8 Physical Therapy Concussion Exercises At Home

Concussions can be very frustrating injuries because the recovery is often slow and unpredictable. There are many misconceptions about the best way to treat concussion injuries. This post will guide you through the 8 most effective physical therapy concussion exercises that you can perform at home with no equipment.

Dos And Don’ts Of Concussion Management

• Do perform light exercise
  • This may include aerobic exercise treatment such as walking, or cycling, strength program, and concussion eye exercises within a tolerable symptom range.
• Do listen to your healthcare providers regarding activity restrictions and return to activities of daily living.
  • Your health care providers will be able to guide you on the right level of exercise and daily activities in order to increase restoration of brain function.
• Do not stop all physical activity and and do NOT sit in a dark room with complete rest.
  • This was the old outdated advice that has since been shown to play a role in prolonged recovery
• Do not overdo it and try to return to your full physical activities or cognitive actitvities too fast too soon.
  • This can also delay the recovery time.

What Is a Concussion?

A concussion is a type of mild traumatic brain injury and occurs when the brain is suddenly forced to move within the skull. This is typically caused by head trauma or head injury and can include car accidents, falls, and sports injuries.

Concussion Symptoms

Concussion symptoms may include a variation of symptoms including physical, cognitive, and emotional symptoms.

• The most common physical symptoms of a concussion are:
  • Headache
  • Dizziness
  • Feeling unbalanced
  • Nausea or vomiting
  • Sensitivity to light or noise
  • Vision problems including blurred or double vision
  • Sleeping problems
• The most common congitive symptoms of concussion are:
  • Difficulty concentrating
  • Confusion or disorientation
  • Memory problems

• The most common emotional symptoms of a concussion are
  • Irritability
  • Anxiety or nervousness
  • Mood swings

Post-concussion symptoms, also known as post-concussion syndrome are concussion symptoms that persist longer than the typical recovery. These persistent concussion symptoms may continue for weeks, months or occasionally even over a year.

Concussion Exercise Program

Physical therapy can be used as part of the treatment plan for concussion recovery. A physical therapist will be the best person to lead you through concussion rehabilitation.

There are many treatment options for concussion, however physical therapy exercises are most effective. These include 1. Habituation 2. Vertical Saccades 3. Horizontal Saccades 4. Diagonal Saccades 5. Vestibular Ocular Cortex VOR x 1 (Horizontal) 6. Vestibular Ocular Cortex VOR x 1 (Vertical) 7. VOR x 2 8. Pencil Push Ups.

1. Habituation Exercises

• Habituation exercises can help to calm down the vestibular system.
  • The best way to do this is through head movements.
• Start in the sitting position and slowly turn your head to the right and then to the left.
• You can also perform vertical head movements by lifting the head upwards towards the ceiling and then downwards towards the floor.

2. Vertical Saccades 

• Vertical saccades are considered a form of vision therapy.
• Start by placing two sticky notes on a wall about 1 foot away from your face.
• Alternatively you can hold two sticky notes at arms length.
• One sticky note should be slightly above your head and one should be slightly below your head.
• Now without moving your head, shift your eyes from the top sticky note to the bottom sticky note.

3. Horizontal Saccades 

• Horizontal saccades have a similar set up to vertical saccades except now you will place a sticky note slightly to the left of your head and slightly to the right of your head.
• Now just like in the previous exercise, do not move your head.
  • Instead move your eyes from one target to the other.
• The more you increase the speed of saccadic eye movements, the harder the exercise will be.
• These eye exercises can increase your symptoms so it is important to start slow and progress the speed within a tolerable range for your symptoms.

4. Diagonal Saccades

• This type of exercise is also considered a vision exercise and can help to improve visual acuity and decrease symptoms of a concussion.
• Start by placing 2 post its diagonal from each other.
  • For example you may have one sticky note to your top left and one to your bottom right in a diagonal line.
• Now keep your head still and perform eye movements one post it to the other.

5. Vestibular Ocular Cortex VOR x 1 (Horizontal)

• VOR is very important in cognitive function.
• Cognitive exercises such as VOR can help to decrease dizziness and improve balance.
• Start by focusing on a target.
• Keep your eyes on the target while slowly turning your head side to side as if shaking your head no.

6. Vestibular Ocular Cortex VOR x 1 (Vertical)

• VOR exercises are a form of gaze stabilization exercises.
• This exercise has the exact same set up as the previous VOR x 1 horizontal exercise.
• The only difference is that now you will be moving your head up and down as if shaking your head “yes” while keeping your eyes fixated on the target.

7. VOR x 2

• Start by holding a sticky note out in front of you at arms distance.
• Now move your arm in one direction while moving your head in the opposite direction, while keeping your eyes fixated on the sticky note.
• For example if you move your arm to the right you will move your head to the left.

8. Pencil Push-Ups

• Pencil push-ups are a form of convergence exercise.
• Focus on target such as the tip of a pencil or pen.
• Hold it in front of you at arms length away and then slowly bring the target closer as if bringing it towards your nose while continuiing the focus on the tip.
• When it becomes double try and make it clear.
• When you are no longer to make it clear return to starting position and repeat.

General Guidelines for Post-Concussion Exercises

Engaging in post-concussion exercises can significantly aid recovery, but it must be approached with caution. Adhering to general guidelines ensures that exercises are safe and effective, minimizing the risk of symptom recurrence or prolonged recovery.

Below are key considerations for incorporating exercises into a concussion rehabilitation plan.

• Medical Clearance and Professional Supervision
  • Always consult a healthcare professional before beginning any exercise program after a concussion.
  • Follow recommendations from specialists, such as a neurologist or physical therapist, to tailor exercises to your needs.
• Gradual Progression
  • Start with light activities and increase intensity and duration slowly.
  • Transition between recovery phases only when symptoms remain stable or improve.
• Monitor Symptoms Closely
  • Pay attention to symptoms like headaches, dizziness, nausea, or fatigue during and after exercises.
  • Stop immediately if symptoms worsen and inform your healthcare provider.
• Emphasize Rest and Recovery
  • Balance exercise with adequate rest to allow the brain to heal.
  • Avoid pushing through symptoms; rest is crucial if discomfort arises.
• Avoid Overexertion
  • Refrain from high-intensity activities until cleared by a professional.
  • Overexertion can exacerbate symptoms and prolong recovery.
• Create a Controlled Environment
  • Perform exercises in a quiet, low-stimulation setting to reduce the risk of sensory overload.
  • Avoid activities that involve high-speed movements, significant head movement, or risk of reinjury.
• Prioritize Consistency Over Intensity
  • Short, consistent sessions are often more beneficial than longer, strenuous workouts.
  • Gradual, steady progress leads to better outcomes.
• Stay Hydrated and Nourished
  • Proper hydration and nutrition support physical and cognitive recovery.
  • Avoid stimulants like caffeine, which can interfere with rest and healing.

Summary

Concussions have a unpredictable recovery process. The speed of recovery may depend on a variety of factors including severity of concussion, pre-existing health conditions and treatment of the concussion. An important factor to note is that every patient will have different healing process and it is important to not treat every patient the same.

If your symptoms of dizziness have improved but you still have balance issues you can find 11 Creative Dynamic Balance Exercises Physical Therapy here.

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