Concussions in Athletes
- 7 days ago
- 3 min read
Each year, there are an estimated 1.6 to 3.8 million sports-related concussions in the United States alone, and many of these occur in contact sports like football, soccer, and lacrosse. Vestibular and sensorimotor impairments (such as dizziness, balance problems, and visual motion sensitivity) are well-documented outcomes of concussions and contribute significantly to prolonged recovery.
Most athletes do improve relatively quickly after a concussion. Large reviews find that the median time to return to sport for many athletes is within about 21 days, although this varies by age, sex, sport, and severity of symptoms. Individual studies of collegiate athletes show wide variation in recovery, with many athletes still exhibiting vestibular or cognitive impairments as long as 3-4 weeks post-injury. Research also highlights that vestibular symptoms (like dizziness or vertigo) immediately after injury are associated with longer recovery times and may predict protracted recovery when severe. It also demonstrates that recovery patterns differ by sport and individual factors, emphasizing that there is no single “normal” recovery timeline.
Because concussions affects multiple interconnected networks in the brain, symptoms often span four major domains (physical, cognitive, emotional, and sleep-related) and can persist even when traditional imaging looks normal. This is why some athletes continue to struggle with balance issues, brain fog, dizziness, nausea, motion sensitivity, or headaches long after the initial injury has occurred.
Traditional return-to-play protocols typically emphasize a graded physical and cognitive return. While this approach works for many, it doesn’t always address specific functional impairments within the nervous system. Research shows that athletes who continue to play soon after a concussion are 5 to 11 times more likely to have prolonged recovery than those who stop and get early care. Research also highlights that recovery definitions vary widely depending on whether recovery is defined by symptoms, cognitive tests, or vestibular-oculomotor function, highlighting that symptom resolution does not always equal neurologic recovery.
This variability underscores the importance of multimodal assessment and individualized care, rather than relying solely on symptom checklists.
How We Approach Concussions
At Carolina Functional Neurology Center, we incorporate evidence-based, individualized strategies that address the specific neurologic systems affected by a concussion. These can include:
Vestibular Rehabilitation Therapy: Tailored to recalibrate balance and sensory integration. Studies in athletes show that early initiation of vestibular therapy (within about 8–10 days) is associated with shorter overall recovery times and faster medical clearance compared with delayed intervention. Other research similarly found that athletes referred earlier to vestibular services had shorter return-to-play and symptom resolution times than those referred later.
Cervicovestibular Integration: Addressing combined neck and vestibular dysfunction. Systematic evidence supports targeted interventions, such as cervicovestibular rehabilitation (combining neck and vestibular exercises) for athletes with dizziness, neck pain, or headaches, showing reduced time to return to sport when compared with rest alone.
Dual-Task and Sensorimotor Training: Challenging balance and cognition together. By systematically challenging athletes to perform cognitive tasks while balancing or walking, dual‑task and sensorimotor training help strengthen coordination between the vestibular system and higher cortical centers responsible for attention, planning, and reaction time. This integrated approach not only improves functional performance under realistic sport‑like conditions but also helps clinicians detect and rehabilitate deficits that can persist even after basic symptom resolution, thereby supporting safer and more complete return‑to‑play decisions.
Oculomotor and Balance Training: Improving gaze stability and postural control. Functional impairments in vestibulo-ocular performance can be objectively measured and improved with therapy. For example, youth athletes showed improved gaze stability performance after individualized vestibular rehabilitation, indicating that targeted exercises can yield measurable neurologic changes that support return-to-play decisions.
Advanced Tools (e.g., GyroStim, Motion Guidance): Enhancing multisensory integration. Motion Guidance is grounded in principles supported by rehabilitation research showing that visual feedback and sensorimotor training improve motor control and proprioceptive awareness, which are key components of functional recovery after a concussion. GyroStim is an FDA‑cleared device used as part of advanced vestibular rehabilitation, particularly for conditions involving balance, dizziness, and sensory integration after concussions and other neurologic injuries.
By targeting both central and peripheral vestibular systems and integrating visual and proprioceptive inputs, our approach supports neuroplasticity or the brain’s ability to reorganize after injury and improve function.
Concussions in athletes is not simply an injury of “feeling better” after a few days. It’s a complex neurologic disruption that affects systems responsible for balance, vision, cognition, and sensory integration. The latest research supports early, targeted intervention, including vestibular and multimodal rehabilitation, to reduce symptom duration and improve functional recovery. At Carolina Functional Neurology Center, we combine clinical expertise with evidence-based therapies to help athletes safely return to sport and everyday life.
If you are seeking relief and a personalized treatment plan, please contact us to learn more or schedule a consultation. We are here to support you on your journey to better health.
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