-content/uploads/VirtualConcussionExamManual.pdf
Concussion Alliance. (n.d.). Vision therapy. Retrieved from https://www.concussionalliance.org/vision-therapy
Gallaway, M., & The Vision Therapy Center. (n.d.). Brain injury and vision: Study shows patients improve after vision therapy. Retrieved from https://www.thevisiontherapycenter.com/discovering-vision-therapy/brain-injury-and-vision-study-shows-patients-improve-after-vision-therapy
Medically Reviewed by The Union Physical Therapy Clinical Team
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