Concussion · Post-concussion syndrome · Mild TBI
Post-concussion symptoms that won't settle? Let's find out why.
Many people feel better within a few weeks of a concussion. Some don't. If you're months or even years out and still dealing with headaches, fog, dizziness or screen intolerance, a closer look at how your brain's systems are working together may help explain what is keeping symptoms going.
Look closer. Recover forward.
Sounds familiar?
- Headaches or a constant feeling of head pressure
- Brain fog, slow thinking or trouble finding words
- Fatigue after reading, screens or conversation
- Sensitivity to light, noise or busy places
- Dizziness, imbalance or feeling "off" in stores and traffic
- Blurred vision, eye strain or losing your place when reading
- Sleep changes, irritability or feeling anxious and on edge
- Symptoms that flare when you try to return to work, school or exercise
You're not imagining it, and you're not alone. These symptoms are real, and many of the systems behind them can be measured.
Why symptoms can persist
A concussion is a brain injury that changes how the brain functions, usually without anything visible on a CT or MRI. That is why so many people are told their scans are normal while they still feel far from normal.
Recovery depends on several systems that have to work together: the eyes, the inner ear and balance system, the autonomic system that manages heart rate and blood flow, attention and processing speed, and sleep. If one or more of these hasn't recovered, the brain works harder to compensate. That extra effort can show up as fatigue, headaches, fog and sensitivity, especially when demands rise.
International consensus statements on concussion recognize that some people have symptoms that persist beyond the usual recovery window, and that a careful, multi-system assessment is the right next step. Persistent symptoms are real, they are common enough to be well described, and they are not a sign that you didn't try hard enough.
What we'll evaluate
Testing is chosen for you based on your history and what you can comfortably tolerate, with rest breaks built in.
Eye movements
How accurately your eyes track, jump between targets, converge for near work and stay steady when your head moves.
Vestibular function
How your inner ear and brain respond to head and body movement, including positional testing.
Balance and gait
Standing and walking balance under changing visual and surface conditions, and while thinking at the same time.
Autonomic response
Heart rate and blood pressure when you move from lying to standing, and your tolerance for graded exertion.
Cognition and reaction time
Processing speed, attention and reaction time, alone and combined with movement.
Symptoms and daily function
Validated symptom questionnaires and a detailed history of what makes symptoms better or worse.
Our assessments guide rehabilitation and don't replace medical diagnosis. More about our testing
How care will work
Your program is built around what the testing shows, not a fixed concussion protocol. Depending on your findings, it may combine eye-movement and vestibular rehabilitation, balance and dual-task training, graded aerobic exercise kept below your symptom threshold when medically appropriate, cognitive pacing strategies, and sleep and nutrition support as an adjunct. Research in adolescent athletes has found that carefully dosed, sub-symptom aerobic exercise is a safe and helpful part of early concussion care.
Each session is dosed to what your nervous system can tolerate that day, then progressed as you improve. Return-to-learn, return-to-work and return-to-sport steps follow current consensus guidance and are coordinated with the physician responsible for your medical clearance.
Intensive program
Several shorter sessions per day, with planned rest, over a block of consecutive days. Designed for people traveling in or who want focused care in less time.
Outpatient program
Regular visits over several weeks with a home program in between. A good fit if you live nearby or prefer a gentler pace.
What to expect
- Before your visitWe review your records and prior testing, then talk on a short fit call so you know whether we're a good match before you book.
- EvaluationAn in-depth neurological exam and objective testing, paced to your tolerance.
- Report of findingsA plain-language explanation of what we found and what we recommend, with a written summary.
- Your programIntensive or outpatient rehabilitation, dosed and progressed as you respond.
- Re-test & home planWe repeat key measures to check progress and send you home with a program you can keep using.
Some people notice changes quickly; others improve gradually, and a few need other types of care. After your evaluation we'll give you an honest view of what we found and what is realistic for you.
When to seek urgent care
Seek emergency care right away for a worsening headache, repeated vomiting, a seizure, new weakness or numbness, slurred speech, increasing confusion or drowsiness, or one pupil larger than the other. If you think you are having a medical emergency, call 911.
This page is educational and is not medical advice. Please talk with your physician about your symptoms. We work alongside your medical team and never ask you to stop medications or replace medical care.
Frequently asked questions
My CT or MRI was normal. Why do I still feel bad?
Standard imaging is designed to rule out bleeding, fractures and other structural injuries. Concussion mainly affects how brain networks function, which imaging usually can't show. Functional testing of eye movements, balance, autonomic responses and processing speed can reveal problems that a normal scan doesn't.
Can you help if my concussion was years ago?
Often it is still worth a closer look. The brain keeps its ability to adapt throughout life, and many persistent symptoms come from systems that can be measured and trained. We'll review your history and records first and tell you honestly whether we think we're a good fit.
Is it safe to exercise after a concussion?
For many people, carefully dosed exercise below the level that provokes symptoms is part of recovery, but it needs to be matched to you. We test exertion tolerance before recommending any exercise and coordinate with your physician on medical clearance.
Do you work with teens and student athletes?
We plan to see teens with a parent or guardian involved, and to coordinate with athletic trainers, school staff and team physicians. We support return-to-learn and return-to-sport planning but do not replace medical clearance.
What if my symptoms started after whiplash rather than a hit to the head?
A concussion can happen without a direct blow to the head when the head is whipped quickly, as in a car accident. Our evaluation looks at the same brain systems either way.
Do I need a referral?
No referral will be required. We'll ask for relevant records so we don't repeat tests you've already had, and with your permission we'll keep your physicians updated.
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We're opening fall 2027. Join the waitlist to hear our location first, get early scheduling access and receive free education about concussion & TBI.
Look closer. Recover forward.
Related conditions
Many people have more than one of these. We look at how the systems interact.
Dizziness & vertigo
Chronic dizziness, imbalance, motion sensitivity, PPPD, or vertigo that keeps coming back.
Visual & cognitive processing
Eye strain, reading trouble, screen intolerance and slow processing that make busy places exhausting.
Migraine & headache
Frequent migraine, vestibular migraine or post-traumatic headache alongside dizziness or visual strain.
Selected research
These sources describe the conditions and rehabilitation principles discussed on this page. They are not studies of our clinic, which is not yet open.
- Patricios JS, Schneider KJ, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695-711. doi.org/10.1136/bjsports-2023-106898 (opens in a new tab)
- Leddy JJ, et al. Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial. JAMA Pediatr. 2019;173(4):319-325. doi.org/10.1001/jamapediatrics.2018.4397 (opens in a new tab)
- Master CL, et al. Vision diagnoses are common after concussion in adolescents. Clin Pediatr. 2016;55(3):260-267. doi.org/10.1177/0009922815594367 (opens in a new tab)