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Concussion? When To Start Physical Therapy

By Dennis Thompson HealthDay Reporter

Medically reviewed by Carmen Pope, BPharm. Last updated on May 20, 2025.

TUESDAY, May 20, 2024 — Think you can simply shake off a concussion without any professional help?

Think again, a recent study says.

People who forego concussion treatment can have lingering aftereffects that make them slow, sluggish and off-kilter, researchers reported recently in the Physical Therapy & Rehabilitation Journal.

“We have people who come in and say they’re fine,” senior researcher Laurie King, a professor of neurology at Oregon Health & Science University in Portland, said in a news release. “Then when we challenge them to turn their head while looking at a fixed point, they’re like, ‘Whoa, that makes me feel sick.’ ”

Earlier physical therapy seems to enable the brain to return to a more normal state of balance following a concussion, clinical trial results show.

Without it, people have lingering problems related to their reaction time for balance and moving their bodies, researchers found.

“It means they’re balanced-challenged and don’t react as quickly as someone with normal reaction times,” King said.

That’s because when physical therapy is delayed, the brain might adapt to the injury by relying more on their vision than their inner ear to help maintain their balance, researchers said.

Those patients had sloppier balance control because using their vision in that way caused delayed reaction time, King added.

“There seems to be a window of opportunity within two months,” King said. “After that point, the brain compensates in a way that’s not good. If vision is your strategy for maintaining balance and you’re in a dark room, you’re not going to function very well.”

For the study, researchers recruited more than 200 people with concussion from the Portland, Ore., metro area.

Of those patients, 82 were randomly assigned to undergo physical therapy earlier in their rehab, within one week of their concussion. The rest started rehab after a six-week waiting period.

Most people naturally recover from a concussion within four weeks, researchers said in background notes.

But an estimated 30% had lingering issues with balance and reaction time, and those folks need physical therapy as soon as possible, researchers said.

Earlier physical therapy helped people bounce back more quickly, results showed.

These lingering aftereffects might explain why people who’ve had a concussion are at higher risk of injuring themselves again during recovery, King said.

“If you’ve had a concussion and you’re not reacting as quickly with balance control, it’s natural to avoid precarious situations,” King said.

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2025 HealthDay. All rights reserved.

Posted May 2025

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