Concussion Recovery and Rehabilitation

Most concussions resolve with the right amount of rest, and with guidance from a pediatrician. About 10-15 percent of concussions will require additional treatment. When symptoms remain for more than a month, a rehabilitation program may be needed to get your child or teen back to the lifestyle they enjoyed before concussion.

CHOC Children’s offers one of the region’s only multidisciplinary teams for concussion and post-concussion syndrome. Our physical therapists, speech and language pathologists, and occupational therapists are uniquely experienced in concussion recovery; our goal is to return your child to their prior level of function and fully participating in school, practice and life. While caring for your child, we meet regularly with a team of neurologists, neuropsychologists, psychologists and athletic trainers to coordinate your child’s care all the way through recovery. We also work with your child’s school to guide their return to academics and activities, and to follow a 504 plan if enacted by a physician.

A concussion can affect the ways that the head, brain, eyes, inner ears, hands, feet and the rest of the body work together.

When any of these systems aren’t working together correctly, here are a few of the symptoms that might occur:

  • Headaches
  • Dizziness
  • Poor balance
  • Convergence insufficiency (when eyes won’t work together to focus on a nearby object)
  • Poor reflexes and slow reaction time
  • Trouble standing from a seated position
  • Trouble walking without looking at your feet
  • Trouble focusing on tasks or recovering from distractions
  • Forgetting tasks that used to be automatic
  • Difficulty multitasking and dividing attention.

Customized Rehabilitation Programs for Children and Teens

Every concussion is different and therefore every rehabilitation plan is different. A rehabilitation program begins with an evaluation of a child or teen’s weaknesses and what causes their symptoms to flare up. From there, our team will recommend a treatment plan that may include physical therapy, speech and language (cognitive) therapy, and occupational therapy. Therapy visits may be held weekly or more, for 45 minutes to an hour each session. Physical therapy, speech and language therapy, and occupational therapy sessions may be scheduled back-to-back or separately depending on a child’s tolerance.

  • Physical Therapy
    Studies have shown that non-contact physical activity is helpful even if your child is still experiencing concussion symptoms. For that reason, physical therapy often makes up the bulk of a concussion rehabilitation plan. Physical therapy addresses issues with balance, coordination, the vestibular (inner ear) system, reaction time, peripheral awareness, multitasking and physical symptoms like headaches and dizziness. Our physical therapists guide a child or teen’s return to activity by using sport-specific strategies to overcome the problems they’re having.
  • Speech and Language (Cognitive) Therapy
    Speech and language therapy focuses on treating any cognitive issues a child or teen may have.  Speech and language therapy addresses issues with perception, fine motor skills, handwriting, learning, memory retention, comprehension and recall. Our speech and language therapists guide a child or teen’s return to academics by helping them adapt to the school setting.
  • Occupational Therapy
    Occupational therapy addresses any visual motor skills that are problematic for a child or teen. Our occupational therapists can also assist your child in regaining fine motor control in the rare instance that this is one of your child’s symptoms.

Sport-Specific Treatments for Athletes

soccer-teen-girls-sports

When an athlete sustains a concussion, we know that getting back into the game is important to our patients. We customize a return-to-play treatment plan based on your chosen activity, whether it’s a contact sport like football, an individual sport like track or other activities like colorguard and dance. Techniques that are customized to your injury or your chosen sport/activity could include:

  • Walking without looking at your feet, to improve eye-foot coordination;
  • Catching a ball without looking at your hand, to improve hand-eye coordination;
  • Reacting to objects being thrown from different angles, to improve reaction skills;
  • Catching/deflecting beach balls quickly and answering math questions at the same time, to improve multitasking skills;
  • Listening to instructions while taking notes, to improve your ability to recover from interruptions.

We work to get you back to sports practice, and then make follow-up recommendations to your athletic trainer with the goal of getting you back in the game.

BioSway Balance System

rehabilitation-balance-teen-girlWe are proud to offer the BioSway Balance System to measure a child or teen’s balance in different situations. Patients who are experiencing balance problems after a concussion stand on a platform that measures their sway while standing with their eyes open, compared to their sway when their eyes are closed. It also measures a patient’s balance while standing on a firm surface compared to a soft surface. The measurements are compared to expected norms and then tracked over time to determine a patient’s progress. The BioSway Balance System also provides prompts that help train patients in improving their balance.

Videos: Home Exercises for Concussion Recovery

Dr. Jonathan Minor, CHOC Children's sports medicine specialist, demonstrates the following visual and vestibular/balance exercises to perform at home during concussion recovery. Download step-by-step instructions here: Visual Exercises | Vestibular/Balance Exercises



Concussion Home Exercise – Vestibular Ocular Gaze Stabilization

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Vestibular Ocular Eye-Head Movement

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Vestibular Ocular Head Movement

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Vestibular Ocular Eye Movement

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Saccades Exercies (Vertical)

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Saccades Exercies (Horizontal)

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Two Thumb Exercise

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Advanced Ball Exercise

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Individual Ball Exercise

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – Tandem Gait

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Concussion Home Exercise – One Leg Balance

In this CHOC video, learn how to perform home exercises to deal with symptoms of concussion such as problems with vision, balance and dizziness.

Contact Us

To begin your child’s concussion rehabilitation at CHOC, please request a referral from your primary care doctor or the specialist who is treating your child’s concussion. To contact the Rehabilitation Services department, please call us at 714-509-4220.

Learn more about CHOC Children’s Rehabilitation Services.

Long Live Childhood

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